Medical journal, The Lancet has joined an ever growing number of international health and human rights organisations calling for the full decriminalisation of sex work in order to address the HIV epidemic more effectively in a new series of papers on sex workers and HIV. The men, women, and transgender people who sell sex the world over are subjected to repressive and discriminatory laws and practices which in turn fuel stigma, discrimination, and in a large number of instances violence being perpetrated against sex workers. These factors all compound and severely impacts on the health and wellbeing of sex workers and sex workers living with HIV. These factors make it very difficult for sex workers from accessing HIV prevention, diagnosis, treatment, care, and support services which sex workers need in order to protect their own health by preventing and treating HIV infection.
In low-and middle income countries, male and female sex workers have a disproportionally higher risk and burden oh HIV. Female sex workers are 13.5 times more likely than females in the general population to be infected with HIV. For male and transgender sex workers, the risk of HIV is even higher.
With heightened risks of HIV and other sexually transmitted infections, sex workers face substantial barriers in accessing prevention, treatment, and care services, largely because of stigma, discrimination, and criminalisation in the societies in which they live. These social, legal, and economic injustices contribute to their high risk of acquiring HIV. Often driven underground by fear, sex workers encounter or face the direct risk of violence and abuse daily. Sex workers remain underserved by the global HIV response.
The Lancet has published a series of seven papers that aim to investigate the complex issues faced by sex workers worldwide. These papers are a very welcome addition to the growing body of evidence that shows the negative effects and harmful impacts of the criminalisation of sex work.
The central importance of decriminalising sex work is reinforced by the Series' examination of sex workers' human rights [Paper 4], which suggests that global commitments to achieving an AIDS-free generation will not be possible unless the human rights of sex workers receive global recognition. Importantly, these papers also criticise so-called partial criminalisation of sex work which criminalises the buyer but not the sex worker. This model is commonly referred to in Europe as ‘the Swedish Model’, or ‘the Nordic Model of Prostitution’ in North America. By reviewing over 800 recent studies addressing human rights violations against sex workers, HIV, law and policy, concluding that criminalisation of sex work fuels and fosters human rights violations and increases sex workers' susceptibility to HIV, including by reducing sex workers' access to HIV prevention, treatment and care. The study also finds thatpartial criminalisation, and other criminalisation of clients and third parties (often referred to as the 'Swedish approach') reproduces many of the same harms as full criminalisation.
The Series provides the most comprehensive analysis to date of HIV and sex workers, contains contributions from sex workers, academics, and legal and public health experts. It is accompanied by Comments introducing the Series, dispelling myths about sex workers and HIV, and addressing trafficking, children and adolescents who sell sex, and sex workers who use substances. The Lancet has also produced a special infographic, Facts about sex workers, to accompany the Series.
These papers are available here and all of the Series content is free to access (and will be permanently), users just need to register for the website, which takes no more than 60 seconds. You can download the infographic below.
(c) The Lancet