Sex Work and HIV in Europe: An Overview

Sex Work and HIV in Europe: An Overview

In her fifth blog posts, ESWA Intern Hanna Nyman provides a comprehensive overview of Sex Work and HIV in Europe, an ESWA advocacy toolkit published in 2021 under its previous name of International Committee on the Rights of Sex Workers in Europe (ICRSE). 

Sex Work and HIV in Europe was born out of a programme developed in 2020 by ICRSE and the European AIDS Treatment Group (EATG) and funded by Gilead Science. The project, titled European Red Umbrella Academy: Sex Work and HIV Training Programme, aimed to strengthen the partnerships between HIV activists and sex workers and to increase their capacities to advocate for the inclusion of sex workers in public health and HIV responses.

Due to the COVID-19 pandemic the programme was adapted and included an online training for 24 sex workers and HIV activists, national level activities such as production of videos and campaigns, and development of a toolkit focused on sex work and HIV in Europe. The toolkit consists of four resources: a briefing paper, a technical paper, a case study of community-led services and community recommendations aimed at informing sex workers, HIV activists and policy makers and at affirming existing recommendations on sex work and HIV.

It was launched in 2021 through an online event hosted by ESWA together with the EU Civil Society Forum on HIV, Hepatitis and Tuberculosis and speakers included:

Opening words by Dr Tlaleng Mofokeng, UN Special Rapporteur on health
Emilie Christie, Senior Human Rights and Law Adviser, UNAIDS 
Lila Milikj, from STAR, sex worker collective in the Balkans
Lya Jawad, Trans United Europe, Netherlands
Giovanna Rincon, ACCEPTESS-T, France
Agata Dziuban, Sex Work Polska, Poland
Luca Stevenson, ICRSE
Stephen O'Hare, HIV Ireland
Facilitated by Jules James, ICRSE

         The first resource included in the toolkit is a briefing paper focused on the effect of repressive laws and policies on sex workers’ vulnerabilities to HIV. It discusses how criminalisation and other forms of repression sex workers face cause difficulties in collecting reliable data on sex work and HIV and how this lack of data in turn acts as a barrier for including sex workers in HIV responses and prioritising sex workers’ needs. Therefore, it is important that community-led organisations are included in data collection on HIV and sex work. Furthermore, criminalisation and legal oppression of sex work have negative implications for sex workers’ health and access to services. Punitive laws drive sex workers towards more precarious and isolating circumstances and increase the violence, abuse, stigma and discrimination that sex workers face. Consequently, sex workers experience an increased risk of acquiring HIV and limited access to health services. Importantly, the briefing paper highlights how the criminalisation and legal oppression of sex work and the conflation of it with human trafficking expose migrant sex workers to repressive policing and deportations and increase the marginalisation they experience.

         The second resource is a technical note focused on defining and summarising the principles of community-led services and meaningful participation. Community-led organisations, community empowerment and the meaningful participation of sex workers in HIV responses are critical to ending HIV. Therefore, this technical note explains what these processes involve, how they are measured and how they can be strengthened. 

         The third resource included in the toolkit is a case study of community-led services reporting on three ESWA members that are led by sex workers and provide services to their communities in Europe. The first is Umbrella Lane (now Numbrella Lane), which has developed successful ways of offering peer support and services to sex workers free of stigma throughout Scotland. The second is STAR-STAR, which as the first sex worker-led collective in the Balkans is implementing Macedonia’s national HIV programme and advocating for the meaningful participation of sex workers. The third and final organisation included is Sex Work Polska. This informal collective based in Poland provides sex workers with outreach, services and support rooted in radical empathy and unconditional compassion.

         The fourth and final resource included in the toolkit is a list of community recommendations aimed at national governments, the European Commission, European Union Agency for Fundamental Rights (FRA), European Center for Disease Prevention and Control (ECDC), funders, researchers as well as health authorities and service providers. These call for the decriminalisation of sex work among other recommendations involving the principles of meaningful participation and community leadership. When the message is this clear, it is time for European actors to listen and to implement evidence- and rights-based policies that meaningfully include sex workers.



Sex Work and HIV in Europe, International Committee on the Rights of Sex Workers in Europe. (2021).



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