If prostitution were legal around the world, the transmission of HIV among female sex workers would go down by at least a third, according to a paper presented at the International AIDS Conference in Melbourne, Australia.
That would be a huge step forward. "Sex workers face a disproportionately large burden of HIV," the paper notes.
Goats and Soda spoke to Dr. Kate Shannon, director of the Gender and Sexual Health Initiative of the BC Center for Excellence in HIV/AIDS in British Columbia, and lead author of the paper published in the July 22 journal The Lancet.
What led you to do research on HIV and female sex workers?
This is part of a larger series of research on sex workers and HIV that also looked at transmission among male and transgender sex workers.
Why has the criminalization of prostitution made sex workers more vulnerable to HIV infection?
We see across many settings that criminalization leads to more violence. Policing practices displace sex workers, sending them to more hidden places where they're less safe and where they lose the ability to negotiate conditions, such as condom use.
It seems counterintuitive: A greater police presence in the sex trade leads to more violence and less safety for sex workers. How does that happen?
From our review, we see that policing efforts include bribes, confiscating condoms, police harassment, forced detainment and abuse. And where sex workers experience violence, or fear violence, they're more likely to have to do things like jump into vehicles quickly [for sex] with a reduced ability to negotiate condom use.
How do the sex workers describe these encounters with the law?
There are some moving quotes in the paper.
From Kenya: "They [the police] found me on the street, took all the condoms I had and destroyed them." From Vancouver, Canada: "You get all these [expletive] cops and security ... pushing us into darker and darker areas ... they'll pick you up and make you do something for them just so you can stay there to work." From India: "He put handcuffs on me and told me I had to go to the police station, but he took me to a remote place instead. Twelve members had sex with me and snatched my money and purse."
The three countries you looked at, Canada, India and Kenya, are quite different. What do they have in common when it comes to HIV and sex workers?
In all three settings, we set up models to see what the impact of removing sanctions against prostitution would have on HIV. By decriminalizing prostitution and having safer environments, indoor environments, we could avert 33 percent to 46 percent of new HIV cases among sex workers over the next decade. Some countries are moving toward criminalizing clients while decriminalizing sex workers. But our work shows that if all laws and sanctions were removed for both clients and sex workers, you'd see this reduction in HIV transmission.
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