That’s the call from the scientists at this year’s International AIDS Conference in Melbourne, Australia:
According to new research — a series of seven studies recently published in the Lancet medical journal — scientists estimate that HIV infection rates among sex workers could be reduced by between 33 and 46 percent if the activity were not illegal.
“Governments and policymakers can no longer ignore the evidence,” asserted Kate Shannon, an associate professor of medicine at the University of British Columbia and the lead author of the study. The research, conducted in Kenya, India, and Canada, found that high rates of violence against sex workers, police harassment, and poor working conditions — all circumstances exacerbated by sex work’s illegal status — combined with lack of access to HIV prevention and care significantly increased the risk of infection among sex workers. According to recent data from the World Health Organization, female sex workers are 14 times as likely to have HIV as other women, yet fear of arrest and stigma often prevents them from seeking medical care. (A Kenyan woman quoted in the study added that when doctors at the health center she visited realized she was a sex worker, she was denied treatment.)
In a report issued earlier this month on how to combat HIV transmission in high-risk populations, the World Health Organization said the same:
What unites these groups is that their activities are either illegal or heavily stigmatized in many parts of the world. That means that they are unlikely to seek out medical help or advice simply because they don’t want to be arrested for being gay or having sex for money. In the case of adolescents, many live in countries where they need parental permission to get birth control or medical care. So they, too, must hide their activities from doctors to avoid being “turned in” to their parents.
When you have populations of people who fear that a trip to the doctor may land them in jail, it makes sense that those populations won’t follow medical guidelines about safer sex or clean needles. Either they don’t know how to reduce their risks; or if they do, they don’t have have access to materials that would allow them to have sex or inject drugs safely. And that’s why the WHO is calling for all countries to decriminalize the behaviors and identities of all these groups so that they can get the health care they need.
Samuel Oakford focuses on the difference between decriminalization and legalization:
Though countries like the Netherlands and Germany have legalized sex work in defined contexts, and nations like Denmark have decriminalized it in certain circumstances (soliciting on the street is still illegal), the only two places in the world to have fully decriminalized it are New Zealand the Australian state of New South Wales. The distinction is important — decriminalization removes all “prostitution-specific regulations imposed by the state,” while legalization introduces new laws and regulations that are less punitive. In the latter framework, sex workers without proper permits or access are still forced to work underground.
“Legalization actually replicates some of the same problems that criminalization does,” [Steffanie Strathdee, director of the University of California at San Diego’s Global Health Initiative and the author of one of the studies,] said. “The perspective is about taxes and control and not about human rights. Even in legalized environments there are police crackdowns.” Countering a common concern voiced against reform, the number of sex workers in New Zealand hasn’t changed significantly since the profession was decriminalized in 2003. In New South Wales, which decriminalized sex work in 2009, sex workers actually have a lower prevalence of HIV than in the rest of the country.
The Dish 