In 2009, 33 million people were living with HIV, 68% of them in Africa. Globally, female sex workers are 13.5% more likely to be living with HIV than the general population (UNAIDS 2013). However, in many places sex workers’ rates of HIV are not known, whether due to insufficient research or due to sex workers’ own reluctance to document it for fear that the response will be to treat them as ‘vectors of disease’, rather than to focus attention on the broader socio-legal context which informs their HIV risk.
The information in this report summarises the findings of five briefing papers on sex workers’ access to HIV treatment in five regions: Africa; Asia Pacific; Europe; Latin America; and North America and the Caribbean. Research was carried out by regional consultants through online surveys and meetings with sex worker-led organisations and individuals, to identify the multiple barriers to ensuring access to appropriate health care for those living with HIV.
Stigma and discrimination are behind many of these barriers. Whorephobia, homophobia, transphobia, racism, and other prejudices, including prejudice against PLHIV, may be espoused by health care staff and backed up by legal measures against sex workers, LGBT people, migrants and HIV-positive people. Furthermore, those who are unable to pay for private health care may be eligible only for limited treatment – or none at all. Access to life-saving HIV drugs is further complicated in many developing countries whose domestic supplies have been interfered with by international free trade regulations. The effects of these cannot be underestimated.
The following pages outline the multiple barriers faced by sex workers living with HIV in realising their right to health, before ending with recommendations for action to overcome them.
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