Abstract
AbstractAll individuals, including sex workers, are entitled to the full spectrum of sexual and reproductive health (SRH) and rights. Yet sex workers continue to bear significant SRH inequities and unmet needs for appropriate SRH services at every step along their sexual and reproductive lives. To illustrate the complex and nuanced barriers that currently impede sex workers’ access to SRH services, this chapter describes the current gaps in access to SRH services experienced by sex workers globally, drawing on in-depth interviews and focus group discussions with 171 sex workers and sex worker organisations from across ten countries. Interviews highlight the lack of tailored, comprehensive, and integrated SRH services. These gaps are driven by intersecting structural forces such as: the criminalisation of sex work, same-sex relationships, and gender non-conformance; harmful and coercive SRH policies; sex work and gender-based stigma; and logistical and practical barriers. To support the SRH needs and rights of sex workers, participants recommended improved access to comprehensive, integrated services addressing sex workers’ broader SRH needs, including family planning, abortion and pregnancy needs, SRH screening, hormone therapy, and other gender-affirming services. Crucial steps towards ensuring equitable SRH access for sex workers include addressing stigma and discrimination within healthcare settings, removal of coercive SRH policies and practices, and dedicating appropriate resources towards sex worker-led SRH models within the context of decriminalisation of sex work.
Highlights
The highest attainable standard of sexual and reproductive health (SRH) is a fundamental human right [1–4], affirmed through numerous international and national laws and mandates including the Universal Declaration of Human Rights [5], the International Conference on Population and Development [6], and the Convention on the Elimination of All Forms of Discrimination against Women [1]
Data SourceMuch of the information, including the methods and results contained in this chapter, were based on the Global Network of Sex Work Projects’ Briefing paper, entitled “Sex Workers’ Access to Comprehensive Sexual and Reproductive Health Services” available at: https://www. nswp.org/sites/nswp.org/files/bp_sws_access_to_comp_srh_-_nswp_2018.pdf
Sex workers experience a multitude of overlapping structural barriers that impede their fundamental SRH rights, including access to SRH care
Summary
The highest attainable standard of sexual and reproductive health (SRH) is a fundamental human right [1–4], affirmed through numerous international and national laws and mandates including the Universal Declaration of Human Rights [5], the International Conference on Population and Development [6], and the Convention on the Elimination of All Forms of Discrimination against Women [1]. Sexual and reproductive rights recognise the basic rights of all individuals to access information, SRH services, and the means and supports to make informed decisions about their SRH, including the spacing and timing of children [1]. Data SourceMuch of the information, including the methods and results contained in this chapter, were based on the Global Network of Sex Work Projects’ Briefing paper, entitled “Sex Workers’ Access to Comprehensive Sexual and Reproductive Health Services” available at: https://www.
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