Living library project on AIDS Memorial Day where the ‘books’ were real people with stories of their own to share © 2008 Alliance Ukraine Participants in the Photovioce project, India © 2006 Jenny Mathews / Alliance / Photovoice

Keeping sex workers safe from HIV in the Caribbean


Althea, a community animator in the Alliance © David Gasser
Female sex workers in the Caribbean are particularly vulnerable to HIV. Thankfully community animators like Althea are working to make a difference to the lives of these women, helping them to stay safe and healthy.

Althea is a former dancer and since leaving the entertainment industry she has worked with the Caribbean HIV/AIDS Alliance (CHAA) in Antigua to reach out to migrant sex workers.

Althea is a qualified HIV counsellor and rapid tester. She works with the National AIDS programme and in the field, to provide non-stigmatising counselling for sex workers.  “They look forward to seeing me on a weekly basis”, says Althea. “Sex workers sometimes can’t always afford condoms so I ensure condoms and lubricants are always there.”


Building on her experience in the field, Althea gathered a group of women for an intimate training session where they could ask her all the questions they wanted to about HIV. “For young women sex workers it is important to know that someone is there that you can relate your problems to and that they will be able to help you to come up with a decision” she says.

In designing the course she didn’t just want to provide them with information and help them cope with their immediate problems. She wanted to help them build self-esteem, identify some life goals and build the skills they needed to achieve these.

After dispelling some myths and misconceptions about HIV, the group identified the problems they encounter in their day-to-day work. The main issues were personal safety in clubs, fear of violent clients, and clients who refuse to use condoms or try to remove them during sex.

As a group they came up with a number of possible solutions to help reduce these risks, and keep each other safe. These included peer support, sharing information about ‘problem clients’ who had either been violent or refused to pay in the past, and finding ‘danger words’ – codes which they could use amongst themselves when checking in on each other.


The women then discussed their personal goals, such as going back to school or building their own businesses. Althea supported these plans with a practical session on life skills such as budgeting. She explained how this was important as “being broke can make you do desperate things, like having sex without condoms for a high price.” As an impact of the training the women have all started saving for the future.

The workshop was a great success and Althea is now running regular sessions. CHAA are also replicating the model in other locations. It is proof that marginalised peers can work together to reduce their own vulnerability to HIV.


Althea is one of many community animators who were part of the first stage of the East Caribbean Community Action Project (EC-CAP), a three year programme funded by USAID through the Alliance Secretariat and CHAA.

All of the community animators were drawn from and work with marginalised populations who are at higher risk of HIV. Animators have reported a reduction in the number of sexual partners among their clients, more effective referrals for people living with HIV to support services, and distribution of condoms and lubricants.

A five year continuation and expansion of EC-CAP is now in place, expanding the work from four to seven countries across the Eastern Caribbean. This follows the successful completion of the first project, and builds on the successes of work by community animators like Althea. You can read more about the project in this evaluation.