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First identification of cases of syphilis affecting or linked to Commercial Sex Workers CSW in 2002 Establishment of So

Outbreak History (ii) . Production of health promotion information packs and fast track cards for CSW to use in South London clinicsLinks developed with non-statutory sectorDistribution of information packs amongst CSW. 250 heterosexually acquired cases of infectious syphilis reported 39

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First identification of cases of syphilis affecting or linked to Commercial Sex Workers CSW in 2002 Establishment of So

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    3. Outbreak History (ii) Production of health promotion information packs and fast track cards for CSW to use in South London clinics Links developed with non-statutory sector Distribution of information packs amongst CSW

    5. Location of cases seen since April 2003

    6. Trust Streetlink Mainliners Spires Local organisations working with CSW

    7. Night and morning outreach – contact, advice, condoms, coffee, works, cigarettes Drop-in – hot meal, showers, clothes, rehab info, housing, legal issues, 1:1 support Court Diversion scheme Working Women Service (WWS) Outreach to non-street sex venues Needle exchange - Brixton Services for CSW

    8. SWOT Analysis Strategic Planning Tool Can Provide a framework for for identifying and analysing strengths, weaknesses, opportunities and threats Can provide an impetus to analyse a situation and develop suitable strategies and tactics

    9. Strengths Approx 100 different contacts per month Approx 35 women seen on regular basis Age range 18 – 55 Multiple issues – drug & alcohol abuse, homelessness, arrests for soliciting, ASBOs, rape and sexual assault, pimps, children, HIV, vice squad

    10. Weaknesses Hard to reach vulnerable groups True prevalence of STI unknown Tracking cases difficult due to chaotic nature of client groups Complexity of Rx regime requires medical setting (?)

    11. Opportunities To strengthen partnership working with agencies involved with CSW To develop weekly outreach sessions incorporating testing and Rx To further increase services offered at weekly drop-in at WWS Streatham Hill

    12. Threats CSW not seen as a high priority Financial constraints/short term funding Increase of STIs resulting in risk of further outbreaks Developing partnerships between the NHS and voluntary organisations

    13. Global issues Commercial sex workers Commercial sex workers, particularly women, experience high levels of HIV infection in some European countries Study in the Netherlands 2002-2003 showed 7% of CSW were infected with HIV. Similarly, 5% of immigrant sex workers in Spain, mostly immigrants from sub-Saharan Africa, were found to be living with HIV Source THT

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    16. 2,600 convictions for soliciting offences every year in England and Wales 90% of street prostitutes take heroin or crack cocaine

    17. Glasgow Sandiford Initiative Data collected between Oct 2002 and Feb 2004 Analysed data on 2,500 men who attended a sexual health clinic. 1 in 10 said they had paid for sex 1 in 4 men repeatedly used prostitutes 43% of men had a regular partner

    18. 20% of men had a sexually transmitted infection Infections found amongst the men included gonorrhoea, chlamydia and syphillis None had HIV

    19. Way Forward Multi–agency working Increased outreach Increased resources Long term funding Bottom up approach Innovative working

    20. ?

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