Back HIV Populations Sex Workers AIDS 2014: Criminalization of Sex Work Increases Vulnerability to HIV

AIDS 2014: Criminalization of Sex Work Increases Vulnerability to HIV


Sex workers from more than 30 countries came together this week at the Sex Worker Pre-Conference preceding the 20th International AIDS Conference in Melbourne to consider proposed changes to policy and funding approaches aimed at positioning human rights as critical to the response to HIV/AIDS.

The group's deliberations have been documented in a Consensus Statement focusing on 5 key areas:

  • Biomedical developments-- including pre-exposure prophylaxis (PrEP) and treatment-as-prevention, and how these may deplete sex worker communities of vital funds for other approaches to HIV prevention while potentially leading governments to focus on mandatory testing for sex workers.
  • Stigma and discrimination-- the need to recognize the voices of sex workers above the perceptions of those without personal knowledge of sex work.
  • Human rights issues-- including criminalization of HIV and sex work, and demanding inclusion of sex workers in all aspects of policy development, particularly law reform aimed at decriminalization.
  • Migration and mobility-- raising awareness that detention of sex workers increases HIV risk as well as restricting access to treatment, care, and support.
  • Funding-- a call to increase direct funding for sex worker communities to do health promotion and human rights advocacy, including funding sex worker community-led research.

The statement raises concerns that funding towards biomedical approaches may be taken from sex worker-led community interventions, which are known to be effective but are increasingly falling behind as funding priorities.

Sex workers also believe current and existing implementations of biomedical approaches are "doomed to fail" if they do not take into account the discriminatory legal frameworks known to create barriers for sex workers.

"Sex work remains criminalized in most parts of the world with laws directly criminalizing sex workers, our workplace, and sometimes even our clients," said Janelle Fawkes, chief executive officer for Scarlet Alliance, the Australian Sex Workers Association.

"Both the 2010 UNAIDS Report on the Global AIDS Epidemic and the 2012 Global Commission on HIV and the Law report call for the decriminalization of sex work.

"Our consensus statement supports these recommendations, which reinforce our own understanding that HIV prevalence is greatly reduced in places where sex work is decriminalized," Fawkes added. 

The statement points out that sex workers have little to gain when the emphasis is put on HIV treatment as prevention rather than decriminalization, as it can lead to increased pressure from governments for mandatory testing. In addition, there can be increased pressure from clients expecting workers to use PrEP in place of existing safer sex practices such as condoms.

"There is extensive research, clinical evidence, and the lived experiences of sex workers indicating that decriminalization enables the most effective HIV response for sex workers," said Fawkes. "Our consensus statement articulates the key areas that will bring the greatest improvements for sex workers and for the broader community. What we’re calling for now is the long awaited commitment from governments to pursue decriminalization of sex work as a response to HIV and as a human rights priority."



Scarlet Alliance. Sex Worker Consensus Statement from the AIDS 2014 Sex Worker Pre-conference. July 2014.