Decriminalise sex work to control HIV

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24 Jul 2014

Decriminalisation of sex work is critical to controlling the HIV pandemic, according to authors of a series of research papers in the Lancet medical journal. The papers, presented at the International AIDS Conference in Melbourne, also highlight the urgent need to recognise sex workers’ human rights.

Sex work remains criminalised in most parts of the world with laws directly criminalising sex workers, their workplace, and sometimes their clients. As a result, sex workers (male, female and transgender) are routinely subjected to repression, stigma, violence and abuse — all causal elements preventing access to services and treatments. 

The Lancet papers show the AIDS pandemic is becoming increasingly prevalent in marginalised communities. Criminalising sex work pushes both workers and clients to the fringes of society. This in turn lowers safeguards and exacerbates the risk of violence and abuse. A reduction in sexual violence could see HIV transmission rates decrease by around a fifth, say the authors; encouraging sex workers to take up antiretroviral treatment would cut rates of infection by a third.

But decriminalisation would have the biggest impact by far, with HIV infections reduced by up to almost a half over the next decade. “Across all settings, decriminalisation of sex work could have the largest impact on the HIV epidemic among sex workers over just ten years,” said Dr Kate Shannon, lead author of the papers.

Fear of arrest prevents sex workers from seeking protection from HIV infection. Indeed, according to the Lancet papers, sex workers report having condoms regularly confiscated by police, who regard them as evidence of criminal behaviour. There is testimony, too, of sex workers being violently and sexually abused by police and other state authorities. It is imperative, say the authors, that sex workers’ human rights are recognised and upheld. Without such a global commitment, the goal of an AIDS-free generation cannot be achieved.

The International AIDS Conference has attracted sex workers from more than 30 countries around the world — among them Sienna Baskin from the Sex Workers’ Project in New York. “Criminalisation can have a direct impact on access to healthcare,” says Baskin. “Treatment requires stability and consistency. Being at risk from criminalisation disrupts this.”

Janelle Fawkes of Scarlet Alliance, the Australian Sex Workers’ Association agrees: “HIV prevalence is greatly reduced in places where sex work is decriminalised, said Fawkes. “What we’re calling for now is the long awaited commitment from governments to pursue decriminalisation of sex work as a response to HIV and as a human rights priority.”