Elsevier

The Lancet

Volume 385, Issue 9962, 3–9 January 2015, Pages 3-4
The Lancet

Comment
Bringing sex workers to the centre of the HIV response

https://doi.org/10.1016/S0140-6736(14)61064-3Get rights and content

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    Female sex workers across the world are at high risk for HIV infection. A recent systematic review conducted across 50 countries found that sex workers had an average HIV prevalence of 11.8%, and in countries with medium to high background HIV rates, this number was as high as 30% (Baral et al., 2012) Although there have been some successful interventions targeted at this population (Bekker et al., 2015; Das and Horton, 2015; Luchters et al., 2008; Manhart and Holmes, 2005), as Baral et al.’s (2012) review noted, much work is needed to scale up HIV prevention programs among this group. Conditional cash transfer programs have been used successfully in recent years in various social policy domains, including public health, to encourage behavior change (Gertler, 2004; Lagarde et al., 2007).

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    The most prominent theme extracted from the interviews was police intervention within the industry, where each interviewee expressed concern with the ‘policing’ of the industry. As sex work is criminalised police enforce laws and it is common for police to take advantage of their power (Donovan et al., 2010; Harcourt & Donovan, 2004; Godwin, 2012; Sanders & Campbell, 2014; Das & Horton, 2014; Abel et al., 2007; Scarlet Alliance, 2014; Decker et al., 2014; Ahmed et al., 2011; Mgbako et al., 2013; Scorgie et al., 2013; O'Doherty, 2011; ICRSE, 2015; Fick, 2006; The Lancet, 2014; WHO, 2012). Sex workers therefore become further marginalised because they look for ways to avoid detection, and are fearful of arrest.

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