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. 

Our objectives

Sex workers enjoy improved access to health care that is responsive to and meets their specific needs and improves health outcomes 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

ESWA is currently implementing 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 is 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 includes:

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).


Related to HIV and sexual health ESWA, EATG and LEGEBITRA (Slovenia) have joined efforts to develop eMPOWER, a programme to overcome the challenges of online learning and empower youth actors in the field of sexual health promotion in the COVID-19 era. This project runs until September 2022. During the pandemic, it appeared more and more clearly that mental health and especially access to mental health care is an important issue within the sex worker community. While dismantling the idea used by abolitionists that sex work and mental health issues are systematically related, ESWA wants to look at the impact o structural issues on mental health such as criminalisation and offer tools to the community to deal with mental health issues.

Lead: Jules

[email protected]