Sex workers constitute a key group affected by HIV, with multiple factors contributing to their vulnerability. Around the world, much HIV programming falls short of taking these factors into account and actively working towards their reduction. This failure can only result, at best, in temporary respite which privileges some sex workers over others, rather than serving to empower the sex worker community as a whole, enabling them to work safely and protect themselves.
Sex workers are put at risk of exposure to HIV by criminalisation; violence; unsafe working conditions; violations of their human rights; stigma, discrimination and social marginalisation; drug and alcohol use; unequal access to appropriate health services; minimal access to HIV prevention tools (such as safe sex supplies and safer injecting equipment); barriers to negotiation of safe sex with clients; offers of higher fees for unprotected sex; and an absence of HIV-related information targeted at sex workers, due to insufficient funding for rights-based and sex worker led programming.
Strategies currently in place in many countries to ostensibly protect sex workers (and/or the general public) from HIV are counterproductive in that, besides failing to take into account sex workers’ human rights, they actually put sex workers’ health at risk. Prime examples are mandatory and coercive testing for HIV and sexually transmitted infections (STIs), as well as line testing and ‘100% Condom Use Programmes’. The following pages discuss these approaches in greater detail.
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