Commercial Sex Workers

A sex worker is a person who is employed in the sex industry. The term is used in reference to all those in all areas of the sex industry including those who provide direct sexual services as well as the staff of such industries. Some sex workers are paid to engage in sex acts or sexually explicit behavior which involve varying degrees of physical contact with clients (prostitutes and some but not all professional dominants); pornography models and actors engage in sexually explicit behavior which are filmed or photographed. Phone sex operators have sexually-oriented conversations with clients, and do auditive sexual roleplay. Other sex workers are paid to engage in live sexual performance, such as web cam sex and performers in live sex shows. Some sex workers perform erotic dances and other acts for an audience (striptease, Go-Go dancing, lap dancing, Neo-burlesque, and peep shows). Sexual surrogates often engage in sexual activity as part of therapy with their clients.

Sex Work - Key Facts and Figures
• Over 75% of new HIV infections occur through sexual contact. Factors that increase the rate and efficiency of heterosexual HIV transmission include high rates of sexual partner change and the presence of other sexually transmitted infections (STIs).
• In many countries, sex workers are frequently exposed to HIV and other STIs. HIV prevalence as high as 60-90% are found in some places where sex workers have poor access to HIV prevention services.
• In commercial sex settings where condom use is inconsistent and access to effective STI treatment limited, half to two-thirds of women working as sex workers typically have a curable STI at any one time.
• Only 16% of sex workers are estimated to have access to HIV prevention services. Regardless of the region, poor access to services correlates with high STI and HIV prevalence.
• Early in epidemics, HIV and STI prevalence frequently rises rapidly among sex workers and their clients, especially where condom use is low and access to health care services poor. In the absence of effective interventions, clients transmit infection both to sex workers and to their regular partners, extending transmission into the general population.
• In the absence of effective interventions, high rates of transmission in commercial sex and drug injecting networks continue to drive HIV epidemics even after HIV has spread more widely in generalized epidemics.

Implementing comprehensive HIV/STI programmes with sex workers: practical approaches from collaborative interventions
This tool offers practical advice on implementing HIV and STI programmes for and with sex workers. It is based on the recommendations in the guidance document on Prevention and treatment of HIV and other sexually transmitted infections for sex workers in low- and middle-income countries published in 2012 by the World Health Organization, the United Nations Population Fund, the Joint United Nations Programme on HIV/AIDS and the Global Network of Sex Work Projects.
Topics covered in the tool include approaches and principles to building programmes that are led by the sex worker community such as community empowerment, addressing violence against sex workers, and community-led services; they include how to implement the recommended condom and lubricant programming, and other crucial health-care interventions for HIV prevention, treatment and care; and they include suggestions on how to manage programmes and build the capacity of sex worker organizations. The tool contains examples of good practice from around the world that may support efforts in planning programmes and services.
The tool is designed for use by public-health officials and managers of HIV and STI programmes; NGOs, including community and civil-society organizations; and health workers. It may also be of interest to international funding agencies, health policy-makers and advocates.