Tetyana I. Vasylyeva, Samuel R. Friedman, Lenore Gensburg, Pavlo Smyrnov; Engagement in sex work does not increase HIV risk for women who inject drugs in Ukraine, Journal of Public Health, Volume 39, Issue 3, 1 September 2017, Pages e103–e110, https://doi.org/10.1093/pubmed/fdw070
We studied the association between sex in exchange for money, drugs or goods and HIV for women who inject drugs (WWID) in Ukraine, as previous data on this association from the post-USSR region are contradictory.
Data come from the Integrated Bio-Behavioral Survey of Ukrainian people who inject drugs collected in 2011 using respondent-driven sampling. Participants were interviewed and tested with rapid HIV tests.
The sample included 2465 WWID (24% HIV positive); 214 (8.7%) of which reported having had exchange sex during the last 90 days. Crude analysis showed no association between exchange sex and HIV (OR = 0.644; 95% CI 0.385–1.077). No confounders were found to alter this result in a multivariable analysis. Further modeling showed that exchange sex modifies association between HIV and alcohol use: no association between HIV and daily alcohol use was found for those women who exchanged sex (OR = 1.699, 95% CI 0.737–3.956); while not engaging in sex work and daily using alcohol reduced odds to be HIV infected (OR = 0.586, 95% CI 0.389–0.885).
Exchange sex may have less impact on the HIV status of WWID who are exposed to injecting risks. The finding that daily alcohol use appears protective against HIV among WWID who do not exchange sex requires more research.
The position of sex workers in society ranges across a wide spectrum. At one end of the spectrum there are slaves and the victims of inhumane traffickers. On the other end sex workers can enjoy a high position in society and are celebrated in the highest art forms such as in paintings or like in the opera la Traviata by Giuseppe Verdi. However, Eduard Manet’s painting of Olympia of 1863 brought some realism into this glamorous stereotypical portrayal by painting an image of a woman with a black cat—symbolizing promiscuity.1 This image of glamor lived on into the 20th century in films like Pretty Woman with its totally unrealistic Cinderella ending.
While the sex industry is present in every country, the reality for many sex workers is far from glamorous. A sex worker is defined by the World Health Organization as a “person who engages in sex work, or exchanges sex for money, which includes many practices and occurs in a variety of settings.” These may include workers who work full time in registered premises, to part time and casual workers working in informal locations.2
Shira Goldenberg, Steffanie A. Strathdee, Manuel Gallardo and Thomas L. Patterson, « “People Here Are Alone, Using Drugs, Selling their Body”: Deportation and HIV Vulnerability among Clients of Female Sex Workers in Tijuana », Field Actions Science Reports [Online], Special Issue 2 | 2010
In many settings, migrants are at disproportionately high risk of HIV. The Tijuana-San Diego border is the world’s busiest international land crossing. Deportations in San Diego County have increased by 48% since 2002; many deportees are delivered to deportation stations in Tijuana, Mexico, where associations between HIV vulnerability and deportation have been documented. Female sex workers (FSWs) and their clients are among the populations at highest risk of HIV in Tijuana. Our objective was to explore the relationship between deportation and HIV vulnerability from the perspectives of deported clients of FSWs in Tijuana. Using in-depth interviews conducted in Tijuana’s red light district in 2008 with 20 male clients of FSWs who had ever been deported from the United States, we explored the relationship between the consequences of deportation and HIV vulnerability. Clients perceived deportation as resulting in social isolation and economic dislocation, which were linked to HIV through substance use and unprotected sex with FSWs. These unintended consequences of immigration policy (social dislocation and economic marginalization) warrant corresponding interventions that address social, economic, and political dimensions of vulnerability. Recommended interventions include (1) social and economic support for deportees in border communities; (2) HIV testing, information, and condom provision to deportees; (3) peer education and condom promotion by jaladores (middlemen); and (4) safer sex interventions that address psychosocial factors and substance use among deportees. We argue that the health impacts of migration depend on the context of migration, with deportation posing a form of involuntary migration that exacerbates HIV vulnerability.
This analysis of prostitution and female sex workers in Germany presents only the knowledge gained from many years of professional experience and the facts derived from scientific studies, including their complexities and discrepancies. Presented are the results of different surveys helping to provide a more objective and nuanced basis for discussion about prostitution. Women must be able and allowed to decide themselves how to live their lives in compliance with the law. This also has to apply to decisions that others cannot or barely understand, such as when women decide to work in prostitution. Women are entitled to expect their decisions to be accepted and respected. To claim or imply that these decisions are never made freely is to oppose the call by all women for the right to autonomy.
