Grassroots participation, peer education, and HIV prevention by sex workers in South Africa
Campbell, C.; Mzaidume, Z.
American Journal of Public Health 91(12): 1978-1986
2001
ISSN/ISBN: 0090-0036 PMID: 11726380 DOI: 10.2105/ajph.91.12.1978Document Number: 264919
Objectives: This microqualitative case study of a community-based peer education programme led by sex workers at a South African mine examined the role of grassroots participation in sexual health promotion, that is, reducing human immunodeficiency virus (HIV) transmission among commercial sex workers . Methods: The study involved in-depth interviews with 30 members of the target community: 7 sex worker peer educators, 15 sex workers, and 8 male amaHumusha (unemployed men who make their living on the fringes of the sex and liquor business). The interviews were analysed in terms of social capital, empowerment and identity. Results: The study yielded a detailed analysis of the way in which community dynamics had shaped the peer education programme's development in a deprived, violent community where existing norms and networks were inconsistent with the ideal criteria for participatory health promotion. Conclusions: Much remains to be learned about the complexities of translating theoretically and politically vital notions of "community participation" into practice among hard-to-reach groups. The fabric of local community life is shaped by nonlocal structural conditions of poverty and sexual inequality in ways that challenge those seeking to theorize the role of social capital in community development, in general, and in sexual health promotion, in particular.