Implementing Comprehensive HIV/STI Programmes with Sex Workers Implementing Comprehensive HIV/STI Programmes with | Page 45

2 Addressing Violence against Sex Workers This chapter provides practical suggestions for HIV programme managers on how to implement strategies that address violence. It builds on the 2012 Recommendations and the values and preferences survey,3 in which sex workers highlighted the role of violence, criminalization and other human-rights abuses in compromising their access to HIV and STI services. Box 2.1 Forms of violence faced by sex workers Physical violence: Being subjected to physical force which can potentially cause death, injury or harm. It includes, but is not limited to: having an object thrown at one, being slapped, pushed, shoved, hit with the fist or with something else that could hurt, being kicked, dragged, beaten up, choked, deliberately burnt, threatened with a weapon or having a weapon used against one (e.g. gun, knife or other weapon). These acts are operationally defined and validated in WHO survey methods on violence against women. Other acts that could be included in a definition of physical violence are: biting, shaking, poking, hair-pulling and physically restraining a person. Sexual violence: Rape, gang rape (i.e. by more than one person), sexual harassment, being physically forced or psychologically intimidated to engage in sex or subjected to sex acts against one’s will (e.g. undesired touching, oral, anal or vaginal penetration with penis or with an object) or that one finds degrading or humiliating. Emotional or psychological violence: Includes, but is not limited to, being insulted (e.g. called derogatory names) or made to feel bad about oneself; being humiliated or belittled in front of other people; being threatened with loss of custody of one’s children; being confined or isolated from family or friends; being threatened with harm to oneself or someone one cares about; repeated shouting, inducing fear through intimidating words or gestures; controlling behaviour; and the destruction of possessions. Human-rights violations that should be considered in conjunction with violence against sex workers are: • having money extorted • being denied or refused food or other basic necessities • being refused or cheated of salary, payment or money that is due to the person • being forced to consume drugs or alcohol • being arbitrarily stopped, su bjected to invasive body searches or detained by police • being arbitrarily detained or incarcerated in police stations, detention centres and rehabilitation centres without due process • being arrested or threatened with arrest for carrying condoms • being refused or denied health-care services • being subjected to coercive health procedures such as forced STI and HIV testing, sterilization, abortions • being publicly shamed or degraded (e.g. stripped, chained, spat upon, put behind bars) • being deprived of sleep by force. 3 A global consultation conducted with sex workers by NSWP as part of the process of developing the 2012 Recommendations. 23