Let’s Talk About Sex Work
Spurred on by the #MeToo movement, many of us are actively engaging in conversations regarding consent, a woman’s right to her own body, the definition of harassment, and the social systems that have allowed for violations against women to occur for so long. These conversations have always been happening, but they are finally becoming difficult to ignore for those who have gone widely unaffected. However, as powerful as the #MeToo movement has been, only certain populations of women have the privileges that allow them to come out as victims or survivors and seek support when they need it. Yet the populations that are most vulnerable — including commercial sex workers — also continue to be left out of the conversation and efforts to provide protection.
Sex workers are by far one of the most neglected populations when it comes to the conversation about who is affected by sexual violence — when we read articles, scroll through our social media feeds, and listen to news, we rarely hear or read about how disproportionately sex workers are affected by sexual harassment or violence.
And I know that as I write this, some people are likely thinking: That is the nature of their work. How can you be raped if you’re a “prostitute”? Of course they are more affected. These women choose to do this work; they know what they’re signing up for. Why should we protect women who are doing “immoral” and/or illegal work?
Unfortunately, I’ve heard and read this argument too many times, and it is incredibly dangerous. No matter your personal views and “morals” regarding sex and sexuality, how one chooses to use their body is an individual choice. As long as you are not harming someone else, no one has a right to comment or infringe upon this right. Health is a human right and everyone deserves comprehensive, equitable health services, without fear of stigma, judgment, or repercussions.
“Health is a human right and everyone deserves comprehensive, equitable health services, without fear of stigma, judgment, or repercussions.”
If the concept of sex work does not align with your personal values, I say fine — don’t get involved in sex work. Working in the Electronic Dance Music industry sounds like my personal nightmare because there is little I dislike more than large crowds of sweaty people screaming “I LOVE YOU” to one another and telling strangers their most intimate secrets. However that does not mean I believe that anyone involved in the industry should have their rights stripped away from them, or that they are any less worthy of comprehensive medical, spiritual, and mental health services.
I think about the human rights of sex workers a lot in the context of my current work as a Global Health Corps fellow in Kasese, Uganda. Kasese District is located on the border of the Democratic Republic of the Congo, and has a tumultuous history of tribal conflict, rebel groups, and political violence sparked by pre-colonial disputes over resources and disruptive colonial-era eviction and displacement of peoples and tribes. The poverty level in Kasese District is around 48%, compared to the national average of about 19%. In other words, life is not easy for a lot of people in Kasese. High levels of poverty, low education rates, and the proximity to the DRC border are some of the few factors that drive commercial sex work in the area, particularly in the border town of Bwera. And like they are in most places in the world, sex workers here are a highly stigmatized and vulnerable population.
My placement organization works with local community-based organizations and nongovernmental organizations in Kasese and Rukungiri Districts, providing hands-on technical training to build the capacity of these organizations to better serve their communities. Our partners work at the grassroots level with some of the most marginalized communities throughout these districts. One of our partners, Youth Partnership Uganda (YPU), is a youth-serving, human rights advocacy organization that is trying to change the conversation around sexual and reproductive health in Bwera, and one of their programs is specifically designed to reach sex workers.
“Without these services that go the extra mile to ensure all communities are being accommodated, social stigma would continue to stand in the way of health equity.”
Stigma prevents many commercial sex workers from seeking HIV testing and counseling services, even though they comprise one of the populations most susceptible to infection. After receiving training on how to conduct a needs assessment, the program staff of YPU recognized that current outreach efforts were not working — sex workers were not coming for testing. Fear of violence, judgment, and community isolation kept them away. And thus, the moonlight testing program was born — setting up outreach camps in the late evening and into the night where commercial sex workers could come receive testing, counseling, and services without fear of judgment from the community. YPU outreach workers go into the communities the day before a moonlight outreach and spread the word within areas where commercial sex work is common. The next evening, people gather to receive services.
Since the YPU team began HIV outreach in May, they have tested over 2,800 individuals, and provided counseling and treatment to the over 70 who have tested positively. If these outreaches did not exist, where would these almost 3,000 individuals be going for testing? How would the 70+ HIV-positive patients find out their status, and how would they receive counseling on how to move forward? Without these services that go the extra mile to ensure all communities are being accommodated, social stigma would continue to stand in the way of health equity.
Globally, sex workers have between a 45% to 75% chance of experiencing sexual violence at one point in their careers, and a 32% to 55% chance of experiencing sexual violence over the course of one year — though this number is likely a lot higher as data is unreliable because of inconsistent reporting. When the Migrant Sex Workers Project conducted a survey of migrant sex workers in Toronto, 100% reported they would not call the police if they experienced violence. Stigma against sex workers means that for most women involved in sex work, there are little to no protections or services available when they are subjected to sexual or other forms of violence. All over the world, there are barriers that prevent sex workers from reporting violence — including vulnerability to police violence, fear of arrest, and fear of other social repercussions, like eviction.
Violence against sex workers has repercussions beyond just the violence itself. Violence against sex workers destabilizes a woman’s ability to use condoms and to choose her sex partners, which means heightened vulnerability to unintended pregnancies, increased psychosocial instability, and HIV/AIDS (sex workers are 10 times more likely to be infected with HIV). All of these repercussions often perpetuate a cycle of poverty.
Ideally, we should not have to be offering midnight testing. Sex workers should feel free and safe to move and receive health services at whatever time of day they prefer, without judgment or fear of repercussions. Until that happens, I am grateful for the brave individuals like the staff of YPU who are willing to look past the stigma to ensure that everyone is receiving their services.
The criminalization and bashing of sex work is not working. Sex work is a huge industry and it’s not going away. Instead of policing and shaming people for what they choose to do with their bodies, making them more vulnerable than they already are, we should be offering protections, providing services, and making sure that whatever someone chooses to do with their body and career, they are given equitable access to services. We absolutely need to change the conversation around sex workers, because when we talk about sex work, there is so much more to talk about than morality. When we talk about sex work, we have to realize that we’re talking about human rights, health equity, and an individual’s right to feel safe in their own body.
Isabelle Charles is a 2017–2018 Global Health Corps fellow at the Foundation for Community Development and Empowerment.
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