Facts About Sex Workers

FACTS ABOUT SEX WORKERS AND THE MYTHS THAT HELP SPREAD HIV THE LANCET series on HIV and sex workers Misconceptions about sex workers hinder effective HIV prevention programmes THE MYTH IS... O BUT THE TRUTH IS... O THE IMPACT BEING... All sex workers are women Sex workers may be male, female, transgender or non-transgender and from diverse backgrounds? Heterogeneity of epidemics across various groups' FALSE Male sex workers are all gay Heterosexual identity in male sex workers represents increased risk among their non-paying female partners Often male sex workers with male clients don't identify as gay or bisexual and have female intimate partnerss FALSE Transgender female sex workers face the same risk of HIV as male Transgender women have distinct biological HIV risks from male sex workers or Transgender female sex workers demonstrate about 1.5 times the risk of HIV compared to male sex workers sex workers FALSE non-transgender women Sex work is not a real job Sex work is officially recognised as an occupation in Brazil, entitling sex workers to labour rights Community empowerment among sex workers reduced the odds of HIV by 32%³ FALSE Greater success in condom uptake has been reported in sex workers than any other affected population? Sex workers won't Condom promotion in South Africa has reduced HIV in sex workers by more than 70%? use condoms FALSE Criminalising sex work prevents HIV spread Police harassment forces One third of sex workers don't carry condoms as they are used as evidence of illegal sex work!4 hurried transactions which FALSE jeopardise condom negotiation4 * THE HIV BURDEN Sex workers have higher burdens of HIV, although epidemics are reflective of, and impact on, surrounding adult populations. HIV PREVALENCE WORLDWIDE 100% WITH HIV GENERAL POPULATION 0.8% FEMALE SEX WORKERS 11.8% MALE SEX WORKERS 14% TRANSGENDER TRANSGENDER WOMEN SEX WORKERS 27.3% WOMEN 19.2% EPIDEMIOLOGICAL TRENDS AMONG MALE SEX WORKERS AND OTHER MEN WHO HAVE SEX WITH MEN* VARY BY REGION SYDNEY SHENZHEN TEL AVIV MEN WHO MEN WHO MALE SEX WORKERS 6.5% MALE SEX WORKERS 4.5% MALE SEX WORKERS 5.6% MEN WHO HAVE SEX WITH MEN (high risk) 9.2% MEN WHO HAVE SEX WITH MEN (low risk) 0% HAVE SEX WITH MEN 23.9% HAVE SEX WITH MEN 7% tmen with no history of sex work who have sex with men HOW MUCH COULD HIV INFECTIONS BE AVERTED? DECRIMINALISING SEX WORK SAFER WORK ENVIRONMENTS SCALE-UP OF ANTI-RETROVIRAL THERAPY ELIMINATION OF SEXUAL VIOLENCE 33-46% reduction' 21-45% reduction' 9-34% reduction' 17-20% reduction *modelled potential improvements in reducing HIV among female sex workers and clients within a decade Read the full series at www.thelancet.com/series/HIV-and-sex-workers SOURCES 1. Shannon K, Strathdee SA, Goldenberg SM, et al. Global epidemiology of HIV among female sex and scale-up. Lancet 2014; published online July 22. DOI: http://dx.doi.org/10.1016/S0140-6736(14)60973-9 4. Decker MR, Crago A-L, Chu SKH, et al. Human rights 7. Beyrer C, Crago A-L, Bekker L-G, et al. An action violations against sex workers: burden and effect on HIV. Lancet 2014; published online July 22. DOI: http://dx.doi.org/10.1016/S0140-6736(14)60800-X 5. Baral SD, Friedman MR, Geibel S, et al. Male sex workers: practices, contexts, and vulnerabilities for HIV acquisition and transmission. Lancet 2014; published online July 22. DOI: http://dx.doi.org/ July 22. DOI: http://dx.doi.org/10.1016/ S0140-6736(14)60833-3 workers: influence of structural determinants. Lancet 2014; published online July 22. DOI: http://dx.doi.org/10.1016/S0140-6736(14)60931-4 2. Bekker L-G, Johnson L, Cowan F, et al. agenda for HIV and sex workers. Lancet 2014; published online July 22. DOI: http://dx.doi.org/ 10.1016/SO140-6736(14)60933-8 8. Strathdee SA, Crago A-L, Butler J, et al. Dispelling myths about sex workers and HIV. Lancet 2014; published online July 22. DOI: http://dx.doi.org/ Combination HIV prevention for female sex workers: what is the evidence? Lancet 2014; published online July 22. DOI: http://dx.doi.org/ 10.1016/S0140-6736(14)60974-0 3. Kerrigan D, Kennedy CE, Morgan-Thomas R, et al. A community empowerment approach to the HIV response among sex workers: effectiveness, challenges, and considerations for implementation 10.1016/S0140-6736(14)60980-6 9. UNAIDS. Global report: UNAIDS report on the global AIDS epidemic 2013. Geneva: Joint United Nations Programme on HIV/AIDS. UNAIDS/JC2502/1/E, revised November 2013. 10.1016/S0140-6736(14)60801-1 6. Poteat T, Wirtz AL, Radix A, et al. HIV risk and preventive interventions in transgender women sex workers. Lancet 2014; published online THE LANCET