Full report available here
Lisa Maher, Thomas Crewe Dixon, Pisith Phlong, Julie Mooney-Somers, Ellen S. Stein, Kimberly Page: “Conflicting Rights: How the Prohibition of Human Trafficking and Sexual Exploitation Infringes the Right to Health of Female Sex Workers in Phnom Penh, Cambodia.” Health and Human Rights Journal. Accessed June 12, 2015.
While repressive laws and policies in relation to sex work have the potential to undermine HIV prevention efforts, empirical research on their interface has been lacking. In 2008, Cambodia introduced anti-trafficking legislation ostensibly designed to suppress human trafficking and sexual exploitation. Based on empirical research with female sex workers, this article examines the impact of the new law on vulnerability to HIV and other adverse health outcomes. Following the introduction of the law, sex workers reported being displaced to streets and guesthouses, impacting their ability to negotiate safe sex and increasing exposure to violence. Disruption of peer networks and associated mobility also reduced access to outreach, condoms, and health care. Our results are consistent with a growing body of research which associates the violation of sex workers’ human rights with adverse public health outcomes. Despite the successes of the last decade, Cambodia’s AIDS epidemic remains volatile and the current legal environment has the potential to undermine prevention efforts by promoting stigma and discrimination, impeding prevention uptake and coverage, and increasing infections. Legal and policy responses which seek to protect the rights of the sexually exploited should not infringe the right to health of sex workers.
Full article available here.
Jump to section
Sex workers in Bangladesh: polluted identities
From ‘prostitution’ to ‘sex work’: the sex worker movement and feminist discourse
HIV programmes in Bangladesh: sex workers as a ‘key population’ at heightened risk
From ‘victims’ to ‘vectors’: HIV and sex worker organisations
- 1. ActionAid Bangladesh. 2013. “Improving the Living Conditions of Children of Sex Workers.” ActionAid Bangladesh, Accessed January 13, 2013, http://www.actionaid.org/sites/files/actionaid/children_of_sex_workers.pdf.
- 2. Ahmed, A.2011. “Feminism, Power, and Sex Work in the Context of HIV/AIDS: Consequences for Women’s Health.” Harvard Journal of Law and Gender34: 225–258.
- 3. Amanullah, A. S. M., and M. N.Huda. 2012. “Commercial Sex and Vulnerability of HIV Infection: A Study on the Children of Sex Workers in Tangail Brothel.” In Sex Workers and Their Children in Bangladesh: Addressing Risks and Vulnerabilities, edited by D. M.Sabet, T.Rahman, and S.Ahmad, 82–106. Dhaka: University of Liberal Arts Bangladesh’s Center for Sustainable Development and ActionAid Bangladesh.
- 4. Anderson, S. A.2002. “Prostitution and Sexual Autonomy: Making Sense of the Prohibition of Prostitution.” Ethics112 (4): 748–780. [CrossRef], [Web of Science ®], [CSA]
- 5. Ara, Z.2005. “Violation & Denial of Access to Health Rights for Women Involved in Commercial Sex Work in Bangladesh.” Women’s Health & Urban Life4 (1): 6–26.
- 6. Azim, F.2005. “Feminist Struggles in Bangladesh.” Feminist Review80 (1): 194–197. [CrossRef]
- 7. Azim, F.2011. “Sexuality and the Women’s Movement in Bangladesh.” In Count Me In! Conference. Kathmandu: CREA.
- 8. Azim, F.2012. “Keeping Sexuality on the Agenda: The Sex Workers’ Movement in Bangladesh.” In South Asian Feminisms, edited by A.Loomba and R. A.Lukose, 267–284. London: Duke University Press. [CrossRef]
- 9. Bell, S.1994. Reading, Writing, and Rewriting the Prostitute Body. Bloomington: Indiana University Press.
- 10. Caldwell, B. B., I. I.Pieris, J. J.Barkat-e-Khuda, and P. P.Caldwell. 1999. “Sexual Regimes and Sexual Networking: The Risk of an HIV/AIDS Epidemic in Bangladesh.” Social Science & Medicine48 (8): 1103–1116. [CrossRef], [PubMed], [Web of Science ®], [CSA]
- 11. Carpenter, B. J.2000. Re-thinking Prostitution: Feminism, Sex and the Self. 6 vols. New York, NY: Peter Lang.
