Ties to visit incarcerated FSW.Author Manuscript Author Manuscript Author Manuscript

Ties to visit incarcerated FSW.Author Manuscript Author Manuscript Author Manuscript Author ManuscriptGlob Public Health. Author manuscript; available in PMC 2016 August 01.Huang et al.PageBuilding trusting relationships between JZ programme staff and FSW–Trust is vital for working with at high-risk groups in China ?such as FSW ?who are socially stigmatised and conducting illegal work. Responses such as `I trust Dr Z’, and `We believed in her’ were frequently shared in discussions with FSW as they explained what motivated them to come to the JZ clinic, why they worked as peer educators and why they felt comfortable introducing other FSWs to the clinic. JZ built trusting relationships through long-term efforts within the community doing outreach, providing clinic services and facilitating social activities. These relationships were tested and strengthened in situations where FSWs were in crisis. A typical case was recorded about Xue (pseudonym), an FSW who explained the process of how her hostile attitude changed to one of trust through interaction with the JZ programme. The following description is excerpted from research field notes: Xue is in her early 30s with a young face. She had experienced many awful things in her life such as seeing a FSW friend being killed, being cheated by her boyfriend in whose bank account she saved all her money. Xue has known JZ programs for seven years, and is now an important program volunteer in addition to her own sex work business …. This is my third time to see Xue. We are sitting in her small but cosy place; only two of us, eating sunflower seeds and chatting. Xue said she changed a lot since she met Dr Z: I didn’t trust them at all at the first 1? years, I didn’t talk to them and even didn’t look at them when they came in trying to give me some material ?I threw them away ?I didn’t trust people, I usually put a knife under my pillow ?and they (program staff) kept coming and trying to talk to me, and I went to the clinic several times when I didn’t feel good (STI) … With time, you know they are good people, so I began to participate in some activities, talked to aunt Z about my experience. It was not only the attitude of the program staff that mattered, but more importantly, the mental and other support they provided. The program helped Xue open her own bank account to save money, and also persuaded her to visit her family who she had not seen since she left more than ten years ago. (Case record of Xue and field notes, 15th January 2013) Tailored IEC material–The information JZ obtained and women generated through clinic services, outreach work and social networking and relationship-building activities informs JZ’s development of three types of tailored IEC materials: (1) contact cards with information about basic clinic services, location and programme phone numbers; (2) themebased booklets targeting occupational health issues, such as reproductive health, HIV/STI, violence and drug use; and (3) monthly newsletters featuring local community issues, including get BMS-214662 stories and experiences Shikonin web written by FSW. These materials are available at the JZ main centre and delivered through outreach work. The contents of JZ’s IEC materials differ from China’s typical IEC materials where are primarily framed in a biomedical context and focused exclusively on condom use, HIV/STI information and testing. Of critical importance, FSWs are involved in the development process of JZ’s IEC materials ?inGlob Public Health.Ties to visit incarcerated FSW.Author Manuscript Author Manuscript Author Manuscript Author ManuscriptGlob Public Health. Author manuscript; available in PMC 2016 August 01.Huang et al.PageBuilding trusting relationships between JZ programme staff and FSW–Trust is vital for working with at high-risk groups in China ?such as FSW ?who are socially stigmatised and conducting illegal work. Responses such as `I trust Dr Z’, and `We believed in her’ were frequently shared in discussions with FSW as they explained what motivated them to come to the JZ clinic, why they worked as peer educators and why they felt comfortable introducing other FSWs to the clinic. JZ built trusting relationships through long-term efforts within the community doing outreach, providing clinic services and facilitating social activities. These relationships were tested and strengthened in situations where FSWs were in crisis. A typical case was recorded about Xue (pseudonym), an FSW who explained the process of how her hostile attitude changed to one of trust through interaction with the JZ programme. The following description is excerpted from research field notes: Xue is in her early 30s with a young face. She had experienced many awful things in her life such as seeing a FSW friend being killed, being cheated by her boyfriend in whose bank account she saved all her money. Xue has known JZ programs for seven years, and is now an important program volunteer in addition to her own sex work business …. This is my third time to see Xue. We are sitting in her small but cosy place; only two of us, eating sunflower seeds and chatting. Xue said she changed a lot since she met Dr Z: I didn’t trust them at all at the first 1? years, I didn’t talk to them and even didn’t look at them when they came in trying to give me some material ?I threw them away ?I didn’t trust people, I usually put a knife under my pillow ?and they (program staff) kept coming and trying to talk to me, and I went to the clinic several times when I didn’t feel good (STI) … With time, you know they are good people, so I began to participate in some activities, talked to aunt Z about my experience. It was not only the attitude of the program staff that mattered, but more importantly, the mental and other support they provided. The program helped Xue open her own bank account to save money, and also persuaded her to visit her family who she had not seen since she left more than ten years ago. (Case record of Xue and field notes, 15th January 2013) Tailored IEC material–The information JZ obtained and women generated through clinic services, outreach work and social networking and relationship-building activities informs JZ’s development of three types of tailored IEC materials: (1) contact cards with information about basic clinic services, location and programme phone numbers; (2) themebased booklets targeting occupational health issues, such as reproductive health, HIV/STI, violence and drug use; and (3) monthly newsletters featuring local community issues, including stories and experiences written by FSW. These materials are available at the JZ main centre and delivered through outreach work. The contents of JZ’s IEC materials differ from China’s typical IEC materials where are primarily framed in a biomedical context and focused exclusively on condom use, HIV/STI information and testing. Of critical importance, FSWs are involved in the development process of JZ’s IEC materials ?inGlob Public Health.

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