Health and HIV

For the last 25 years the focus of attention on sex workers health has been HIV. However transgender, female and male sex workers and their families are frequently affected by a range of issues that directly and indirectly affect their wellbeing and impact on public health. 

Sex workers in developing countries are disproportionately affected by illnesses and conditions caused by social exclusion, poverty and gender based violence. Lack of access to  sexual and reproductive health services mean that sex workers of all genders are vulnerable to STIs and women are at greater risk of unwanted pregnancies and unsafe abortion. 

Although the potential for commercial sex to play important roles in expanding HIV epidemics is well recognised, HIV and AIDS-related prevention, treatment and care for sex workers remains inadequate and the specific dynamics of commercial sex in HIV epidemics remains controversial. The same is true of the efficacy and ethics of disease control measures as they apply to sex workers. In recent years controversies have been created by the United States HIV policy which has encouraged the criminalization of sex work in developing countries through conditions of its funding allocations and by the UN which encourages prevention of sex work via poverty reduction. 

Paulo Longo Research Initiative research projects will examine the impact of the architecture of international and national public health interventions and policy. We will map and critique the evolution of established evidence and ‘best practice’ in respect of the health of sex workers and their clients and investigate issues in health policy and programming that affect sex workers. These might include HIV testing policy, new HIV prevention technologies such as microbicides, integration of sexual and reproductive health and HIV services, delivery of sexual and reproductive health services and harm reduction strategies for drug users.

Resources

  • Respecting sex work - 2008

    A news story from the Afrol News website.

    Mozambique's deputy Minister of Women's Affairs and Social Welfare has called for the urgent establishment of legislation that would lead to the respect of the fundamental rights of sex workers. He said the legislation would help in advancing issues like the right to health, to dignity, protection against violence and other forms of abuse, and respect for the women's choice of profession, regardless of their motives for becoming sex workers. (adapted from author)

  • Rights-Based Sex Worker Empowerment Guidelines : An Alternative to the 100% Condom Use Programme - 2008

    In this publication CASAM argues for HIV programming targeting sex workers within the framework of a rights-based and justice-based sex worker empowerment model.

  • Sex Work and the City The Social Geography of Health and Safety in Tijuana, Mexico - 2008

    A gateway at the U.S.-Mexico border, Tijuana is a complex urban center with a sizeable population of sex workers. An in-depth case study of the trade, Sex Work and the City is the first major ethnographic publication on contemporary prostitution in this locale, providing a detailed analysis of how sex workers' experiences and practices are shaped by policing and regulation.

  • Taking Care of Business - 2008

    A news story for Poz Magazine by Scott L. This story explores HIV prevention efforts with sex workers in India. It highlights the work of the Bill and Melinda Gates Foundation and their partners and suggests that the policy of the US President's Emergency Plan for AIDS Relief (PEPFAR) should be amended to allow investment in interventions of this type.

  • U.N. guidance note on HIV and sex work “reworked” by activists - 2008

    Article by Seshu M, Hunter A, Reynaga E, Strack F, Mollet S, Morgan Thomas R, Overs C, Ditmore M, Allman D in the Canadian HIV/AIDS Legal Network HIV/AIDS Policy and Law Review. The article describes how, in 2007, UNAIDS issued a guidance note on HIV and sex work, the tone and contents of which angered sex workers, activists and public health workers worldwide. In this article, based on presentations at the International AIDS Conference, M.

  • 2007 Survey of Sexual and Reproductive Health of Sex Workers in Thailand - 2007
    The Institute for Population and Social Research (IPSR), Mahidol University together with the Service Workers in Group (SWING) conducted a survey on Sexual and Reproductive Health of Sex Workers in four major cities in Thailand in 2007. The survey was structured to provide up-to-date information about sex workers regarding their socio-economic background, their access to health care, health care seeking behaviour, and their sexual and reproductive health well-being.
     
    The study found few sex workers under the age of 18.
  • Comparing Prevalence of Condom Use Among 15,379 Female Sex Workers Injecting or Not Injecting Drugs in China - 2007

    This study compared the prevalence of condom use with clients and regular sex partners between female sex workers (FSWs) who were or were not injecting drug users (IDUs).

    Behavioral surveillance data (2002–2004) conducted in Sichuan, China were analyzed. Mapping exercises were done. About250 to 400 FSWs were anonymously interviewed from selected establishments in 19 surveillance sites.

    Of all 15,379 FSWs studied, 3.2% were IDUs. This group, when compared with the non-IDU group, was less likely to have used condoms with clients

  • Good participatory practice guidelines for biomedical HIV prevention trials - 2007

    UNAIDS guidelines.

  • HIV-Related Risk Behaviors and History of Sexually Transmitted Diseases Among Male Migrants Who Patronize Commercial Sex in China - 2007

    This study in China found that ten percent of men in a community sample and 32.7% of men in an STD clinic sample reported having ever paid for sex. Nearly 20% of clients from the community sample and 60% of clients from the STD clinic sample reported a history of STDs. For both the community and STD clinic samples, working at industrial or construction sectors, multiple sexual partners, regular sex partner having sex with others, and a history of drug use were associated with being a male client.

  • Review of the Evidence Base for an “Evidence-Based” Policy on HIV Programming with Sex Workers - 2007

    A literature review produced by Matt Greenall.

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