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Sex work on the rise in Jamaica
HIV and the Sex Trade

By Andrea Downer

WHY IS it important to target sex work settings with HIV prevention and care initiatives?

In many places, sex worker settings are characterized by high rates of partner change, low rates of condom use, unsafe sex and high rates of sexually transmitted infections, (STIs). Consequently, the risk of HIV infection is often high and the virus can quickly spread through sexual networks encompassing sex workers, clients, regular partners and associated lovers, spouses and children. Furthermore, some sex workers or clients may be involved in additional types of risky behaviour such as drug use by injection.

VULNERABILITY

In many places, underlying economic and socio-cultural factors cause vulnerability to HIV. These factors – which may operate indirectly – are related to the low status of women, lack of educational or economic opportunities, and local attitudes to sex and sexuality which create a market for sex work while simultaneously stigmatizing those involved in it.

In addition, the social and legal status of sex work can create situations in which sex workers have little control over the conditions in which they work, as well as present barriers to the use of health and welfare services. At the same time, the stigma and fear commonly associated with HIV contribute to a reluctance to come forward for HIV-related services.

COMPETITIVE AND ISOLATED

The internal structure of the sex industry may also increase vulnerability to HIV and hinder sex workers’ ability to protect themselves. Sex work can be competitive and isolated, making it difficult to maintain social or family links. Working conditions can be highly exploitative, leaving individual sex workers with limited power over their lives. Vulnerability is highest where sex workers are isolated from mainstream society and where they lack internal solidarity and their own social support networks. In such circumstances, the capacity for community action around health and other issues may be low.

Together, these various social, legal, interpersonal and epidemiological factors create the conditions in which HIV and STIs rapidly spread.

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