The problem of protecting the rights of sex workers
Listen to Sex Workers
One of the world's leading concerns about sex workers is the issue of protecting their rights. The situation with sex workers is one of the most difficult in modern social life. In some states, their activities are illegal, because of which they suffer not only from various medical problems, but also from harassment by law enforcement agencies. Even in those countries where the activity of sex workers is legalized, there are persistent stigmas against this category of the population. "Sex workers are discriminated against and their human rights unrecognised around the world, even where sex work isn't illegal", says co-ordinator of the Red Umbrella Fund.
It is generally accepted in society that this niche is occupied by the most unfortunate people who fell into the commercial sex system due to hopeless life circumstances, that they are fallen, that they need to be saved, at least - that they need to be forcibly removed from this harmful environment, even if such changes are accompanied by a break with children, with parents and other relatives. Today there is a clear need to recognize that sex workers are just commercial sex workers. This is a type of work that should be taxed, accompanied by the provision of certain conditions, in particular, affordable medical care. A strategy where the only thing that sex workers can count on from the authorities and from ordinary people is pity is doomed to failure. Modern society has long reached a stage of development when it is necessary to move from marginalization to law, to the legal regulation of the problems of sex workers, to the protection of their rights.
Today, an increasing number of sex workers are declaring that they are not slaves, and that even if they are in the circumstances that led them to choose to engage in commercial sex, police brutality and police violence should not be allowed to see them as weak-willed slaves who need to be forcibly rescued. Moreover, such a rescue is fraught with serious abuses of power, which are observed in particular in Thailand, Malaysia, India and many other countries. Hiding behind the idea of rescuing women, and sometimes men and transgender people, from human traffickers and pimps, the police forcibly place them in so-called rehabilitation centers, where they experience only more violence and humiliating treatment.
The problems of the so-called forced solution of the problems of sex workers strongly resemble the problems experienced by the most ordinary women in very different countries of the world. Briefly, they can be expressed as follows: when people in power decide for a woman what is good for her, what she needs to be protected from, what to save and what to encourage. It is in connection with the similarity of the perception of human rights in relation to a woman in general and to a sex worker in particular that the world movement for women's rights should listen to sex workers, to their struggle for the right to be heard (see https://www.huffpost.com/entry/sex-workers_b_1561428).
Managing HIV and STI
Among women involved in sex work, the most pressing issue is sexual and reproductive health. At the same time, the intimate health of sex workers is affected by a fairly wide range of different factors. In different countries, within the same country, and moreover, even within the same city, populations of sex workers are very heterogeneous. In this regard, local health programs should prioritize not standardized delivery of standardized treatment and prevention of diseases, but the development of strategies that are relevant to the specific location and specific type of sex workers, taking into account their needs, behavior, age and the place where they provide services.
Among the barriers that female sex workers face in accessing sexual and reproductive health services, stigma and discrimination rank first, followed by high prevalence of sexually transmitted infections, HPV, risk of pre-cancer and cervical cancer, unwanted pregnancy, physical and psychological abuse, lack of necessary documents, for example, the status of an illegal immigrant. in some countries, such as South Africa, HIV prevalence among sex workers is about 20 times higher than among women in the general population. Contributing to the difficulty in accessing health care is the fact that most women who work in commercial sex tend to use health services only when they are provided directly at their place of work. In this regard, the situation is usually better in brothels and hotels than among those women who are based on the street.
The criminalization of commercial sex increases the vulnerability of sex workers to HIV and sexually transmitted diseases, as well as serious disenfranchisement such as trafficking, sexual exploitation and abuse. Therefore, it can be concluded that the decriminalization of this industry is an essential condition for improving the health of sex workers. However, despite the fact that the discussion on the subject of the legalization of prostitution dates back more than one decade and even more than one century, there is still a strong tension between those legalists who are ready to defend the rights of sex workers and those who believe that sex work is itself a violation of human rights. Various modern law enforcement practices interpret the rights of sex workers in different ways, and different countries interpret human rights law in different ways. There is no uniform legislation in this area. In order to ensure the health, safety and freedom from abuse of sex workers, a fundamentally new regulatory framework is needed, and this requires serious work in various areas of legislation, a better understanding of a wide range of laws and law enforcement practices. Consideration of various cultural and ethnic contexts, economic conditions is also important. Many researchers note that in order to legalize sex work, a revision of UN policy and human rights conventions is necessary.
