Ilitate the work of JZ programme staff and foster the health and safety of FSW. We describe each of these main activities and cross-cutting themes below. Core programmatic activities A welcoming clinic setting and high-quality clinical services–FSWs face the dual stigma of HIV/STI and sex work, creating barriers to seeking and receiving medical care. JZ provides a safe physical and social space for FSW to see doctors and share their lives. The JZ clinic and activity centre are located in a discrete, convenient area within the city. This centre was intentionally designed for comfort: a clean, warm environment, a reception desk at the entrance, plants and decorations, a television and two massage beds at the back of the first floor. On the second floor, an outside room is used as a waiting room. The walls are decorated with IEC materials and notes written by FSW with wishes and `words from the heart’. Practical tips for women are also posted, such as an example of counterfeit money (a common problem in China) with a description of how to identify it. A round table and drinking water are always set out for chatting. BMS-214662 web Separated from the waiting room, an inner room is outfitted with a clean bed and standard medical facilities for physical exams, STI testing and treatment. The clinic is reserved especially for FSW and is not open to the public. As Dr Z noted, this allows the clinic to offer a safe, confidential space ?a feature that was highly valued by the FSW we interviewed. FSWs come to the clinic through outreach contact and introduction by other FSW. Women were also mobilised to bring new FSW and their regular partners (boyfriends, regular male clients) for STI treatment. The welcoming environment and high quality of clinic service, as illustrated below, made JZ clinic well known via word of mouth among the local FSW community. In addition, to avoid being recognised as the `FSW clinic’, which might bring stigma upon clientele, Dr Z named the clinic the `JZ Love and Health Consultation Centre’. Within the welcoming clinic environment, JZ staff provides high-quality reproductive and gynaecological services including physical exams and blood testing for syphilis and HIV. When the JZ clinic first opened, services were provided free of charge. Later, a basic feefor-service plan (e.g. 3? USD/blood test for STI) was implemented in order to foster FSWs’ self-responsibility to care about their health and to support the financial sustainability of the project. Dr Z is a trained expert in STI and gynaecology. According to her, `you must know your own body well, rather than only focusing on getting the disease cured; one of our goals is to increase health awareness in everyday life’. As we observed, the exam process was usually accompanied by dialogue on how a woman may have gotten sick (e.g. partners, behaviours) and how to avoid getting sick in the future. Dr Z approached FSW as if they were friends or sisters when talking about their sexual relationships. The following passage describes a typical clinic scene based on our fieldwork observations:Glob Public Health. Author manuscript; available in PMC 2016 August 01.Author Manuscript Author Manuscript Author Manuscript Author ManuscriptHuang et al.PageFSW usually came either with another female friend, or their boyfriends (occasionally with pimps) in late morning and early afternoon before their business Avermectin B1a price started. In a situation with boyfriends or pimps there (at clinic), the staff would avoid topic.Ilitate the work of JZ programme staff and foster the health and safety of FSW. We describe each of these main activities and cross-cutting themes below. Core programmatic activities A welcoming clinic setting and high-quality clinical services–FSWs face the dual stigma of HIV/STI and sex work, creating barriers to seeking and receiving medical care. JZ provides a safe physical and social space for FSW to see doctors and share their lives. The JZ clinic and activity centre are located in a discrete, convenient area within the city. This centre was intentionally designed for comfort: a clean, warm environment, a reception desk at the entrance, plants and decorations, a television and two massage beds at the back of the first floor. On the second floor, an outside room is used as a waiting room. The walls are decorated with IEC materials and notes written by FSW with wishes and `words from the heart’. Practical tips for women are also posted, such as an example of counterfeit money (a common problem in China) with a description of how to identify it. A round table and drinking water are always set out for chatting. Separated from the waiting room, an inner room is outfitted with a clean bed and standard medical facilities for physical exams, STI testing and treatment. The clinic is reserved especially for FSW and is not open to the public. As Dr Z noted, this allows the clinic to offer a safe, confidential space ?a feature that was highly valued by the FSW we interviewed. FSWs come to the clinic through outreach contact and introduction by other FSW. Women were also mobilised to bring new FSW and their regular partners (boyfriends, regular male clients) for STI treatment. The welcoming environment and high quality of clinic service, as illustrated below, made JZ clinic well known via word of mouth among the local FSW community. In addition, to avoid being recognised as the `FSW clinic’, which might bring stigma upon clientele, Dr Z named the clinic the `JZ Love and Health Consultation Centre’. Within the welcoming clinic environment, JZ staff provides high-quality reproductive and gynaecological services including physical exams and blood testing for syphilis and HIV. When the JZ clinic first opened, services were provided free of charge. Later, a basic feefor-service plan (e.g. 3? USD/blood test for STI) was implemented in order to foster FSWs’ self-responsibility to care about their health and to support the financial sustainability of the project. Dr Z is a trained expert in STI and gynaecology. According to her, `you must know your own body well, rather than only focusing on getting the disease cured; one of our goals is to increase health awareness in everyday life’. As we observed, the exam process was usually accompanied by dialogue on how a woman may have gotten sick (e.g. partners, behaviours) and how to avoid getting sick in the future. Dr Z approached FSW as if they were friends or sisters when talking about their sexual relationships. The following passage describes a typical clinic scene based on our fieldwork observations:Glob Public Health. Author manuscript; available in PMC 2016 August 01.Author Manuscript Author Manuscript Author Manuscript Author ManuscriptHuang et al.PageFSW usually came either with another female friend, or their boyfriends (occasionally with pimps) in late morning and early afternoon before their business started. In a situation with boyfriends or pimps there (at clinic), the staff would avoid topic.
