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

  • Facilitating access to sexual health services for men who have sex with men and male-to-female transgender persons in Guatemala City - 2011

    Article in Culture, Health and Sexuality.

    The purpose of this study was to identify barriers to accessing sexual health services among gay, bisexual and heterosexual-identifying men who have sex with men and male-to-female transgender persons in Guatemala City, to inform the development of high quality and population-friendly services. In-depth, semi-structured interviews were conducted with 29 purposively sampled individuals, including 8 transgender, 16 gay/bisexual and 5 heterosexual-identifying participants.

  • Listen to sex workers: support decriminalisation and anti-discrimination protections - 2011

    Article in Interface: a journal for and about social movements, Volume 3(2): 271 - 287 (November 2011).

    Despite the massive achievements of the Prostitutes Collective of Victoria and the historic significance of this important organisation, sex workers as a community and the funds we had attracted drew an unhealthy level of interest from the health and community sector, stemming from a perception that sex workers were politically unable to run their own collective, and that the funds we had lobbied for could be better spent by people who were not sex workers.

  • Treatment as Prevention: How might the game change for sex workers? - 2011

    “What drives continued expansion of the pandemic is not the absence of effective preventative technologies but discrimination, exploitation and repression of certain social groups,” Dr Peter Piot.

    This article looks at the potential impact of partially effective, non contraceptive HIV prevention methods on sex workers in the light of recent news that anti-retroviral treatment (ART) by people with HIV substantially protects their HIV-uninfected sexual partners from acquiring HIV infection, with a 96 percent reduction in risk of HIV transmission.

  • "Over here, it's just drugs, women and all the madness”: The HIV risk environment of clients of female sex workers in Tijuana, Mexico - 2011

    HIV vulnerability depends upon social context. Based in broader debates in social epidemiology, political economy, and sociology of health, Rhodes’ (2002) “risk environment” framework provides one heuristic for understanding how contextual features influence HIV risk, through different types of environmental factors (social, economic, policy, and physical) which interact at different levels of influence (micro, macro).

  • A Psychosocial Study of Male-to-Female Transgendered and Male Hustler Sex Workers in São Paulo, Brazil - 2011

    This study examined sociodemographic variables, personality characteristics, and alcohol and drug misuse among male sex workers in the city of Santo André, São Paulo, Brazil. A total of 45 male-to-female transgender sex workers and 41 male hustlers were evaluated in face-to-face interviews at their place of work from 2008 to 2010. A “snowball” sampling procedure was used to access this hard-to-reach population.

  • A study on morbidity and psychosocial behaviour of children of commercial sex workers of North Bengal, India - 2011

    Article in the Health 2011; 2(2):37-40.

    Background: Children of commercial sex workers (CSW) are deprived from almost all the rights of the society. More attention is paid to the CSWs but their children are neglected. This study was conducted to estimate the morbidity and psychosocial behaviour of children of CSWs and their needs.

    Methods: A community-based cross-sectional study was conducted.

  • Acceptability of HPV vaccine and HPV prevalence among female sex workers in Lima, Peru - 2011

    While it may not be financially possible at this time to vaccinate all women in developing countries against HPV, a focus on high risk populations may be achievable, and may provide secondary protection to the general population. We examined sexual behaviors, cervical abnormalities, HPV prevalence and vaccine acceptability among female sex workers (FSWs).

  • Adolescent female sex workers: invisibility, violence and HIV - 2011

    Article in the Arch Dis Child doi:10.1136/adc.2009.178715.

  • Advancing sexual health and human rights in the Western Pacific - 2011

    Widespread criminalization of sex work has had the effect of undermining the sexual health of sex workers, for instance by preventing them from accessing health care services for fear of criminal prosecution if found to be a sex worker. Moreover, laws permitting mandatory HIV or STI testing of sex workers and mandating disclosure of private health information to employers sanction direct interference in the private lives of sex workers.

    Extract from report
     

  • Ain't I a Woman? A Global Dialogue between the Sex Workers’ Rights movement and the Stop Violence Against Women Movement - 2011

    This is a resource written by Bishakha Datta and sponsored by CASAM and CREA. The report documents a meeting entitled "Ain't I A Woman? A Global Dialogue between the Sex Workers Rights Movement and the Stop Violence against Women Movement" from 12-14 March 2009 in Bangkok, Thailand. 


    The report features the presentations from many great speakers including , Ruth Morgan Thomas, Anna-Louise Crago, Kaythi Win, Hua Sittipham Boonyapisomparn, Swapna Gayen and Meenakshi Kamble,Cheryl Overs and  Meena Seshu

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