Top Medical Journal: Decriminalization of Sex Work Critical to Fight Against AIDS

The decriminalization of sex work is critical to tackling the global AIDS epidemic and protecting the health and human rights of this at-risk population, according to research published Tuesday in top medical journal Lancet.

The release coincides with the International Aids Conference taking place in Melbourne this week.

Summarizing the findings of a series of seven research papers on sex work, Lancet editors Pamela Das and Richard Horton argue there is “no alternative” to decriminalizing sex work “if we wish to reduce the environment of risk faced by women, men, and transgender people worldwide.”

Sex workers are at high risk of HIV infection, with cisgender women (women born female) and transgender women especially hard hit, the research finds. The crisis in the continent of Africa is particularly acute, with sub-Saharan African countries accounting for all of the nations where more than 50% of sex workers live with HIV.

Sex workers disproportionately face human rights violations, such as homicide and sexual and physical violence—including at the hands of police, the series finds. Discrimination, stigma, abuse, and criminalization force sex workers further underground and prevent them from receiving the care and prevention services they need. This leads to a health crisis among sex workers which spreads to the societies in which they live.


Yet, the new research shows that empowering and decriminalizing sex workers saves lives.

One paper in the series, presented Tuesday morning in Melbourne, finds that the decriminalization of sex work in Canada, India, Kenya, and other countries could reduce infection rates among sex workers by 33 to 46 percent.

Another article, based on a meta-analysis of low- and middle-income countries, finds that “community empowerment-based approaches to addressing HIV among sex workers were significantly associated with reductions in HIV and other sexually transmitted infections, and with increases in consistent condom use with all clients.”

Das and Horton ultimately raise the question, “[W]hy should we condemn and criminalize the exchange of money for sex, especially if the severely adverse conditions we create for such exchange hurt women and men and often fatally so?”

Their answer? “Sex work is part of the human story. Accepting and embracing sex work—supporting those engaged in sex work to protect their health and bodily integrity and autonomy—should be our humane, as well as our pragmatic, approach to the reality of our human lives.”


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