Challenge
Three years ago, access to affordable condoms for vulnerable populations was scarce in the Dominican Republic, a country in which prostitution is widespread and brothels can be found throughout the country. Studies estimate that there are between 70,000 and 130,000 sex workers in the Dominican Republic. This constitutes a population at high risk of infection as noted in its significantly higher HIV/AIDS prevalence rates (4-13% depending on the province). Providing education and access to protection for this and other vulnerable populations was needed to counter the rapid spread of HIV/AIDS.
Initiatives
The USAID Mission in the Dominican Republic worked with grantee Population Services International (PSI) to develop a national targeted condom social marketing program to ensure access to low-price, good quality condoms for commercial sex workers and their clients. The program complemented existing behavior change communication activities already implemented by several local Non Governmental Organizations (NGOs). With a limited budget and a goal of distributing one million PANTE brand condoms in the first six months, PSI conducted an assessment of sales outlets serving vulnerable populations, such as commercial sex workers and their clients. The assessment included a review of existing local NGO infrastructure and ability to facilitate access to condoms through peer educators, community-based health promoters and in some cases, existing sales forces.
Results
Today, all PANTE condoms (an average of one million per month) are sold through local NGO partners. These partners report their sales back to PSI, ensuring that the condoms are reaching the target population. PSI’s training sessions with NGO staff strengthens their capacity to implement social marketing programs.
This program also provides an alternative to sex work. Commercial sex workers are hired and paid competitive wages to pack the condoms. This enabled many of them to leave sex work, as they earned enough money to invest in small business (sewing machine, utensils for a food stand) and have a “respectable” reference to use when applying for jobs in the formal sector. Additionally, many former sex workers now work as peer educators and sales agents. The German Development Bank, KfW, has also entered into a partnership with PSI and will assume support of this program as USAID/DR assistance phases out.
