Fundamental to reducing HIV risk

Fundamental to reducing HIV risk and vulnerability is enhancing access for all,
including those engaged in sex work, to HIV prevention, treatment, care and support.
Comprehensive rights-based programmes on HIV and sex work are critical to the success
of the HIV response. Working in partnership with sex workers to identify their needs and
to advocate for policies and programmes that improve their health, safety and engagement
in the AIDS response is a proved strategy and an essential feature of UNAIDS approach.
Alongside the global epidemic of HIV is an epidemic of violence against women, girls and
other vulnerable groups, including men who have sex with men. Far too often, stigma and
discrimination, gender-based violence and other critical human rights violations, such as
denial of education and employment on the basis of gender, constitute the norm in many
parts of the world. Women’s rights are human rights. Progress for women is progress for all.
Efforts to address the construction of dominant norms of masculinity and to redress gender
imbalances are essential to the success of rights-based approaches to HIV and sex work, for
all people selling sex—female, male and transgender.
HIV and sex work is a complex issue and needs to be understood as such. The delivery
of effective services to sex workers and their clients often encounters barriers and resistance
that reflect complex and longstanding cultural, religious, and social dynamics. While
these barriers will not be overcome overnight or with ease, delaying action to address these
factors will merely continue to undermine the global response to HIV. Through honest
dialogue and evidence-informed action, sustained progress towards universal access to HIV
prevention, treatment, care and support for sex workers can be achieved.
The Three Pillars outlined in this Guidance Note together provide a framework for
developing effective strategies to reduce the immediate HIV risk to sex workers and their
clients, and to the spouses and regular partners of clients; provide care for sex workers
living with HIV; and reform official policies, practices and legislation to protect the human
rights of sex workers. These strategies should be accompanied by programmes to build
supportive environments to facilitate full and equal participation of sex workers, provide
meaningful alternative livelihoods and life choices, ensure full and universal enjoyment
of human rights, combat stigma and discrimination, and strengthen partnerships between
government, civil society, and community actors.