Sex workers in sub-Saharan Africa are highly vulnerable to HIV infection, but little data exist regarding the size of the population and the epidemiologic, behavioral and cultural factors influencing the epidemic. This information is crucial to understanding the burden and scale of the epidemic so that resources may be allocated properly and effectively to reduce the high incidence of HIV infection among sex workers in South Africa. To this end, findings will help stakeholders advocate for needed services for sex workers, and assess the impact of the South African response to the HIV epidemic over time. Through collaboration with South African investigators on this project, UCSF will build the capacity of South African researchers to conduct routine HIV surveillance with key populations at high risk for HIV infection, potentially extending to injection drug users and MSM.

This project continues UCSF’s commitment in helping the CDC’s Global AIDS Program (GAP) achieve its goals in GAP countries and regions, strengthen local capacity, as well as collect vital data on the HIV epidemic among Sex Workers (SW) in South Africa.

1. To estimate the prevalence of HIV and syphilis, and associated risk behaviors among female sex workers in Johannesburg, Cape Town, and Durban, South Africa.

2. To estimate the population size and distribution of SW’s at these three locations.

3. To identify and assess determinants of access and utilization of health and social welfare programs in South Africa among sex workers.

4. To enhance the national capacity to conduct Integrated Bio-Behavioral Surveillance (IBBS) for key populations in South Africa as a key component of a strengthened second generation national HIV surveillance system.

This study is the first of its kind in South Africa and will be conducted in Johannesburg, Durban, and Cape Town. We will use key informant interviews, focus group discussions, and mapping as an initial Formative Assessment to guide the implementation of a more in-depth IBBS