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“The room has a bed made of concrete, a mattress, and that's it. And the same sheet stays there for the entire day, it's only changed the next morning. And the room is not used only by one girl, but by several. Some women come from the other bar, the one at the corner, that does not have rooms. Everything is dirty.” (WSW, Belize). “Yes, there are problems where I work. First of all, the establishment owner. She does not care about cleanliness. Often I go in with a client and find dirty rooms, stained sheets, used condoms, toilet paper on the floor, dirty bathrooms. And sometimes clients feel disgusted and leave. Nobody takes good care of that place.” (WSW, Colombia). “You come out sick, with a headache, with earache. Because it's very, very loud music, not music that would create a good environment.” (WSW, Costa Rica) “Because the music is so loud, you tend not to hear well. And tend not to be heard. You might even damage your throat and your ears because you can't hear and whenever you speak, you practically have to shout to be heard. I think we, as workers, face risks when working in an establishment.” (WSW, El Salvador) “Hotels are horrible here. There are bugs, cockroaches, bad smells. When you get off the car, sometimes you have to wait as they are still cleaning the room and then they leave it all wet, without condoms – and they should have them because there is a Health Plan. It's mandatory, they have to have condoms in the rooms where sex work is done. Same for where people just go to have sex. Not just sex workers. And they don't even provide that." (WSW, Panama) The bad condition of the rooms in which WSWs conduct their occupation, the lack of properly kept work materials and decent sanitary conditions, added to the lack of bathrooms with running water, and the poor standards of cleanliness not only of the rooms and salons but also of the beds and mattresses, put WSWs' health at on-going risk. Labour risks, often pointed out as intrinsic to this occupation, result directly from the lack of legal protection that has already been mentioned. The lack of protection with which WSWs live and work not only affects them while engaging in their occupation but also excludes them from any kind of health coverage and access to services that can provide them with adequate medical care, as they lack the entitlements and rights associated with legally recognized labour. “So, you can get an infection. Not just from a client. You can get it from the floor itself. I want to address this issue. They can install a chemical bathroom for the weekend, from Friday to Sunday, and then remove it. Because you don't have a place to clean yourself, to urinate. It's impossible. What I do in Arica is that I go out with my little bottle of water, I carry it in my bag. I go out with my bag and it looks as if I am going on a trip." (WSW, Chile). “What we do is that we often talk to compañeras and tell them that when they go to a space that does not offer them the minimum conditions, they should take their own sheets and make the bed with them so they can avoid getting sick. Now some of them are changing the sheets and carrying wet paper towels to clean themselves. Alcohol, you see? As a safety measure. Because it seems in many of those places the bed sheets are not changed. It looks clean but the sheets are not cleaned and you know somebody else has been right there." (WSW, Nicaragua) “No, because I don't have resources. I have to work so I can pay for the medicines. The establishment will not cover those expenses for me. And I have to keep in mind that because of all that dirtiness there are insects, animals, rats, cockroaches and all that. And flies. Depending on the area, if it is cold or hot, you can develop illnesses." (WSW, Colombia) By not being recognized as workers and by being excluded from the Conventions regulating and establishing workers' rights and obligations, WSWs are also excluded from the institutions that protect labour – social security; access to health; sick, menstruation and pregnancy leave. In this context it is important to point out that the different strategies employed by WSWs while they are menstruating (using cotton, sponges, tampons or injections to delay the bleeding, etc.) have negative implications for their health and constitute risk factors for WSWs. They use these strategies to be able to work and to avoid being fined in their workplaces or to lose the workday if they work in the street, 13 This abuse will be further discussed later but it also includes the forced payment of fees by WSWs to security forces, and to gangs, in countries where they exist. WSWs are charged daily, weekly or monthly.

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Sex work and working conditions: The impact of being clandestine  

Research conducted in 14 Latin American and Caribbean Countries