Sex Work and HIV - like peanut butter and jelly?

by Alanna Shaikh · 2009-01-09 20:26:00 UTC
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(photo credit: redjar)

Amanda wrote about HIV and sex trafficking today in the end human trafficking blog, so I thought I'd toss out my two cents.

People really like to pin HIV transmission on sex work. I think it's comforting to think of AIDS as something that belongs to risk groups like sex workers and drug users, and not something that can happen to regular people.

The truth, as always, is more complicated. While AIDS has a devastating impact on commercial sex workers, prostitution is not synonymous with the spread of HIV. Sex workers are at a very high risk for getting AIDS, pretty much globally. But they are not necessarily a major driver of AIDS epidemics. In some places they are, especially Southeast Asia and Central Asia. In other places, like Western Europe, not so much. There is an awful lot of conflicting writing out there about HIV and commercial sex workers. Some of it is good, and some of it is based on very shoddy research.

The best paper I have seen on the topic argues that there are two important numbers that determine whether sex work is an important drive of an AIDS epidemic. The first is the percentage of the total country population made up by sex workers.  The second number is the percentage of sex workers infected with HIV. Together, they represent the role of commercial sex workers in the epidemic.

This means that global organizations like PEPFAR and the Global Fund don't get far trying to set general policies on reducing HIV in commercial sex workers. Effective responses will be planned country by country, and adapted to local circumstances within a nation.

Alanna Shaikh
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