The situation

Criminalisation, legal oppression, stigma, discrimination and violence experienced by sex workers in Europe and Central Asia increase the vulnerability of sex workers to HIV, sexually transmitted infections (STIs) and other health risks such as mental health issues. Legal barriers and stigma effectively drive sex workers underground, away from medical facilities and other health care services. This also hinders the collection of reliable data on sexual and reproductive health issues faced by people selling sexual services and makes it difficult to present a clear picture of sex workers’ vulnerabilities to HIV and other STIs in the European region. 

Available data shows, however, that sex workers in Europe and Central Asia are much more affected by HIV and STIs than the general population, while the HIV/STI prevalence among sex workers varies significantly depending on the country and sub-region of Europe. 

The increased vulnerabilities of sex workers to HIV and STIs are often overshadowed by stigmatising perceptions of sex work and those involved, casting sex workers as vectors of disease and responsible for transmission. This view of sex workers presented in regional, national and local discussions from politically and ideologically motivated and further propel stigma experienced by people working in the sex industry and have often driven the surge of discriminatory and rights-violating policies and programmes, including mandatory testing and forced registration. 

The COVID-19 pandemic has exacerbated the challenge. NGOs that have previously been able to support vulnerable populations have faced increasingly stretched resources and legal restrictions impeding their capacity. As their services have not been able to reach some people, those individuals have experienced greater isolation, vulnerability and risks to their physical and mental wellbeing.

Our objectives

Sex workers enjoy improved access to health care that is responsive to and meets their specific needs and improves health outcomes, both physical and mental, for all sex worker communities.

  • Sex workers, including those who are migrants, enjoy access to inclusive, accessible health services, that are responsive to their needs and without the threat of punitive repercussions.
  • Health inequalities experienced by sex workers are reduced and health outcomes improved, particularly in the areas of HIV, sexual, reproductive and mental health.
  • Sex workers are engaged with, inform and are protected by public health responses without discrimination.

Our current activities

In regards to health ESWA has been concentrating efforts on developing resources and improving the capacities of sex worker-led organisations around the prevention and treatment of HIV and STI’s and has recently started tackling the issue of mental health within the community.

Engagement with European institutions and partnerships:

ESWA is a member of:

Mental health programme

In 2021, ESWA implemented its first programme to support the mental health of sex workers and advocate for the inclusion of sex workers in mental health services. The programme was designed to offer tools on how to prevent and address mental health crises in the community while developing a briefing paper exploring the issues related to access to mental health care for sex workers. 

The capacity building part of the programme included:

5 thematic session webinars open to all ESWA members: presentations and discussions on thematics such as sexual violence, anxiety, addiction, suicide, wellbeing

7 support sessions in a closed group of LGBTQI sex workers’ rights activists 

The resources include a briefing paper as well as a small ‘organisation tool kit’. The briefing paper is developed through an e-consultation with all ESWA members, focus groups and case studies on community-led projects in Europe and Central Asia. In parallel, an awareness campaign is being developed showcasing sex workers as part of the support sessions through illustrations and testimonies (illustrations by Ambrose).

Click Here to Download the Briefing Paper on Sex Work and Mental Health

Click Here to Download the Toolkit on Supporting Sex Workers' Mental Health and Wellbeing 


e-MPOWER - Partnership to Overcome Challenges of Online Learning and to Empower Youth Actors in the Field of Sexual Health Promotion in the COVID-19 Era

With funding from Erasmus+ and in partnership with EATG and LEGEBITRA (Slovenia), ESWA has proudly collaborated to develop eMPOWER.

eMPOWER has been specifically designed to combat the additional challenges posed by the COVID-19 pandemic. With NGO capacity impacted by limited resources and legal restrictions, eMPOWER aims to increase the capacity of young advocates and activists working or volunteering in healthcare to help meet the needs of the sex worker community. Recognising the need for such training to be provided in remote, rather than in-person, settings, eMPOWER aims to meet the challenges and provide tools for effective online learning.

The project, running until September 2022, will:

  • Adapt training activity for young advocates/activists previously offered by sexual health orgs so that it can be online
  • Focus on mental health - particularly the impact of structural issues such as criminalisation and stigma - and offer tools to the community to deal with mental health issues
  • Focus on sexual health - meeting the specific needs of the sex worker community, as well as those who may be living with HIV or a member of the LGBTQ+ community, and understanding how criminalisation and stigma interacts with these needs
  • Provide knowledge of online safety and digital rights - such as data protection, privacy issues and censorship - which can be relevant to young stigmatised or criminalised populations
  • Provide the means to exchange knowledge and best practices through an online platform providing a clear and implementable model of training that can be accessed by other organisations and advocates with a focus on sexual health

ESWA envisions the following outcomes from the eMPOWER project:

  • Needs assessment and research to inform the design of future activities 
  • Written recommendations based on the above
  • Monitoring and evaluation framework of trainees to assess the impact of training activities
  • Wellbeing guide for trainees
  • Youth activist training materials online toolbox that will be freely accessible
  • Presentation of the project outcomes via a public webinar, recorded and shared online via project partner social media platforms 
  • Pilot training to test the programme and materials

Lead: Jules

[email protected]


 EU_erasmus.png e-MPOWER is co-funded by the Erasmus+ Programme (Grant No 008320)