seek nor have access to HIV prevention

sell sex as a full-time occupation, part-time, or occasionally to meet specific economic
needs (such as education costs, or in a family financial crisis). Others are trafficked or
coerced into selling sex. Many people who exchange sex for money or goods do not selfidentify
as sex workers12, and do not seek nor have access to HIV prevention, treatment,
care and support advice or services for sex workers, including in humanitarian and postconflict
settings13.
The settings in which sex work may occur range from brothels or other dedicated
establishments to roadsides, markets, petrol stations, truck stops, parks, hotels, bars,
restaurants and private homes, and may be recognizable or hidden. Sex work settings may
cater to local communities or primarily involve transient, migrant and mobile populations
of both sex workers and clients. Depending on their individual circumstances, sex workers
may be further victimized by discriminatory gender-based attitudes, violence, and sexual
exploitation, and by membership in other populations that are highly vulnerable to HIV
exposure, such as men who have sex with men and injecting drug users14. Policies and
programmes to address the links between HIV and sex work must recognize the social and
geographic diversity of sex work, as well as the rapid changes that may occur in patterns of
sex work, including types of transactional sex15, and in sex work settings.16
The conditions in which sex work occurs may have a profound impact on HIV risk
and vulnerability17. While some sex work settings have served as excellent venues for
HIV-prevention programmes, many others neither promote safer sex nor protect sex
workers from violence perpetrated by clients, law enforcement officers, gangs, establishment
owners or controllers. In addition, debt-bondage, low pay and inadequate living conditions
may further compromise the health and safety of sex workers. Where sex workers are able
to assert control over their working environments and insist on safer sex, evidence indicates
that HIV risk and vulnerability can be sharply reduced. Excellent examples of community
organized HIV-prevention programming for sex workers include AVAHAN (India),
Clinque de Confiance (Cote d’Ivoire), CONASIDA (Mexico), DAVIDA (Brazil), Durjoy
Nari Shango (Bangladesh), EMPOWER (Thailand), FIMIZORE (Madagascar), Durbar
Mahila Samanwaya Committee (India), SWING (Thailand) and TAMPEP (Europe)18.