Grant: Project Grant

Female sex workers (FSW) often bear a high burden of HIV and in order for HIV, sexually transmitted (STI) and Hepatitis C (HCV) prevention programs to effectively control these epidemics, they need to understand how sex work operates so they can design and deliver interventions that match the needs of those most at risk. Sex work is not static; it is constantly adapting to the local context. At times of conflict, the organization, pattern and practice of sex work may change; and as a result, the HIV/STI/HCV risks faced by FSW and their clients may also change. The goal of this project is to examine the impact of the conflict in Ukraine on sex work and the spread of HIV/HCV in the FSW/client populations. This project will be conducted in Dnipropetrovsk (DNK), 200km from the conflict zone in the eastern region of Ukraine. DNK is a strategic location as frontline Ukrainian forces regularly pass through this city. DNK has also recently become a destination for many internally-displaced people. Moreover, having the highest HIV rates in Europe, a further rise in HIV cases in Ukraine will have important implications beyond its borders. There is very limited data about how conflict affects FSW and their HIV/STI/HCV risks. Building on our previous work which examined early HIV risk among young women and FSW in DNK (a project that was ongoing when conflict first erupted), our team is uniquely positioned to carry out this 5-year study. We will use complementary methods to characterize how conflict shapes FSW's daily lives and influences sex work and HIV/STI/HCV risks, and to estimate the extent to which conflict alters the spread of HIV and HCV among FSW and clients. Our study will generate important information for our Ukrainian partners who design and implement HIV prevention programs in DNK as well as address an important knowledge gap globally.