Can rights stop the wrongs? Exploring the connections between framings of sex workers’ rights and sexual and reproductive health

Abstract

BackgroundThere is growing interest in the ways in which legal and human rights issues related to sex work affect sex workers’ vulnerability to HIV and abuses including human trafficking and sexual exploitation. International agencies, such as UNAIDS, have called for decriminalisation of sex work because the delivery of sexual and reproductive health services is affected by criminalisation and social exclusion as experienced by sex workers. The paper reflects on the connections in various actors’ framings between sex workers sexual and reproductive health and rights (SRHR) and the ways that international law is interpreted in policing and regulatory practices.MethodsThe literature review that informs this paper was carried out by the authors in the course of their work within the Paulo Longo Research Initiative. The review covered academic and grey literature such as resources generated by sex worker rights activists, UN policy positions and print and online media. The argument in this paper has been developed reflectively through long term involvement with key actors in the field of sex workers’ rights.ResultsInternational legislation characterises sex work in various ways which do not always accord with moves toward decriminalisation. Law, policy and regulation at national level and law enforcement vary between settings. The demands of sex worker rights activists do relate to sexual and reproductive health but they place greater emphasis on efforts to remove the structural barriers that limit sex workers’ ability to participate in society on an equal footing with other citizens.Discussion and conclusionThere is a tension between those who wish to uphold the rights of sex workers in order to reduce vulnerability to ill-health and those who insist that sex work is itself a violation of rights. This is reflected in contemporary narratives about sex workers’ rights and the ways in which different actors interpret human rights law. The creation of regulatory frameworks around sex work that support health, safety and freedom from abuse requires a better understanding of the broad scope of laws, policies and enforcement practices in different cultural contexts and economic settings, alongside reviews of UN policies and human rights conventions.

How Are Gender Equality and Human Rights Interventions Included in Sexual and Reproductive Health Programmes and Policies: A Systematic Review of Existing Research Foci and Gaps

“…These included interventions targeted at the health facility[8–10], community[10, 11], and policy[12] levels. Given this dearth of information, the primary topical gap is a lack of explicit focus on human rights interventions in SRH research.…”

“…One review focused on the negative impact of discriminatory laws around sex work, including their impact on voluntariness of medical care and access to health services; yet the review itself found limited data regarding the positive impact of changes in policies on SRH outcomes (e.g. how law influences sex workers ability to avoid STIs or to access SRH services as opposed to measuring levels of HIV infection)[12]. Another included some review of how changes in policies positively impact human rights related outcomes such as access to FP, participation of diverse stakeholders, or equity, nondiscrimination, and quality of SRH care.…”

Male sex workers: practices, contexts, and vulnerabilities for HIV acquisition and transmission

“…Where legal and cultural contexts make it feasible, the provision of legal protections and HIV/STI surveillance and treatment for adult film actors in Los Angeles might be used as a model for the provision of such services to the broader population of MSW 64 . In Brazil, ‘male sex workers’ can report sex work as an official occupation facilitating access to social benefits and there is a history of government-sponsored anti-homophobia social marketing campaigns; however, recent government changes in Brazil may negate these advances in HIV prevention 65 . Thus, while governmental entities are crucial stakeholders, it is communities of MSW that need to be supported to be at the anchor of an effective response to their needs.…”

Human rights violations against sex workers: burden and effect on HIV

“…They are most egregious in climates ofcriminalization.The United Nations High Commissioner on Human Rights and UNAIDS hasrecommended decriminalization to uphold sex workers’ human rights and health, 9 as have the United Nations Special Rapporteur on Health and Human Rights, 20 the UNAIDS Guidance Note on HIV and Sex Work, 5 the Global Commission on HIV and the Law, 11 and the United Nations Development Program. 10 Sex workers, national and international advocates, 13,15,105106 also call for decriminalization premised on the importance of sex workers’ health and safety as a means of promoting health and human rights.The Supreme Court of Canada recently struck down key provisions of the law governing sex work to improve sex workers’ rights to life, liberty and security.…”