Grant: Doctoral Award - Frederick Banting and Charles Best Canada Graduate Scholarships

Existing models of targeted HIV prevention interventions (TI) are successful in providing health services to older/well-established female sex workers (FSW), but often miss young women who are new to sex work (SW) or engaging in transactional sex (TS), but do not self-identify as FSW. Thus, many women involved in SW are already HIV+ before accessing health services. It is necessary to tailor TI to reach and meet the sexual health needs of young women prior to and immediately following self-identification as FSW. In order to improve TI accessibility and acceptability for these "high risk" young women, it will be critical to better understand their personal healthcare priorities and how these priorities might affect HIV risk/vulnerability during these periods. Little research specifically explores the healthcare priorities of young women newly practicing SW or those engaging in TS. While HIV is likely a concern for these women, it may not be a specific healthcare priority. This study intends to address this gap. My proposal focuses on "high risk" young women in Dnipropetrovsk, Ukraine and Mombasa, Kenya. Ukraine's relatively new HIV epidemic is concentrated among FSW - who are 10-times more likely to be HIV+ than women in the general population - but is rapidly expanding. In Kenya, the HIV epidemic is stable and generalised with average adult prevalence of 6%, but is also significantly concentrated among FSW, who are burdened by nearly 30% prevalence. This study will significantly contribute to an important yet poorly understood area in HIV prevention. Using knowledge of women's healthcare priorities to inform TI design is an innovative approach to further tailor HIV prevention efforts specifically for "high risk" young women. Findings from this work can be used to inform policy and TI design, while beginning to understand HIV prevention strategies that meet the unique needs of young women involved in commercial SW and TS.