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Accessing and educating female sex workers in Ukraine via a peer-driven intervention


A peer-driven intervention (PDI) for female sex workers (FSWs) was implemented in harm reduction projects in two Ukrainian cities. The goal was to recruit and interview 500 FSWs in 6 months who had never received services before, and to measure how well FSW-recruiters educated FSWs in a body of fresh HIV prevention information. Recruiters were rewarded by earning tickets to win special prizes in a weekly lottery.


A PDI relies on respondent educating and recruiting peers for services. All recruits also get to serve as peer-educator/recruiters. Each recruit’s score on an 8-item knowledge test, measuring how well the recruiter educated her, determined how many lottery tickets the recruiter earned. A weekly lottery was held each week offering prizes to 4 lucky winners.


The two PDIs in 6 months recruited 532 and 437 FSWs never seen before, 2-3 times more new FWSW-recruits than the number recruited 6 months prior to the PDIs’ start-up. Both projects held 23 lotteries with an average attendance of 8 FSWs. Very significant differences in levels of drug- and sex-related risk behaviors were found between FSW drug-users and non-users, heavily shaped by education, knowledge, and other social variables, suggesting more targeted types of intervention.


The FSW-respondents were eager to serve as peer-educators/recruiters. The lottery proved to be a cost-saving and effective reward system that was highly motivating. The PDI offers harm reduction projects an entirely new model for accessing and educating FSWs, as well as a new method for targeting special sub-populations of FSWs.

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Correspondence to Oksana Matiyash.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Matiyash, O., Smyrnov, P. & Broadhead, R. Accessing and educating female sex workers in Ukraine via a peer-driven intervention. Retrovirology 9 (Suppl 1), P118 (2012).

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