scholarly journals Overview and Evidence-Based Recommendations to Address Health and Human Rights Inequities Faced by Sex Workers

2021 ◽  
pp. 1-11
Author(s):  
Shira M. Goldenberg ◽  
Ruth Morgan Thomas ◽  
Anna Forbes ◽  
Stefan Baral
Keyword(s):  
Human Rights ◽  
Sex Work ◽  
Sex Workers ◽  
Research Policy ◽  
Community Empowerment ◽  
Evidence Based ◽  
Policy Changes ◽  
Health And Human Rights ◽  
Sexually Transmitted ◽  
Social Inequities

AbstractThis volume uses community case studies and data from around the world to highlight the sustained health and social inequities that sex workers in all of their diversity experience in 2020. Guided by a balanced community–academic partnership, this volume aims to ensure that sex workers’ voices are amplified in describing both challenges and the ways forward. Collectively, the chapters describe an elevated burden of HIV, sexually transmitted infections, drug-related harms, violence and other human rights violations, and significant unmet sexual and reproductive health needs. They also demonstrate that sex workers are not passive recipients of such inequity, but rather actively resist and continue to mobilise to advocate for improved health, safety, and human rights conditions and policy changes. Evidence-based recommendations include sex work decriminalisation, ensuring accessible and sex worker-friendly services, removal of punitive policing and surveillance, community empowerment, and strengthening capacity for community engagement in research, policy, and programmes.

scholarly journals Best Practices and Challenges to Sex Worker Community Empowerment and Mobilisation Strategies to Promote Health and Human Rights

2021 ◽  
pp. 189-206
Author(s):  
Cynthia Navarrete Gil ◽  
Manjula Ramaiah ◽  
Andrea Mantsios ◽  
Clare Barrington ◽  
Deanna Kerrigan
Keyword(s):  
Human Rights ◽  
Case Studies ◽  
Sex Workers ◽  
Interpersonal Violence ◽  
Scale Up ◽  
Community Empowerment ◽  
Health And Human Rights ◽  
Sex Worker ◽  
Sexually Transmitted ◽  
Policy Environments

AbstractSex workers face a number of health and human rights challenges including heightened risk for HIV infection and suboptimal care and treatment outcomes, institutional and interpersonal violence, labour rights violations, and financial insecurity. In response, sex worker-led groups have been formed and sustained across geographic settings to address these challenges and other needs. Over the last several decades, a growing body of literature has shown that community empowerment approaches among sex workers are associated with significant reductions in HIV and other sexually transmitted infections. Yet legal and policy environments, as well as funding constraints, have often limited the reach, along with the impact and sustainability, of such approaches.In this chapter, we first review the literature on community empowerment and mobilisation strategies as a means to collectively address HIV, violence, and other health and human rights issues among sex workers. We then utilise two case studies, developed by the sex worker-led groups APROASE in Mexico and Ashodaya Samithi in India, to illustrate and contextualise community empowerment processes and challenges, including barriers to scale-up. By integrating the global literature with context-specific case studies, we distil lessons learned and recommendations related to community empowerment approaches among sex workers.

scholarly journals An ethnographic exploration of factors that drive policing of street-based female sex workers in a U.S. setting -  identifying opportunities for intervention.

2020 ◽  
Author(s):  
Katherine HA Footer ◽  
Bradley E. Silberzahn ◽  
Sahnah Lim ◽  
Steven Huettner ◽  
Victor A. Kumar ◽  
...  
Keyword(s):  
Public Health ◽  
Human Rights ◽  
Sex Work ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Health Determinant ◽  
Health And Human Rights ◽  
Individual Level ◽  
Female Sex ◽  
Police Practices

Abstract Background: Building on a broader sociological discourse around policing approaches towards vulnerable populations, increasing public health and human rights evidence points to policing practices as a key health determinant, particularly among street-based sex workers. Despite the importance of policing as a structural health determinant, few studies have sought to understand the factors that underlie and shape harmful policing practices towards sex workers. This study therefore aimed to explore the drivers for policing attitudes and practices towards street-based cisgender female sex workers.Methods: Drawing on ethnographic methods, 280 hours of observations with police patrol and 10 stakeholder interviews with senior police leadership in Baltimore City, USA were carried out to better understand the drivers for policing strategies towards cisgender female sex workers. Analysis was data- and theory-driven, drawing on the concepts of police culture and complementary criminological and sociological literature that aided exploration of the influence of the ecological and structural environment on policing practices.Results: Ecological factors at the structural (e.g., criminalization), organizational (e.g., violent crime control), community and individual level (e.g., stigmatizing attitudes) emerged as key to shaping individual police practices and attitudes towards cisgender female sex workers in this setting. Findings indicate senior police support for increased alignment with public health and human rights goals. However, the study highlights that interventions need to move beyond individual officer training and address the broader structural and organizational setting in which harmful police practices towards sex work operate. Conclusions: A more in-depth understanding of the circumstances that drive law enforcement approaches to street-based sex work is critical to the collaborative design of interventions with police in different settings. In considering public health-police partnerships to address the rights and health of sex worker populations in the U.S. and elsewhere, this study supports existing calls for decriminalization of sex work, supported by institutional and policy reforms, neighborhood-level dialogues that shift the cultural landscape around sex work within both the police and larger community, and innovative individual-level police trainings.

