Chapter 1
Introduction
Since the beginning of the epidemic sex workers have experienced a heightened burden of HIV across settings, despite their higher levels of HIV protective behaviors (UNAIDS, 2009). Unfairly, sex workers have often been framed as “vectors of disease” and “core transmitters” rather than workers and human beings with rights in terms of HIV prevention and beyond. By gaining a deeper understanding of the epidemiologic and broader policy and social context within which sex work is set one begins to quickly gain a sense of the complex backdrop for increased risk to HIV among sex workers. This backdrop includes the critical role of stigma, discrimination and violence faced by sex workers, as well as, the importance of community empowerment and mobilization among sex workers to address these regressive forces. Unfortunately to date, sex workers’ HIV-related risks and human rights have often gone unattended and global resource allocation (Global Fund, 2011) and funding and investment recommendations related to HIV prevention, treatment and care have not been based on rigorous analysis in terms of the evidence specifically related to sex work (Schwartländer et al 2011). This analysis, in turn, seeks to inform a holistic and evidence-based response to HIV among sex workers in lower and middle income countries by responding to the following key questions:
1