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Research Alert: Study Casts Doubt on "Shock and Kill" Cure Strategy

Sex Work, Criminalization and HIV: Lessons From Advocacy History

Summer/Fall 2010

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Conclusion

As noted previously, no national survey estimates are available regarding the number of HIV infections among sex workers in the U.S. But the research that has been done in specific cities is telling.

Among street-based, drug-using women selling sex in Miami, 22.4% were HIV positive in a study published in 2006. In a recent study of male sex workers in Houston, 26% tested HIV positive. And the rates among transgender individuals tend to be even higher: In a 2009 study of male-to-female transgender sex workers in Boston, one third had HIV. The CDC reports that HIV infection rates among transgender populations range from 14% to 69%, with the highest prevalence among male-to-female transgender sex workers.

The lack of public health attention to sex workers in the U.S. is clearly not due to the fact that their HIV rates are too low to warrant it. Rather, the limited available data strongly suggest that this population is, in fact, fundamentally "like the others" and is just as deserving of the attention and dedicated support of HIV prevention advocates as are MSM and IDU.

As always, the most persuasive case is made by those whose story it is. "People are not aware of sex workers and what they go through ... or why they are in the work that they're in," observed a sex worker named Patricia, who was interviewed for the Sex Workers Project's 2005 report. "When they were growing up, they didn't say, 'Oh, you want to be a ballerina? I want to be a hooker.' It didn't work that way."

Will Rockwell, a sex worker and youth officer for the global Network of Sex Work Projects, told National Public Radio in 2008 that, "[in] a culture in which sex work is criminalized, this sort of work is invisible, and so is the police harassment, the legal abuse, the client violence" that sex workers face. According to Rockwell, sex workers need "affordable housing and heath care, along with a legal framework that takes into account reproductive rights, labor rights, [and] immigrant rights -- and considers sex workers human beings."

These are not impossible goals if advocates are willing to make the noise, generate the data and demand the representation to achieve them.

Anna Forbes is a writer, organizer and women's health activist who has been working full-time in HIV/AIDS since 1985. She is currently an independent consultant and is learning sex workers' rights advocacy from some inspiring teachers.


Selected Sources

  1. Centers for Disease Control and Prevention. 2003-2008 HIV Prevention Community Planning Guidance. Atlanta, Georgia: CDC.
  2. Center for Health and Gender Equity. Implications of U.S. policy restrictions for HIV programs aimed at commercial sex workers. 2008.
  3. Colvin, M. and others. Analysis of HIV Prevention Response and Modes of HIV Transmission: The UNAIDS-GAMET Supported Synthesis Process. UNAIDS. Undated.
  4. Ditmore, M. and others. Behind Closed Doors: An Analysis of Indoor Sex Work in New York City. Sex Workers Project, Urban Justice Coalition. 2005.
  5. Ditmore, M. and D. Allman. A case story analysis of the implementation of PEPFAR's anti-prostitution pledge and its implications for successful HIV prevention among organizations working with sex workers. 18th International AIDS Conference. Vienna, Austria. July 18-23, 2010. Abstract THAF0103.
  6. Ditmore, M. The Use of Raids to Fight Trafficking in Persons. Sex Workers Project, Urban Justice Coalition. 2009.
  7. Global HIV Prevention Working Group. Global HIV Prevention Progress Report Card 2010. Washington, D.C.: Henry J. Kaiser Family Foundation/Public Affairs Center. July 20, 2010.
  8. Godwin, J. Legal environments, human rights and HIV responses among men who have sex with men and transgender people in Asia and the Pacific: an agenda for action. APCOM and UNDP. July 2010.
  9. Inciardi, J. and others. HIV, HBV and HCV infections among drug-involved, inner-city, street sex workers in Miami, Florida. AIDS and Behavior 10(2):139-47. March 2006.
  10. International Planned Parenthood Federation. Verdict on a Virus: Public Health, Human Rights and Criminal Law. 2008.
  11. Kenya Medical Research Institute. Kenya AIDS Indicator Survey Report -- 2007. September 2009.
  12. New Zealand Ministry of Justice. Report of the Prostitution Law Review Committee on the Operation of the Prostitution Reform Act 2003. Wellington, New Zealand. May 2008.
  13. Reisner, S. and others. HIV risk and social networks among male-to-female transgender sex workers in Boston, Massachusetts. Journal of the Association of Nurses in AIDS Care 20(5):373-86. September/October 2009.
  14. Reynaga, E. Sex work (plenary session). 17th International AIDS Conference. Mexico City. August 3-8, 2008. Abstract WEPL0103.
  15. Rockwell, W., interviewed by M. Martin. Behind closed doors: the reality of prostitution. Tell Me More, NPR. May 5, 2008.
  16. Timpson, S. and others. Characteristics, drug use and sex partners of a sample of male sex workers. American Journal of Drug and Alcohol Abuse 33(1):63-69. 2007.
  17. UNAIDS. UNAIDS Guidance Note on HIV and Sex Work. Geneva, Switzerland: UNAIDS. March 2009.
  18. Vlahov, D. and others. Needle exchange programs for the prevention of human immunodeficiency virus infection: epidemiology and policy. American Journal of Epidemiology 154(12):Supplement. 2001.
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This article was provided by San Francisco AIDS Foundation. It is a part of the publication Bulletin of Experimental Treatments for AIDS. Visit San Francisco AIDS Foundation's Web site to find out more about their activities, publications and services.
 

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