Evaluation of the STI-AIDS Intervention Programme in Ghana

The evaluation of the STI-AIDS Intervention Programme in 1999 concluded that the intervention had considerably decreased the number of new HIV/AIDS infections among sex workers and their clients, thus slowing the increase in the overall prevalence and incidence of the epidemic in Ghana.


The project worked with local health authorities in offering services to sex workers in Accra and Tema in Ghana through the Ministry of Health's (MOH) service delivery system. It recruited nurses and trained them in health education and communication, STI management, and in working with vulnerable groups.


“Initially, the West Africa Project to Combat AIDS (WAPTCA) had to maintain a low profile because sex work was a sensitive issue in Ghana. Impressed by the project's results, however, the MOH recognised it as an important intervention in the control and prevention of STIs and HIV/AIDS. Local sex workers received the project’s activities enthusiastically, and WAPTCA is considering expanding its efforts to still more regional and district towns.


There are now 12 sex-worker-friendly clinics located in eight out of Ghana's ten regions. The clinics, which are located on the premises of public-sector health facilities, serve as resource centers for university and nursing school students and for local and international project partners.”


Lessons learned from its experience include:

• Integrating services for sex workers within existing MOH institutions, staffed by MOH personnel, maximises the likelihood of success and of sustainability.
• Charging for condoms and for treatment visits contributes to sustainability, but free drugs and treatment are an important and effective incentive for sex workers to come for screening.
• Sex workers will collaborate with an STI intervention provided that the health team takes the initiative to go where sex workers live and work, treats them with respect and dignity, and offers affordable services and drugs.
• Peer educators are more effective in reaching roamers than health staff.
• A national policy legalising prostitution, banning police harassment, and funding health screening for sex workers is needed.
• HIV/AIDS interventions that target sex workers are probably among the most cost-effective measures in public health.