Protecting the health of sex workers: will the real agenda please stand up

Interest in the health of women selling sex began in earnest towards the end of the 20th century with the advent of HIV. Although heterosexual transmission of HIV failed to reach the magnitude of problem that industrialised countries initially feared, research funded to assess HIV risk in sex workers revealed the significant risks to health experienced by this group. This set the scene for the now substantial body of research highlighting the extremely poor health and barriers to healthcare access experienced by many sex workers. Increased awareness of these unmet health needs has led to pressure on governments and authorities to improve conditions and healthcare for these women. Response to this pressure has been variable, but the focus has tended to be on the law rather than healthcare. Many governments maintain that their focus on prostitution is to promote the well-being of the women involved. However, much of their effort is actually invested in attempts to enforce a reduction in the numbers of women selling sex at the expense of safety and health. This fails to take account of the fact that good healthcare services are likely to have the greatest potential for reducing the numbers of women in prostitution. As life options are limited by poor physical and/or mental health, maintaining good health is central to ensuring that women are able to exit prostitution when they consider it their best option. Women selling sex often fall into multiple groups …