Micro-planning: The Sex Workers Outreach Programme (SWOP) Experience Nairobi, Kenya   Authors: Rhoda Wanjiru*, Collins Mudogo1, Paul Sore1, Gloria Gakii1, Festus Muriuki1, Julius Munyao1, L. Gelmon1; Joshua Kimani1 *Corresponding author 1SWOP

Introduction Sex Workers Outreach Program (SWOP) is a University of Manitoba, Nairobi program Aims to scale-up a combination of evidence-based, cost- effective HIV prevention interventions for KPs in Nairobi Funding by CDC-PEPFAR grant Services on offer include biomedical, behavioural and structural interventions Has two core teams outreach and clinical Outreach utilizes - peer-led, hotspot-based and also employs other outreach & mobilization strategies.

Coverage SW NO. 27116 HOTSPOTS 1364 ORW 40 PE 245 S2s 14 PHDP 8 ADVOCACY 9 P.O 11

Outreach strategies Initially, group meetings were organised by peer educators in the hotspots One on one approach was then adopted for sustainability The one on one approach had its own shortcomings This created a need to scale up the one on one approach thus need for microplanning in addition to other current strategies including;- SMS reminders Clinic extension Medical camps Satellite clinics

Micro-planning Adopted from the Avahan India AIDS Initiative in 2013 A data -driven approach which aims to increase ownership by PEs/ ORWs Utilizes microplanning tools as well as MoH KP tools Occurs at hotspot level and individual level Micro-planning tools and activities feed into the MoH outreach tools

Hotspot Load Map Shows hotspot location Helps prioritize the sites for outreach depending on number of sex workers Provides an understanding of the area of coverage

Hotspot Analysis Profiles hotspots in terms of; Helps in determine; Operating time Level of violence Type of sex workers operating in the site Age of the sex workers operating in the site Client volume Helps in determine; Best time for outreach Need for violence reduction activities Peer educator

Contact Listing Enables outreach workers to know the contacts of the shortlisted peers and help in final PE selection Also helps understand the networks to avoid duplication when allocating sex workers to PEs.

Peer Plan Involves profiling individual sex workers- No of clients, age, type of sex and level of violence Helps in planning outreach activities- commodity requirement, tracing lost to follow up and prioritization of sex workers based on risk profile

Gap Analysis Includes gaps in; contacting the estimated sex workers condom distribution Clinical service uptake Plans are then developed to counter the gaps Helps understand risk reduction challenges

Outcomes More consistent, accurate and less duplicated data Individualized commodity requirement Individualized risk profiling Improved retention and tracing of the lost to follow up

Outcome Contd

Outcome Contd.

Challenges Illiteracy among some of the peer educators Too much paperwork Hostile environments in some hotspots Some hotspots do not allow commodity distribution Assumption applied ‘one condom one shot’ is not always true PE turnover

Conclusions Micro-planning is an effective outreach approach in peer led models Implementation should be situational as hotspots have varying setups Terminology and legality of sex work influences how well micro planning can be implemented

Acknowledgement MOH - GOK CDC- PEPFAR University of Manitoba University of Nairobi SWOP staff Sex workers Other partners a