1 / 16

Zoyla Segura Anna Gorter Esteban Zuniga Roger Torrentes ICAS-Nicaragua Financed by NOVIB

Zoyla Segura Anna Gorter Esteban Zuniga Roger Torrentes ICAS-Nicaragua Financed by NOVIB. A voucher scheme to reach young sex workers (including young glue-sniffing girls), to treat STI’s and to prevent HIV transmission. NICARAGUA. First AIDS case reported: 1987

brier
Télécharger la présentation

Zoyla Segura Anna Gorter Esteban Zuniga Roger Torrentes ICAS-Nicaragua Financed by NOVIB

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Zoyla Segura Anna Gorter Esteban Zuniga Roger Torrentes ICAS-Nicaragua Financed by NOVIB A voucher scheme to reach young sex workers (including young glue-sniffing girls), to treat STI’s and to prevent HIV transmission

  2. NICARAGUA • First AIDS case reported: 1987 • AIDS cases reported: 392 • Prevalence HIV adults: 0.2% • Prevalence sex workers Managua: 1991 0.8% 1997 1.3% 1999 2.0% • Highest among young sex workers

  3. What is a Voucher Program • A program in which health service providers are reimbursed for the number of patients attended • Services best performing are selected • Provision of services can be targeted to special (vulnerable) populations ( • It puts the patient central and gives the power of choice to the consumer

  4. A document which can be exchanged for defined goods or medical services as a token of payment OR “Tied cash As opposed to liquid cash” What is a voucher Example of voucher

  5. The Voucher Program in Managua • Started in 1995 • The vulnerable groups it reaches are: • Female sex workers, including glue-sniffing girls • Glue-sniffing boys • Transvestite sex workers • Clients/partners of these groups (since 1999) • Men who have sex with men (since 2001) • Prevention and treatment of STIs • Prevention development AIDS epidemic

  6. NGO's V O U C H E R V O U C H E R V O U C H E R Voucher V Agency O U C H E R V O U C H V E O R U C H E R Donor/ Government Vulnerable groups Clinics V O U C H E R V Clients & O U C H Partners E R

  7. Methods • City-wide map of sites with prostitution • Interviews with vulnerable groups • Competitive tender/contracting of clinics • Training of all staff in clinics • Voucher distribution biannually (rounds) • Medical attention with “best practice” treatment protocols • Monitoring quality clinics, only best clinics contracted for subsequent rounds

  8. Services Offered • Consultation and follow-up • Tests for syphilis, trichomonas,candida, gardnerella and cervical cancer • Physical examination of condilomata, herpes, chancroid and other STIs • Counseling safe sex, condoms • Single dose of Azithromycine • Additional treatment if necessary • Voluntary counseling and HIV testing Gonorrhoea testing was performed during the first 4 years to measure impact of the program

  9. Prostitution in Managua(1,300,000 inhabitants) • 50-60 sites with prostitution • 1,150 female sex workers • 24% younger than 20 years • of the young SW ¼ is addicted to glue • Turnover sex workers is high with a medium working time of: • Overall 2 years (range 1 week-30 years) • Adult women 3 years • Young sex workers 1 year

  10. Overall results • Between 8 to 10 clinics are contracted (public, private and NGO clinics) • In 7 years (13 rounds ) • > 20,000 vouchers distributed • > 7,000 medical consultations • > 3,000 STI’s detected and treated • Of vouchers distributed to sex workers 40% is used • 2,840 different sex workers attended (690 younger than 20)

  11. Young and glue-sniffing sex workers Young SW’s in nightclub Glue-sniffing SW’s market

  12. Young SW’s have more STIs then adult SW’s

  13. Prevalence in young sex workers decreased

  14. Prevalence in gluesniffers decreased

  15. Conclusions • Young SW, including glue-sniffers can be reached effectively • Girls most in need make more use of their voucher • STI rates reduced considerably • Voucher schemes should be considered as highly effective in attracting young SW’s with high levels of STIs, treat their STI’s and promote safer sexual behavior

  16. More information: www.icas.net bonos@ibw.com.ni agorter@ibw.com.ni

More Related