scholarly journals Criminalised Interactions with Law Enforcement and Impacts on Health and Safety in the Context of Different Legislative Frameworks Governing Sex Work Globally

2021 ◽  
pp. 121-140
Author(s):  
Andrea Krüsi ◽  
Kate D’Adamo ◽  
Ariel Sernick
Keyword(s):  
Human Rights ◽  
Law Enforcement ◽  
Sex Work ◽  
Sex Workers ◽  
Interpersonal Violence ◽  
Health And Safety ◽  
Work Environments ◽  
Specific Work ◽  
Health And Human Rights ◽  
Cis And Trans

AbstractThis chapter focuses on cis and trans sex workers’ experiences with law enforcement, and how various regimes of regulating sex work including full and partial criminalisation, legalisation, and decriminalisation shape the human rights and the work environments of sex workers globally including access to occupational health and safety, police protection, and legal recourse. Criminalisation and policing of sex work constitute forms of structural violence that perpetuate and exacerbate experiences of interpersonal violence and negative health outcomes among sex workers globally. Country spotlights from the global North and South provide examples of different regimes of regulation and draw attention to how laws and regulations interact with specific work environments in various settings to shape sex workers’ lived experiences of health, safety, and human rights. This chapter highlights how various approaches to criminalising and policing sex work undermine sex workers’ safety, health and human rights, including violence and poor health and concludes with an evidence-based call for the decriminalisation of sex work globally.

scholarly journals HIV and STI positivity rates among transgender people attending two large STI clinics in the Netherlands

2021 ◽  
pp. sextrans-2020-054875
Author(s):  
Susanne Drückler ◽  
Ceranza Daans ◽  
Elske Hoornenborg ◽  
Henry De Vries ◽  
Martin den Heijer ◽  
...  
Keyword(s):  
The Netherlands ◽  
Gender Identity ◽  
Sex Work ◽  
Sexual Behaviour ◽  
Sex Workers ◽  
Hiv Prevalence ◽  
Hiv Positive ◽  
Gender Identities ◽  
Transgender People ◽  
Sexually Transmitted

BackgroundGlobal data show that transgender people (TGP) are disproportionally affected by HIV and sexually transmitted infections (STIs); however, data are scarce for Western European countries. We assessed gender identities, sexual behaviour, HIV prevalence and STI positivity rates, and compared these outcomes between TGP who reported sex work and those who did not.MethodsWe retrospectively retrieved data from all TGP who were tested at the STI clinics of Amsterdam and The Hague, the Netherlands in 2017–2018. To identify one’s gender identity, a ‘two-step’ methodology was used assessing, first, the assigned gender at birth (assigned male at birth (AMAB)) or assigned female at birth), and second, clients were asked to select one gender identity that currently applies: (1) transgender man/transgender woman, (2) man and woman, (3) neither man nor woman, (4) other and (5) not known yet. HIV prevalence, bacterial STI (chlamydia, gonorrhoea and/or infectious syphilis) positivity rates and sexual behaviour were studied using descriptive statistics.ResultsTGP reported all five categories of gender identities. In total 273 transgender people assigned male at birth (TGP-AMAB) (83.0%) and 56 transgender people assigned female at birth (TGP-AFAB) (17.0%) attended the STI clinics. Of TGP-AMAB, 14,6% (39/267, 95% CI 10.6% to 19.4%) were HIV-positive, including two new diagnoses and bacterial STI positivity was 15.0% (40/267, 95% CI 10.9% to 19.8%). Among TGP-AFAB, bacterial STI positivity was 5.6% (3/54, 95% CI 1.2% to 15.4%) and none were HIV-positive. Sex work in the past 6 months was reported by 53.3% (137/257, 95% CI 47.0% to 59.5%) of TGP-AMAB and 6.1% (3/49, 95% CI 1.3% to 16.9%) of TGP-AFAB. HIV prevalence did not differ between sex workers and non-sex workers.ConclusionOf all TGP, the majority were TGP-AMAB of whom more than half engaged in sex work. HIV prevalence and STI positivity rates were substantial among TGP-AMAB and much lower among TGP-AFAB. Studies should be performed to provide insight into whether the larger population of TGP-AMAB and TGP-AFAB are at risk of HIV and STI.

