PEPFAR Policy in Nigeria - results from a Masters thesis
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Dear Friends,
In follow-up to my April 24th posting, I would
like to share the final results of my thesis
research on the effects of PEPFAR policy in the
context of Nigeria's response to HIV and AIDS in
the female sex worker population (abstract
below). As the full document cannot be posted to
the listserv, those who are interested in
receiving it can kindly contact me directly.
Many thanks to those who responded to my call for
participation, and who helped by providing
valuable contacts in Nigeria.
With kind regards,
Kate Elder
mailto:kateelder@gmail.com
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Nigerian Sex Workers and the United States
President's Emergency Plan for AIDS Relief: Will
Policy Promote or Prevent an Effective National Response?
Katharine M. Elder
*Abstract*
This study examines the effects of specific
policy requirements of the United States
President's Emergency Plan for AIDS Relief
(PEPFAR) in the context of Nigeria's response to
HIV and AIDS in the female sex worker population.
The policies under examination guide the use of
United States government HIV/AIDS funding in the
realm of prostitution and sex trafficking,
limiting how those funds can be employed and
requiring that PEPFAR beneficiaries adopt certain
organizational policies to be eligible to receive
funds. Undertaken over a period of three months,
the study objective was to assess the impact of
these policies, commonly known as the
'anti-prostitution pledge,' at the country level
and determine if PEPFAR guidelines are helping or
hindering an effective national response to the
HIV/AIDS-related needs of female sex workers in Nigeria.
Qualitative and quantitative methods were used to
answer the study question. In-depth interviews
were conducted with four participant cohorts in
New York City, USA, and Lagos, Ibadan, Abuja, and
Jos, Nigeria, in April and May, 2006,
respectively. Participants were drawn from:
1. Legal, policy and advocacy-related
organizations that are involvedin the domestic
response to the policy in the United States (US);
2. PEPFAR and non-PEPFAR-funded non-governmental
organizations (NGOs) working on the domestic
response to HIV/AIDS in Nigeria, particularly
those focusing on the needs of female sex workers;
3. Governmental officers, both US officials
responsible for administering and managing
PEPFAR-funded activities within the country, and
Nigerian officials responsible for HIV/AIDS
responses in the country; and
4. Multilateral organizations involved in the
domestic response to HIV and AIDS in Nigeria.
Data was primarily in the form of interview
transcripts which were analyzed for emerging
themes, and quantitative 'yes/no' answers to six related questions.
A total of forty-three (43) individuals and
organizations participated in the study. The
policy was found to impact Nigeria 's response to
HIV and AIDS in the sex worker population in a
variety of ways and at varying levels of
intervention, including in the civil society,
bilateral and multilateral, and national arenas.
The policy was also characterized by extreme
confusion among all participants, with a spectrum
of policy adherence methods developed by PEPFAR
implementing partners, or a lack of observance of
the limitations due to misinterpretation. Among
NGO participants, the policy was found to have
the greatest impact, both in direct
organizational experience since the arrival of
PEPFAR in Nigeria and in hypothesized outcomes by
study participants. Consequences of the policy at
the civil society level included a decrease in
available sex worker-friendly health services,
stifling the development of an evidence base,
redirecting funds to less experienced
organizations, hindering partnerships, and
promoting dishonesty between organizations and
their sex worker constituencies, among other
impacts. The effects of the policy at the
bilateral/multilateral and national levels were
less overt due to the limitations of the policy's
application, however, were notable nonetheless.
In light of the study results, the following recommendations were made:
- *Expand Documentation of the Policy at the Country Level *
- *Modify PEPFAR Policy to Reflect Country Realities *
- *Establish an Evidence Base on Key Populations in Nigeria*
- *Revise Policies to Include Sex Workers *
- *Increase Resource Allocation to Sex Worker Initiatives *
Key words: PEPFAR, sex work, prostitution, Nigeria, HIV/AIDS policy
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[afro-nets] Inquiry on HIV/AIDS, PEPFAR, Sex Work in Nigeria
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Inquiry on HIV/AIDS, PEPFAR, Sex Work in Nigeria
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Dear Friends,
I hope that this email finds the group well. I am writing from
the Université Victor Segalen in Bordeaux, France, where I am a
MSc student in International Health studying with the European
tropEd Network. In fulfilment of my Masters, I will be writing
my thesis on US PEPFAR policy and its impact on Nigeria's re-
sponse to HIV in the female sex worker population. My research
will be done through confidential in-depth interviews with vari-
ous individuals and organizations involved in Nigeria's HIV re-
sponse (in general and specifically with sex workers), those
benefiting from PEPFAR funding, and those managing and adminis-
tering PEPFAR within the country.
In hopes of learning more about USAID PEPFAR policy in the Nige-
rian context, I will be travelling to Nigeria to speak with
relevant organizations and individuals from May 4 - June 6,
2006. In preparation for this trip I am kindly requesting any
information the group may have on:
- Responses to HIV/AIDS in the sex worker population of Nigeria;
- Organizations that work with sex workers in Nigeria;
- Information/statistics on the scope of female sex work, and
HIV/AIDS within this population, in Nigeria;
- PEPFAR partner organizations that are working on responses to
HIV/AIDS in the female sex worker population.
I would also be interested in speaking with any organizations
that are related to my thesis topic (those working on HIV/AIDS
responses, those working with sex workers, those benefiting from
PEPFAR funds). All interviews would be greatly appreciated and
are completely confidential.
Many thanks in advance for any information you can pass along!
Your help is much appreciated.
With best regards,
Kate Elder
tropEd Erasmus Mundus Scholar
Université Victor Segalen Bordeaux 2
146, rue Léo Saignat
33076 Bordeaux Cedex
France
mailto:kateelder@gmail.com