Sex workers health issues

This study sought to understand the health and social wellbeing needs of sex workers in Victoria to identify best practice for policy and service provision. It did so by means of qualitative interviews with 31 diverse sex workers and 17 key stakeholders, including service providers and peer community leaders.

The report highlights how the health and wellbeing needs of sex workers in Victoria can be shaped by the experience of stigma, criminalisation, and a lack of safe, high-quality services. However, the health of our sex worker participants was also shaped by good sexual health knowledge, commitment to safer sex practices, strong peer support networks and resilience in the face of adversity.

The report presents strong evidence that having sex work criminalised and regulated by police (including under a licensing system) is harmful to sex workers’ health and wellbeing. The fear of being prosecuted or stigmatised by disclosing their sex work creates barriers to accessing and engaging with health services. In case of violence and assault, the majority of sex worker participants would not seek help by police.

Sex work decriminalisation was greeted by our study participants as the best way to start addressing the stigma and barriers to health and protection faced by diverse sex workers. To achieve this goal, our recommendations point at the need to fully repeal the criminalisation of street-based sex workers previewed by the Sex Work Decriminalisation Bill 2021. Service provision to sex workers should, on the other hand, be restructured to maximise the influence of peer-only services.

The sexual and reproductive health needs of sex workers have been neglected both inresearch and public health interventions, which have almost exclusively focused on STI/HIV prevention. Among the reasons for this are the condemnation, stigma and ambiguous legal status ofsex work. This paper describes work carried out by two feminist NGOs in Brazil, Mulher e Saude (MUSA) in Belo Horizonte and Coletivo Feminista Sexualidade e Saude in Sao Paulo, to promote
sexual and reproductive health for sex workers. MUSA’s project ‘‘In the Battle for Health’’, was begun
in 1992; sex workers were trained as peer educators and workshops were offered on self-care for sex workers and their clients. In Sao Paulo, the Coletivo project ‘‘Get Friendly with Her’’, begun in 2002, offers clinic consultations and self-care workshops on sexuality, contraception, STI/HIV prevention
and self-examination. Health care needs during menstruation and unhealthy vaginal practices led to
promotion of the diaphragm as a contraceptive, for prevention of reproductive tract infection and to catch menstrual blood. Meeting the sexual and reproductive health needs of sex workers depends on the promotion of their human rights, access to health care without discrimination, and attention to
psychosocial health issues, alcohol and drug abuse, and violence from clients, partners, pimps and police.