Sex Workers Promoting Action, Risk Reduction, and Community Mobilization

SPARC Center

Sex Workers Promoting Action, Risk Reduction, and Community Mobilization

Overview

The SPARC women’s center is the central component of a community empowerment, HIV prevention intervention aimed to reduce sexual- and drug-related HIV risk behaviors among female sex workers (FSW) in Baltimore. SPARC is open to all women and providesa range of drop-in and clinical services as well as street outreach and community capacity building in targeted intervention neighborhoods. This comprehensive intervention is one of the first targeting FSW in the United States.The study’s overall goal is to stimulate community empowerment, through such mechanisms as social cohesion and collective action, resulting in sustainable HIV risk reduction and improved behavioral outcomes.

The Center is open to all women, regardless of age or sex work history. Center facilities include showers, laundry, and computers. The Center also employs a social worker who provides on-site case management and provider coordination services. Several partner agencies, which have experience working with marginalized populations in Baltimore City, provide services at the Center:

• the Baltimore City Health Departmentoffers HIV/STI testing and counseling, and reproductive health services by a nurse practitioner and medical assistant;
• Healthcare for the Homeless, which provides individual and group therapy with licensed clinical social workers;
• Legal Aid, which offers free legal services in the Center; and the
• Behavioral Health Leadership Institute, which supports addiction management through inducting and maintaining women on suboxone and providing referrals to long-term drug treatment programs.

SPARC aims to provide services that address the needs of women in a convenient, safe, and non-stigmatizing environment, reducing the need for outside referrals and increasing likelihood of continued engagement in care and service utilization. SPARC also conducts peer outreach to women engaged in street-based sex work our neighboring communities, with peers with sex worker experience. During outreach, peers provide harm reduction materials and information about safety strategies, HIV and STIs, wound care, sex worker rights, and more. These peer outreach workers will continue to facilitate community engagement throughout the course of the study.

SPARC’s goal is to ensure the Center provides services well beyond the scope of the grant. It is for this reason that the Center, by design, is employing the services of partnering organizations whose organizations could be interested in continuing at the Center beyond the 5-year grant period. The Center plans to grow and expand through continuous engagement with service providers in Baltimore. It will conduct regular community needs assessments by collecting client feedback and holding community advisory board and neighborhood meetings, adjusting schedules, policies, and services to reflect the needs of the community. Additional Center activities (e.g., parenting classes, financial management classes) and services will be introduced based on community interest. SPARC has also engaged a professional advisory board, which is comprised of clinicians, social workers, researchers, and community leaders to provide strategic advice on Center programming, development opportunities, partner engagement, and public policy and advocacy.

Dr. Susan Sherman is a Professor in the Department of Health, Behavior, and Society who focuses on improving the health of marginalized populations, particularly that of drug users and sex workers. She is interested in the structural drivers of health and risk in both the conduct of observational and intervention research. She has over 17 years of experience in developing and evaluating HIV prevention, peer-outreach behavioral and microenterprise interventions in Baltimore, Pakistan, Thailand, and India. She is the Co-Director of the Baltimore HIV Collaboratory and a part of the Executive Leadership Committee of the Johns Hopkins Center for AIDS Research. She co-leads the Addiction and Overdose workgroup of the Bloomberg American Health Initiative. She is the PI of a study that examines the role of the police on the STI/HIV risk environment of street-based sex workers and includes the first cohort of sex workers in the US. She is also evaluating an innovative pre-booking diversion program for low level drug offenders.Her new study focuses on the effects of a structural level intervention with sex workers in Baltimore, which will create a full-service drop-in center for sex workers in Baltimore. She serves on several Baltimore City and state advisory commissions on syringe exchange and overdose prevention initiatives, as well as the Board Secretary of the National Harm ReductionCoalition.