HIV Prevention for Adolescent Female Drug Users in the Prostitution Scene in Hamburg

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  1. Experience and tips

    With adolescents, it is often more effective to convey information in a fun way. The questions were designed to be age-appropriate; some questions were puzzling (e.g. how often a tampon should be changed), and some referred to topics adolescents are dealing with anyway (friendship, sexuality). I think there was a good mixture of questions from various areas, since there were not only “right” or “wrong” answers, but also questions about personal opinions were asked. This relieved the girls of the pressure of having to give a correct answer and at the same time provided the group an opportunity for discussion. All in all, the girls enjoyed the quiz very much. As an additional incentive to get the game going, we gave away small prizes. In addition to the game, I also set up a table displaying all contraceptives, dildos to practice putting on condoms as well as informational literature. This gave the girls the opportunity to take a look at contraceptives like the vaginal ring or to demonstrate the correct use of a condom.


    This case study is part of the following chapters:

  2. Scientific guidance

    Berlin Social Science Centre (WZB); Research Group Public Health, Berlin

  3. Preventive measure subjected to quality assurance

    HIV/AIDS prevention for adolescent female drug users in the prostitution scene

  4. Aim of the quality assurance

    The quality assurance was aimed at developing a survey instrument to find out about the target group’s knowledge and use of condoms.

  5. What were the benefits of the quality assurance?

    The quality assurance provided benefits in terms of both processes and results.

    Benefits in terms of processes:

    • By taking a closer look at their own work, the workers’ implicit knowledge of their activities became explicit and thus transparent.
    • Additionally, the workers’ appreciation of their own work increased.
    • The identification of a new target group was facilitated.

    Benefits in terms of results:

    • The practical prevention work improved.
    • The developed rapid assessment in the form of a quiz is so short that it can be integrated in the daily work routine. Firstly, the results of the survey serve to find out how much additional knowledge the girls need about condoms and their use.
    • Secondly, these insights can be used for the planning of further measures that serve to provide information about and raise awareness for safer work and safer sex issues.
    • Furthermore, the instrument (survey) can be applied after a counselling session to verify the effectiveness of the measure regarding the target group’s level of knowledge.
    • The newly acquired method of developing local objectives and strategies (ZiWi method) is being and will be used for other issues in the service organisation.

    The quality assurance provided benefits for:

    • Professional development of workers
    • Practical prevention work
    • Collaboration within the team
    • Collaboration with the target group
  6. Methodology

    Based on the SMART criteria and the method of developing local objectives and strategies (ZiWi method), the team defined the prevention objectives of the service organisation, which were subdivided into long-, medium- and short-term objectives.

    In order to specify the milestones and strategies on the way to the long-term objective of HIV/STI prevention (elimination of chronic infectious diseases), the clients need be enabled to assess the risks they are exposed to.

    Firstly, they are enabled do so if they have sound knowledge of STIs, safer use, safer sex and safer work. Secondly, they also need to have protective instruments at their disposal and apply them properly and self-reliantly.

    As part of the intervention project, the clients receive condoms and lubricants either from Sperrgebiet or from the outreach social worker as well as information on how to use them to avoid HIV/STIs. In order to determine how much additional information the clients need and what they already know about condoms and their use, a rapid assessment was developed, which can be used as a fun quiz.

    Which method(s) of this platform was/were applied?

    • SMART criteria
  7. Results of the quality assurance

    Results of the quiz

    Existing knowledge of clients (survey):
    - Nearly all of them were well informed about condom use.
    - Regarding contraceptives, nearly all of them were well informed about conventional contraceptives such as “birth control pills” and “condoms”.

    Where is need for improvement (needs assessment)?
    - Nearly all clients were alarmingly uniformed about the menstrual period and the processes in their own bodies. The girls and young women had hardly any idea about the phases of a period and their temporal sequence.
    The clients need more information about:
    - Homosexuality
    - Contraceptives such as vaginal ring, hormone rod and IUD
    - Sexually transmitted diseases and the necessity to protect themselves during sex not only against pregnancy but also against STIs.

    How much do clients remember of the information conveyed (evaluation)?
    - They know that there are various types of contraceptives. We had an increasing number of inquiries about vaginal ring, hormone rod and IUD (information and/or escort to the gynaecologist is requested).
    They clients also developed more trust, now being able to talk with us about sexuality in an unprejudiced way.
    Some girls were astonished themselves about how little they knew about their own period. They gladly accepted information (brochures, illustrations on the body) and asked questions.

    Starting points for new/changed intervention projects (strategy planning):
    Some girls are very negative about homosexuality (calling it perverted, disgusting...). What is the reason for this? What can we do to overcome prejudices, etc?

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