Harm Reduction and Decriminalization of Sex Work: Introduction to the Special Section

Introduction: This special section of Sexuality Research and Social Policy, edited by Belinda Brooks-Gordon, Max Morris and Teela Sanders, has its origins in a colloquium sponsored by the University of Cambridge Socio-Legal Group in 2020. The goal was to promote the exchange of ideas between a variety of disciplinary research fields and applied perspectives on harm reduction and the decriminalization of sex work. The colloquium took place during the emergence of the coronavirus pandemic in February 2020. Methods: We explore the impact of Covid-19 on understandings of sex work, outline the basic underpinning legal philosophical question, explore the intersectional politics of decriminalization, summarize contemporary international health and human rights campaigns, explore contemporary public opinion trends on the issue, and illustrate the universal principles. Finally, we summarize the special section papers (N=12). Results: The Covid pandemic provided a lens through which to analyse the changes that have occurred in sex work and sex work research in the past decade and it also exacerbated intersecting inequalities, accelerated many social shifts already in motion whilst changing the course of others. In combination the papers in this special issue examine sex work policy and research across 12 countries in four continents to provide and important space for international and cross-cultural comparison. Conclusions: We present the timely contributions of diverse authors and comment on the significance of their research projects which support a decriminalization policy agenda for the benefit of academics, policymakers and practitioners to improve public health strategies and international responses. Policy Implications: The research here amplifies the focus on harm reduction and strengthens the case for public policy that decriminalizes commercial sex between consenting adults as the best strategy to reduce harm.

Sex work, containment and the new discourse of public health in French colonial Levant

This article addresses how French academics, doctors and state bureaucrats formulated sex work as a pathology, an area of inquiry that had to be studied in the interest of public safety. French colonisation in the Levant extended the reach of this ‘expertise’ from the metropole to Lebanon under the guise of public health. Knowledge produced by academics was used to buttress colonial state policy, which demanded that sex workers be contained to protect society against medical contagion. No longer drawing conclusions based on speculation, the medical establishment asserted its authority by harnessing modern advances in science and uniting them with extensive observation. ‘Empirical facts’ replaced ‘opinions’, as doctors forged new approaches to studying and containing venereal disease. They accomplished this through the use of statistics and new methods of diagnosing and treating maladies. Their novel approach was used to treat sex workers and to support commercial sex work policy both at home and abroad. Sex workers became the objects of scientific study and were consequently problematised by the state in medicalised terms.

The Continued Criminality of Selling Sex: A Trajectory of South African Sex Work Law Reform

This article explores the regulation of sex work in South Africa and follows the trajectory of the South African Law Reform Commission (SALRC) in investigating whether sex work should be decriminalized. The legal regulation of sex work is a hotly contested topic. South Africa currently criminalizes the selling and buying of sex, but policy reform has been on the cards since the SALRC launched its project on the topic in the early 2000s. As most sex work policy responses are grounded in feminist theory, the article analyses the main theoretical ideologies and questions the influence of these ideologies in structuring sex work law reform in the South African context. The author calls for a more inclusive understanding of feminism and sex work, and the need to acknowledge the importance of rights discourse in furthering political growth and protecting sex workers’ constitutional rights.

Decriminalisation of sex work in the post-truth era? Strategic storytelling in neo-abolitionist accounts of the New Zealand model

In the context of on-going debates regarding sex work laws, in most jurisdictions forms of criminalisation continue to dominate. Despite decades of sex workers calling for the decriminalisation of sex work and collectively organising against repressive laws, decriminalisation remains uncommon. New Zealand was the first full country to decriminalise sex work with the passing of the Prostitution Reform Act in 2003, which aimed to improve occupational health and safety. Several empirical studies have documented positive impacts of this framework. However, despite this, neo-abolitionists persistently describe the New Zealand model as a failed approach. This article examines neo-abolitionist knowledge claims regarding the New Zealand model and in doing so unpacks the strategic stories told about this approach, considering the implications for sex work policy making.

National sex work policy and HIV prevalence among sex workers: an ecological regression analysis of 27 European countries

BackgroundSex workers are disproportionately affected by HIV compared with the general population. Most studies of HIV risk among sex workers have focused on individual-level risk factors, with few studies assessing potential structural determinants of HIV risk. In this Article, we examine whether criminal laws around sex work are associated with HIV prevalence among female sex workers.MethodWe estimate cross-sectional, ecological regression models with data from 27 European countries on HIV prevalence among sex workers from the European Centre for Disease Control; sex-work legislation from the US State Department's Country Reports on Human Rights Practices and country-specific legal documents; the rule of law and gross-domestic product per capita, adjusted for purchasing power, from the World Bank; and the prevalence of injecting drug use among sex workers. Although data from two countries include male sex workers, the numbers are so small that the findings here essentially pertain to prevalence in female sex workers.FindingsCountries that have legalised some aspects of sex work (n=17) have significantly lower HIV prevalence among sex workers than countries that criminalise all aspects of sex work (n=10; β=–2·09, 95% CI −0·80 to −3·37; p=0·003), even after controlling for the level of economic development (β=–1·86; p=0·038) and the proportion of sex workers who are injecting drug users (−1·93; p=0·026). We found that the relation between sex work policy and HIV among sex workers might be partly moderated by the effectiveness and fairness of enforcement, suggesting legalisation of some aspects of sex work could reduce HIV among sex workers to the greatest extent in countries where enforcement is fair and effective.InterpretationOur findings suggest that the legalisation of some aspects of sex work might help reduce HIV prevalence in this high-risk group, particularly in countries where the judiciary is effective and fair.