Characteristics, sexual behaviour and access to health care services for sex workers in South Africa and Kenya

Richter, Marliese (2013): Characteristics, sexual behaviour and access to health care services for sex workers in South Africa and Kenya (PhD dissertation; Available here)

Preface
Across the globe, many people make a living from supplying sexual services for reward. This
is in spite of the heavy tolls that sexual moralism, religious fervour, criminalisation, harsh health
services and abusive security services extract from them; sex work is hard and the dangers
numerous. Many women, men and transgender people in Sub-Saharan Africa have few or no
other choices available to earn an income, while others weigh up the risks and benefits of sex
work, and decide that that the risks are worth it in the short- and/or long-term.
Of the various hazards that sex workers face, the human immunodeficiency virus (HIV) and
other sexually transmitted infections (STIs) have been a major focus of health research and
concern. Frustratingly, little of the knowledge generated about what is effective and necessary
to make sex work and sex workers safer, has been translated into practice, or brought to
sufficient scale. Evidence indicating the need for the decriminalisation of sex work has not
transformed the much outdated legal and policy landscape associated with the criminalisation of
sex work that is characteristic of most countries in Sub-Saharan Africa. Despite a growing body
of evidence and improved programmatic responses to sex work, the political will, the necessary
funding and the urgency needed to implement an effective response to the context of sex work
in Sub-Saharan Africa are mostly absent. It is hoped that, as the voices of sex workers and sex
worker advocates become stronger and as sex workers are supported to engage with policy
makers, law enforcement agencies, and health service providers, the changes needed to make
sex work safer will be made.

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