- 12. Choi, S. Y. P., and H.Eleanor. 2007. “The Influence of Power, Poverty and Agency in the Negotiation of Condom Use for Female Sex Workers in Mainland China.” Culture, Health & Sexuality9 (5): 489–503. [Taylor & Francis Online], [PubMed], [Web of Science ®]
- 13. Chowdhury, R.2006. “‘Outsiders’ and Identity Reconstruction in the Sex Workers Movement in Bangladesh.” Sociological Spectrum26 (3): 335–357. [Taylor & Francis Online], [Web of Science ®]
- 14. Chowdhury, N.2010. Of Mangroves and Monsters: Women’s Political Participation and Women’s Studies in Bangladesh. Dhaka: Pathak Shamabesh.
- 15. Chowdhury, M., and S.Gulrukh. 2000. AIDS o Jounota niye Discourse: Rogir Prantikota [Discourses on AIDS and Sexuality: The Marginality of AIDS Patients]. Dhaka: Rupantor Prokashona.
- 16. Crago, A.2008. Our Lives Matter Sex Workers Unite for Health and Rights. New York, NY: Open Society Institute.
- 17. Douglas, M.2003. Purity and Danger: An Analysis of Concepts of Pollution and Taboo. New York, NY: Routledge. [CrossRef]
- 18. Ghosh, S.2005. “Surveillance in Decolonized Social Space: The Case of Sex Workers in Bengal.” Social Text8323(2): 55–69.[CrossRef]
- 19. Guhathakurata, M., and S.Begum. 2005. “Bangladesh: Displaced and Dispossessed.” In Internal Displacement in South Asia: The Relevance of the UN’s Guiding Principles, edited by P.Banerjee, S. B. R.Chaudhury, and S. K.Das. New Delhi: Sage Publications.
- 20. Hossin, M. Z.2012. “Steroid Use, Sexual Risk and Violence among Brothel-based Female Sex Workers in Daulatdia, Bangladesh.” In Sex Workers and Their Children in Bangladesh: Addressing Risks and Vulnerabilities, edited by D. M.Sabet, T.Rahman, and S.Ahmad, 82–106. Dhaka: University of Liberal Arts Bangladesh’s Center for Sustainable Development and ActionAid Bangladesh.
- 21. Huq, S.2003. “Bodies as Sites of Struggle: Naripokkho and the Movement for Women’s Rights in Bangladesh.” The Bangladesh Development Studies29 (3&4): 47–95.
- 22. Huq, S.2006. “Sex Workers’ Struggles in Bangladesh: Learning for the Women’s Movement.” IDS Bulletin37 (5): 134–137.[CrossRef], [Web of Science ®]
- 23. Huq, S.2008. “Confronting Our Prejudices: Women’s Movement Experiences in Bangladesh.” In Development with a Body: Sexuality, Human Rights and Development, edited by A.Cornwall, S.Corrêa, and S.Jolly. London: Zed Books.
- 24. Huq, S.2012. “My Body, My Life, Whose Rights ? – Bangladeshi Women’s Struggle for a Fair Deal.” Contemporary South Asia20 (1): 11–18. [Taylor & Francis Online]
- 25. Ibrahim, N.1994. Ami Birangona Bolchi [I, the War Heroine, am Speaking]. Dhaka: Jagriti Prokashoni.
- 26. Joint United Nations Programme on HIV/AIDS (UNAIDS). 2012. UNAIDS Guidance Note on HIV and Sex Work. Geneva: UNAIDS.
- 27. Joint United Nations Programme on HIV/AIDS (UNAIDS). n.d. “HIV Estimates with Uncertainty Bounds 1990–2012.” Accessed April 30, 2014, http://www.unaids.org/en/dataanalysis/knowyourepidemic/epidemiologypublications/.
- 28. Khan, M. I.2010. “Is Trafficking Main Direct Pushing Factor for Engaging in Sex Trade: A Study at Kandapara Brothel Tangail, Bangladesh.” The Social Sciences5 (4): 305–311. [CrossRef]
- 29. Khan, Z. R., and H. K. S.Arefeen. 1989. Potita Nari: A Study of Prostitution in Bangladesh. Dhaka: Centre for Social Studies.
- 30. Kole, S. K.2009. “From ‘Veshyas’ to ‘Entertainment Workers’: Evolving Discourses of Bodies, Rights, and Prostitution in India.” Asian Politics & Policy1 (2): 255–281. [CrossRef]
- 31. Kotiswaran, P.2011. Dangerous Sex, Invisible Labor: Sex Work and the Law in India. Princeton: Princeton University Press.[CrossRef]
- 32. Lozano, S. M. C.2010. Theoretical Reading on ‘Trafficking’ in Women for the Purpose of Sexual Exploitation in Prostitution. Case of Study: Colombia. Budapest: Department of Gender Studies, Central European University.
