Happy Halloween, everyone. This month I’ll be addressing stigma and sex workers. Sex workers can be of all genders, sexual orientations, races, and any sex. They face so many challenges created by people’s negative opinions of their professions, HIV stigma, police brutality, etc. We need to address these issues in our community as a whole to decrease discrimination, stigma, and HIV acquisitions.
According to the CDC (2016), sex workers are “people who exchange sex for money or nonmonetary items” and are at increased risk of acquiring or transmitting HIV and other STIs because they are more likely to engage in risky sexual practices and substance use.
So what are some factors that keep sex workers at risk for acquiring HIV/STIs?
In a 2008 report, “Move Along: Policing Sex Work in Washington, D.C.,” by the Alliance for a Safe & Diverse DC, thirty-eight percent of the participants in the survey reported abuse (both verbal and physical) from police. Seventy-five percent of transgender and 82.4 percent of Latinx sex workers reported that their treatment while in jail was worse than others that were in jail with them. How can sex workers rely on help from the police when they are constantly being abused by the very ones who are supposed to be protecting them? Also, after being abused by police, 8.6 percent of the survey participants said that the police took or destroyed their safer sex supplies.
People often discriminate against sex workers because of the negative perception that sex workers are disposable. This is not true. We have to start looking at sex workers as members of our society who deserve the right to be known and counted. Consider supporting organizations that advocate for sex workers, especially those run by sex workers.
Access to PrEP
Pre-exposure prophylaxis (PrEP) is an opportunity for sex workers to protect themselves against HIV infection. Luckily, according to the Global Advocacy for HIV Prevention, the drug Truvada, which is the medication used in the only PrEP regimen currently in use, is available through most private insurance and Medicaid. Gilead Sciences, which makes Truvada, also has two programs that can help you pay for PrEP (Medication Assistance Program and Gilead Advancing Access program). But how can someone pay for or even have access to PrEP when their very livelihood is contantly being attacked and there is no information available to properly advise sex workers of the benefits of this relatively new prevention tool? We must do more to ensure access to PrEP (and PEP).
Male Sex Workers
As we know, men who have sex with men (MSM) are in one of the highest risk demographics to acquire HIV. In a 2015 study by Amanja Verhaegh-Haasnoot et al., in a group of 212 male participants who identified as male sex workers, forty percent tested positive for HIV/STIs. Fourteen percent of the 801 female sex workers who participated in the same study also tested positive for HIV/STIs. Male sex workers also reported having fewer clients in the same study. Knowing this fact, it is very possible that fewer clients means the male sex workers were more apt to have raw sex because the client will give them more money.
Sex work is one of the oldest professions in our nation, and luckily technology has allowed sex work to go mainstream and, in some ways, legally. It is not up to us to judge anyone for the work they do. The more judgment you give, the more you should feel ashamed…not them.
Justin B. Terry-Smith, MPH, DrPH, has been fighting the good fight since 1999. He’s garnered recognition and awards for his work, but he’s more concerned about looking for new ways to transform society for the better than resting on his laurels. He started up in gay rights and HIV activism in 2005, published an HIV-themed children’s book, I Have A Secret (Creative House Press) in 2011, and created his own award-winning video blog called, “Justin’s HIV Journal”: justinshivjournal.blogspot.com. Visit his main Web site at www.justinbsmith.com. He welcomes your questions at [email protected].