Empowering young sex workers for safer sex in Dowa and Lilongwe Districts of Malawi.

Introduction Selling of sex for money and other materials has increasingly become a popular means of making money and acquiring materials for young girls especially in the urban areas in Malawi1. Scores of young people are seen loitering the street corners of some hotels, casinos, bars and other places of entertainment. The young girls are also seen to frequent disco houses and patronising other places of entertainment. The girls seduce men or vice versa, they are coaxed into having quick sex in exchange for money. In a needs assessment study in Lilongwe and Dowa districts of central Malawi (FPAM, 2004), 61% young sex workers solely depended on earnings from sex work for their living1. Worse still, these young girls are subjected to unprotected sex for various reasons which include failure to access condoms and pressure from their clients who bargain to pay more if they do not use a condom. The consequences that arise from this situation include infection with STIs including HIV, adolescent/teen age pregnancy leading to young motherhood or unsafe abortions. The majority of the young women were knowledgeable on the transmission, signs and symptoms and prevention of HIV and other STIs. The young women indicated that they were aware of the relationship between ‘prostitution’ and HIV and AIDS. 72.2% acknowledged to having had an unprotected sex and 21.3% indicated that they have had an STI before. Although prostitution is illegal in Malawi, it is still a popular trade among young girls because they regard it as an easy way of getting money and other materials. In 2004 Family Planning Association of Malawi (FPAM) with financial assistance from the United Nations Population Fund (UNFPA) implemented an intervention targeting sex workers in places of entertainment by cooperating with owners of disco houses, pubs and other forms of entertainment places (proprietors), through working with the disco jockeys and some willing sex workers. The intervention project employed various IEC media to provide short but moving talks, stories and other messages that would empower and encourage the sex workers to insist on correct and consistent use of the condoms regardless of how much a client is willing to pay. The messages were also designed to encourage the young sex workers to modify their behaviour and withdraw from the practice and opt for other sources of generating income and earning a living. This study investigated the role of involving sex workers as peer educators and owners of disco houses, pubs, disco jockeys as partners in an IEC campaign to empower young sex workers to reduce STI infections including HIV.