The regulation of sex work is controversial in a wide variety of countries, both at the level of both governments and the public, as well as sex workers themselves, including developed countries. An example is Canada, where in 2014 all commercial sex was criminalized. Since then, there has been a clear trend in Canadian society to demand the decriminalization of this type of service due to the fact that being outside the legal field makes it difficult for sex workers to access medical care and is at odds with the very notion of protecting their rights. At the same time, in order to ensure that the use of commercial sex services does not criminalize not those who provide them, but those who use them, it is not the Swedish model of prostitution law that is optimal (which criminalizes buyers, not sellers of sex), but the complete decriminalization of this areas. Commercial sex is not an area of life in which hypocrisy is appropriate. If the goal of governments is to reduce sexually transmitted infections as much as possible, the only possible way to change the law is to completely decriminalize sex services, their sellers and buyers (https://www.change.org/p/the-honourable-peter-mackay-say-no-to-the-nordic-model-and-yes-to-decriminalization-of-sex-work-in-canada).
Intimate Health Problems Impulses
Such external factors as wars, mass events, waves of emigration, etc. tend to influence the level of supply and demand for paid sex. In the minds of the average person, mass entertainment events, such as, for example, the World Cup or the carnival in Rio de Janeiro, are fraught with the greatest flowering of demand and supply for sexual services. However, studies show that these events don't always and everywhere lead to any tangible change in the level of supply and demand for commercial sex. Rumors that were inflated in the media that after, for example, the 2010 FIFA World Cup, the number of cases of sexually transmitted diseases will increase significantly due to the increase in the demand for commercial sex, turned out to be unfounded (https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-12-763). A much more serious impact on this area of life is exerted by constant, smoothly occurring changes associated with the movement of the population, the arrival of foreigners, especially migrants, for a more or less long stay, the seizure of the territory of one state by another, etc. And if events such as the World Cup or Formula 1 races can be used as an occasion to raise awareness of sex workers of the importance of preventing sexually transmitted diseases and contraception, then migration changes, the emergence of military contingents, etc. are much more serious triggers of outbreaks of HIV, hepatitis and other sexually transmitted diseases among female sex workers.
HIV in Developing Countries
The prevalence of HIV among the population of developing countries, especially Muslim ones, such as Pakistan, has its own characteristics. In this country, the first place in the incidence of HIV is occupied by people who inject drugs, as well as their spouses. In second place is male sex workers. Of course, in Pakistan, as in a strict conservative Muslim country, any commercial sex is illegal, but male prostitution here has a long history and is practically ineradicable. In third place is female sex workers, however, their number is significantly inferior to the number of men involved in commercial sex. Also at risk are migrants from poor rural areas who leave Pakistan for the Gulf countries. Among those categories of the population that are also vulnerable to HIV are truckers, people working in mines on a rotational basis (they spend a lot of time outside the family and tend to use the services of sex workers), and prisoners. Even beauty salons and barbershops can lead to HIV infection, not to mention intrauterine transmission of the infection. All this is due to poverty, gender inequality, low awareness of the population about sexually transmitted diseases, low availability of medical care, stigma, etc.
To date, the only serious alliance of sex workers is the Network of Sex Work Projects, led by Cheryl Overs, who pays great attention to protecting the rights of male, female and transgender sex workers in developing countries.
Of great importance in the prevention of HIV is the use of pre-exposure prophylaxis, and also, provided that the sex worker already has HIV, the timely intake of antiretroviral therapy. This, like testing sex workers for HIV, is especially important in developing countries with low living standards and low sexual literacy. At the same time, it should be noted that the majority of sex workers today are aware of the importance of HIV testing and treatment, and awareness of the importance of prevention is growing. However, discrimination, financial costs, and neglect by healthcare professionals are major barriers to accessing these services. It is a very harmful practice to penalize HIV-positive status, as it discourages sex workers from testing treatment and prevention. The foundation of the basics for minimizing the incidence of HIV is the use of condoms in all types of sexual intercourse (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60973-9/fulltext).