Penelope Saunders, PhD, Different Avenues, 1603 Rhode Island Ave, NE, Washington, DC 20018, 917 817 0324, penelope.saunders@usa.net

This presentation draws from data collected during the implementation of the Demonstration project From the Streets to the House in Washington DC throughout 2003 and early 2004. The pilot program addressed the following issues: potential limitations of program planning via the category of commercial sex worker when carrying out integrated HIV prevention and care measures with locally mobile [intra-city] populations; mobility of populations due to weather conditions and policing activities whereby outreach targets move from public space to more clandestine indoor locations including abandoned buildings, trick houses, clubs, and hotels; and the need for secure, comprehensive services for highly mobile, marginalized populations engaging in clandestine sexual exchanges. During the pilot project information was collected via participant observation by outreach workers and an ethnographer over a 6 month period, 20 qualitative interviews exploring issues of identity and risk with population, and focus groups with persons in locales [bartenders, receptionists of trick house and motel]. This presentation will outline lessons learned in relation to the proportion of population not identifying as commercial sex workers and their behaviors and the ways in which HIV risk is constructed according to this non-identification. The flows of persons throughout the city will be mapped and explained, and success in outreaching to mobile populations discussed. Lessons about strategies to improve safe sex environments in clandestine locales will be considered along with barriers and success in creating alternative meeting spaces for comprehensive services in a La Sala like drop in center environment. The presentation will recommend new program design based on broader understandings of sexual exchange and mobility.

Learning Objectives: This presentation draws from data collected during the implementation of the Demonstration project From the Streets to the House in Washington DC throughout 2003 and early 200