Implementing Comprehensive HIV/STI Programmes with Sex Workers Implementing Comprehensive HIV/STI Programmes with | Page 44

2 Addressing Violence against Sex Workers

2.1 Introduction
2012 Recommendations:1 Good-practice Recommendations

Female, male and transgender sex workers face high levels of violence, stigma, discrimination and
other human-rights violations. Violence against sex workers is associated with inconsistent condom
use or lack of condom use, and with increased risk of STI and HIV infection. Violence also prevents
sex workers from accessing HIV information and services.
Violence is defined by the World Health Organization (WHO) as the intentional use of physical force
or power, threatened or actual, against oneself, another person, or against a group or community
that results or has a high likelihood of resulting in injury, death, sexual or psychological harm, maldevelopment or deprivation of liberty (see also Box 2.1).
Male, female and transgender sex workers may face violence because of the stigma associated with
sex work, which in most settings is criminalized, or due to discrimination based on gender, race, HIV
status, drug use or other factors. Most violence against sex workers is a manifestation of gender
inequality and discrimination directed at women, or at men and transgender individuals who do not
conform to gender and heterosexual norms, either because of their feminine appearance or the way
they express their sexuality.
Modelling estimates in two different epidemic contexts (Kenya and Ukraine) show that a reduction of
approximately 25% in HIV infections among sex workers may be achieved when physical or sexual
violence is reduced.2 More HIV prevention programmes are implementing strategies to address
violence against sex workers and protect their human rights as an integral part of HIV prevention,
treatment and care. Addressing violence can make it easier for sex workers to access services and
make their own choices about their long-term health and welfare.

1 Prevention and treatment of HIV and other sexually transmitted infections for sex workers in low- and middle-income countries: recommendations for a public health approach.
WHO, UNFPA, UNAIDS, NSWP, 2012.
2 See Decker et al (Section 2.4, Further reading No. 3).

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