Sex workers living with HIV

Sex workers living with HIV often find it especially difficult to leave sex work.
Comprehensive assistance should be readily available for HIV-positive sex workers,
including skills training, alternative livelihoods, and microfinance. There are many successful
examples of microcredit and microfinance programmes providing economic opportunities
for people living with HIV or to alleviate poverty among girls and women. Such
programmes use economic empowerment as a means to reduce stigma and discrimination
and expand life choices73. To date, however, only a few have specifically focused on meeting
the needs of sex workers74. Partnerships between local authorities and communities should
be strengthened to ensure sex workers living with HIV have equal access to HIV treatment,
care and support, as well as to available employment programmes. Every effort should be
made by governments, donors, civil society, sex worker organizations and the UN system to
ensure sex workers’ meaningful access to such programmes and services. Laws, policies, and
practices that diminish sex workers’ potential for their economic independence and social
inclusion must be reviewed and revised।
States should take measures to reduce the vulnerability, stigmatization and discrimination that
surround HIV and promote a supportive and enabling environment by addressing underlying prejudices
and inequalities within societies…
International Guidelines on HIV/AIDS and Human Rights 2006:55
HIV prevention efforts will not succeed in the long term unless the underlying drivers
of HIV risk and vulnerability are effectively addressed.75 The evidence base for structural
interventions is limited but there is wide recognition that these are a critical component
of combination prevention.76 Factors that commonly contribute to vulnerability to HIV
infection include gender inequality, discrimination and social exclusion77. These same
structural issues, together with poverty, mobility and displacement, may lead people to
engage in sex work and increase their vulnerability to HIV।
Addressing Societal Causes of HIV Risk and Vulnerability: Key Findings79
Long-term success in responding to the HIV epidemic will require sustained progress in
addressing human rights violations, gender inequality, stigma, and discrimination.
Significant investment in girls’ education, supported by policies mandating universal
primary and secondary education, would substantially reduce HIV risk and vulnerability
for women and girls.
Evidence-informed programmes to forge norms of gender equity should be brought
to scale, with particular attention to initiatives focused on men and boys.
National governments and international donors should prioritize strategies to
increase women’s economic independence and legal reforms to recognize women’s
property and inheritance rights.
All countries should ensure rigorous enforcement of antidiscrimination measures to
protect people living with HIV. The one third of countries that lack legal protections
against HIV-based discrimination should immediately enact such laws. Countries
should also protect populations most at risk from discrimination and ensure their
equal enjoyment of human rights.
Countries should include anti-stigma strategies as integral components of their
national AIDS plans, investing in a broad range of activities, including public
awareness and ”know your rights” campaigns, legal services for people living with
HIV, expansion of access to antiretroviral drugs, and expressions of national solidarity
in the HIV response.
Much stronger financial and technical support is needed for capacity-building for
organizations and networks of people living with HIV, and groups of people most at
risk of HIV infection.