AIDS 2018: Laws meant to end demand for sex work increases workers’ HIV risks, researchers say

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Science Speaks is covering the 22nd International AIDS Conference this week live from Amsterdam, the Netherlands, with breaking news, updates and analysis of new research findings, evidence-based responses, and community action for global access to HIV treatment and prevention.

AMSTERDAM – Laws and policies that criminalize clients of sex workers put sex workers at higher risk of HIV infection, researchers said here on Thursday. Sex workers are at 10 times higher risk of becoming infected with HIV than the general population, researchers said. Sex work criminalization laws and so-called “end demand” policies – laws attempting to abolish sex work by making it a crime to pay for sex services – increase marginalization, stigmatization, discrimination and subsequently reduce access to health services and increase risks for HIV infection, they said.

Researchers from the University of British Columbia found a 41 percent reduction in access to health services by sex workers after the implementation of an end-demand policy in Canada in 2014. Researchers also found a 23 percent reduction in sex worker utilization of community-based services and support programs, Elena Argento said – services which are proven contributors to better health outcomes.

Under France’s end-demand policy, sex workers are more stigmatized, face more violence from both clients and law enforcement, are made to pay more fines than clients, and are generally criminalized more often than their clients by law enforcement, Helene Lebail of the National Center for Scientific Research in France, said.

Sex workers living with HIV face treatment interruption when they feel compelled to move from one city to another to find work, Lebail said, and workers face increased difficulty in negotiating safe sex practices, resulting in a decrease in condom use.

France’s law has driven sex work further underground, decreasing sex workers’ ability to access HIV and other health services, Lebail said. “Violence is increasing, working conditions are becoming more dangerous, sex workers’ autonomy is decreasing,” she said. “All elements that are often described by police and prohibition activists as collateral damage,” she said.

While it’s too early to evaluate the HIV-related health impacts, Lebail said, some nongovernmental organizations in Paris report an increase in sexually transmitted infections among sex workers, notably syphilis.

“We want full decriminalization,” Duduzile Dlamini, an activist sex worker from South Africa, said. “We’re not able to exercise our human rights and we can’t report violence or go to the police.”

“Full decriminalization is the only thing that will make us feel free and like human beings,” she said.

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