scholarly journals HIV testing and its associated factors among street-based female sex workers in Iran: results of a national rapid assessment and response survey

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Sina Ahmadi ◽  
Mehrdad Khezri ◽  
Payam Roshanfekr ◽  
Salah Eddin Karimi ◽  
Meroe Vameghi ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Sex Workers ◽  
Associated Factors ◽  
Female Sex Workers ◽  
Rapid Assessment ◽  
Evidence Based ◽  
Multivariable Model ◽  
Sexually Transmitted ◽  
Female Sex ◽  
Self Testing

Abstract Background Female sex workers (FSWs) are at a disproportionate risk of sexually transmitted infections and they may face significant barriers to HIV testing. This study aimed to examine HIV testing prevalence and its associated factors among street-based FSWs in Iran. Method A total of 898 FSWs were recruited from 414 venues across 19 major cities in Iran between October 2016 and March 2017. Eligible FSWs were women aged 18 years of age who had at least one commercial sexual intercourse in the previous year. HIV testing was defined as having tested for HIV in the lifetime. Bivariable and multivariable logistic regression were used to examine the correlates of HIV testing. We report adjusted odds ratios (aOR) and their 95% confidence intervals (CI). Result Overall, 57.8% (95%CI: 20.0, 88.0) of participants reported having tested for HIV, and HIV prevalence among FSWs who tested for HIV was 10.3% (95%CI: 7.5, 13.0). The multivariable model showed that unstable housing (aOR: 8.86, 95%CI: 2.68, 29.32) and drug use (aOR: 3.47, 95%CI: 1.33, 9.06) were associated with increased likelihood of HIV testing. However, FSWs with a higher level of income were less likely to be tested for HIV (aOR: 0.09, 95%CI: 0.02, 0.43). Conclusion Almost one in ten street-based FSWs had never tested for HIV. These findings suggest the need for evidence-based strategies such as outreach support and HIV self-testing to improve HIV testing in this marginalized population.

Demographic Change, Prostitution, and Sexually Transmitted Infection Rates in China

2016 ◽  
Author(s):  
Avraham Ebenstein ◽  
Ethan J. Sharygin
Keyword(s):  
Sex Work ◽  
Sex Workers ◽  
Census Data ◽  
Supply And Demand ◽  
Transmitted Infection ◽  
Demand And Supply ◽  
Sexually Transmitted ◽  
Policy Responses ◽  
Large Numbers ◽  
History Of

China has experienced an explosion in the sex ratio at birth, with 25 million more men than women younger than 20 (2005 census). This chapter examines the implications of large numbers of men failing to marry on the supply-and-demand dynamics of sex work, with a focus on how this affects the prevalence of sexually transmitted infections (STIs). The chapter begins with a history of prostitution in China and describes the massive increase in sex work following economic reforms in the late 1970s. It then analyzes the current dynamics of demand and supply for sex work in China, using national census data and detailed microdata on sex workers. The authors find a clear link between high-population sex ratios, the prevalence of sex work, and STI rates. The analysis concludes with projections for the future and a discussion of policy responses in light of an anticipated increase in sex work.

Recognising the Human Rights of Female Sex Workers in India: Moving from Prohibition to Decriminalisation and a Pro-work Model

2018 ◽  
Vol 25 (1) ◽  
pp. 26-46 ◽  
Author(s):  
Jaya Sagade ◽  
Christine Forster
Keyword(s):  
Human Rights ◽  
Sex Work ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Legal Regulation ◽  
Sex Trade ◽  
Female Sex ◽  
Women’S Human Rights ◽  
Work Model ◽  
Women's Human Rights

This article sets out a women’s human rights approach to the legal regulation of sex work developed through an analysis of feminist perspectives, international human rights standards—in particular, the approach of the Committee on the Convention on the Elimination of All Forms of Discrimination against Women 1979 (CEDAW)—and the voices of female sex workers within India. It categorises sex work into four legal models, namely, prohibition which criminalises all aspects of the sex trade, partial decriminalisation which criminalises only those who force women into sex work and those who trade in under-age sex workers, social control legalisation which decriminalises but regulates the sex trade with the aim of containing through (often punitive) restrictions, and finally pro-work which approaches sex work as valid employment by extending the legal and human rights of other workers to sex workers. The article places India’s current regulatory framework into the prohibition model and argues that the legal response to sex work that most closely accords with a women’s human rights approach is partial decriminalisation coupled with a pro-work model. Although the introduction of this model in India poses considerable challenges, it has the greatest capacity to first, reduce the crime and corruption that surrounds the sex trade; second, to enhance, promote and protect public health and third, provide appropriate legal and human rights protection to sex workers as international obligations require.

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