This article presents findings from a study of HIV/AIDS programmes for urban sex workers in Dakar, Senegal. The objective of the research was to assess HIV prevention and treatment efforts to date, and to identify challenges that must be overcome in the long term to reduce the spread of HIV in Senegal. The research team organised four day-long community dialogues, in June 2008, with registered and unregistered sex workers in the Senegalese capital. In addition to these sessions, we conducted interviews with physicians employed by the Senegalese Ministry of Health, leaders of sex-worker organisations, and directors and staff at non-governmental organisations whose programmes target sex workers and other vulnerable groups. Our findings indicate that Senegal's public health strategies have been largely effective at containing the country's HIV epidemic, but not at addressing the social drivers of HIV transmission or protecting the rights of sexual minorities, such as sex workers and men who have sex with men. For Senegal's HIV/AIDS response to continue on a successful path, it must expand to include structural interventions and incorporate a human-rights approach.
Keywords: West Africa; equity; gender issues; health interventions; health policy; national programmes; public health; sex workers; social conditions.