- 33. Ministry of Health and Family Welfare. 1996. National Policy on HIV/AIDS and STD Related Issues (Final Draft). Dhaka: Government of Bangladesh.
- 34. Mookherjee, N.2006. “‘Remembering to Forget’: Public Secrecy and Memory of Sexual Violence in the Bangladesh War of 1971.” Journal of the Royal Anthropological Institute12 (2): 433–450. [CrossRef], [Web of Science ®]
- 35. National AIDS/STD Programme (NASP). 2011. National HIV Serological Surveillance, 2011 Bangladesh 9th Round Technical Report. Dhaka: National AIDS/STD Programme.
- 36. National AIDS/STD Programme (NASP). n.d.3rd National Strategic Plan for HIV and AIDS Response (2011–2015), Ministry of Health and Family Welfare, Accessed November 12, 2014,http://www.aidsdatahub.org/sites/default/files/documents/3rd_national_strategic_plan_for_hiv_and_aids_response_(NSP)_2011_2015.pdf.
- 37. Pheterson, G.1993. “The Whore Stigma: Female Dishonor and Male Unworthiness.” Social Text, no. 37: 39–64. [CrossRef]
- 38. Rozario, S.1992. Purity and Communal Boundaries: Women and Social Change in a Bangladeshi Village. Sydney: Allen and Unwin.
- 39. Sacks, V.1996. “Women and AIDS: An Analysis of Media Misrepresentations.” Social Science & Medicine42 (1): 59–73.[CrossRef], [PubMed], [Web of Science ®], [CSA]
- 40. Sanders, T.2007. “Sexuality and Risk.” In Beyond the Risk Society: Critical Reflections on Risk and Human Security, edited by G.Mythen and S.Walklate, 96–113. New York, NY: McGraw-Hill.
- 41. Scott, J. G.2003. “Competition Paper. Prostitution and Public Health in New South Wales.” Culture, Health & Sexuality5 (3): 277–293. [Taylor & Francis Online], [Web of Science ®]
- 42. Scott, J. G.2005. How Modern Governments Made Prostitution a Social Problem: Creating a Responsible Prostitute Population. Lewiston: Edwin Mellen Press.
- 43. Shukla, R.2010. Sex Work and Laws in South Asia: A Monograph. Maharashta: Center for Advocacy on Stigma and Marginalization (CASAM).
- 44. Spector, J.2006. Prostitution and Pornography: Philosophical Debate about the Sex Industry. Stanford: Stanford University Press.
- 45. Tahmina, Q.-A.2009. “Bangladesher Somaje Jounokormi: ‘Jibontare Kon Jibone Thui’ [Sex Workers in Bangladeshi Society: ‘Where to Place this Life]’.” In Bangladesher Nari O Samaj [Gender and Women’s Studies – 2], edited by S.Hossain and Masuduzzaman, 140–160. Dhaka: Mowla Brothers.
- 46. Tahmina, Q.-A., and S.Moral. 2000. Bangladeshe Jounota Bikri: Jiboner Dame Kena Jibika [Sex-workers in Bangladesh Livelihood: At What Price]. Dhaka: SEHD.
- 47. Talking About Reproductive and Sexual Health Issues (TARSHI). 2009. “The Woman Question.” In Plainspeak, Issue 2. Accessed November 12, 2014, http://www.tarshi.net/asiasrc/plspk/2009_2/interview.asp.
- 48. UCANEWS.COM. 1991. “Islamic Group Moves to Evict 8000 Prostitutes.” UCANEWS.COM, November 11, Accessed October 1, 2014, http://www.ucanews.com/story-archive/?post_name = /1991/11/11/ucan-feature-islamic-group-moves-to-evict-8000-prostitutes&post_id = 40164.
- 49. Uvin, P.2007. “From the Right to Development to the Rights-based Approach: How ‘Human Rights’ Entered Development.” Development in Practice17 (4–5): 597–606. [Taylor & Francis Online]
- 50. White, S. C.1992. Arguing with the Crocodile: Gender and Class in Bangladesh. Dhaka: University Press Limited.
© 2015 The Author(s). Published by Taylor & Francis.
This is an Open Access article. Non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly attributed, cited, and is not altered, transformed, or built upon in any way, is permitted. The moral rights of the named author(s) have been asserted.