Designing Disparity: Sex Workers and COVID-19

‘Health disparity’ is a concept created by governments and social institutions, and systematically enforced to reproduce the hegemonic conditions under which they thrive. It is an ethical judgement of which resources can be reasonably withheld from certain communities; namely, a judgement of which people’s disadvantage is socially acceptable. For sex workers, globally, the COVID-19 pandemic has amplified existing disparities, and exposed the underlying foundations of structural violence which predispose these workers to ill health through restricted access to crucial healthcare and neglect in the formation of government policy. According to the World Health Organisation, sex workers are among those most susceptible to the Human Immunodeficiency Virus (HIV), due to the nature of their profession and the lack of accessible HIV prevention services. The COVID-19 pandemic intensified these foundations of inequality, as HIV testing facilities were scaled down in 44 countries to reduce community transmissions. These closures are detrimental to the health of many sex workers in the Global South. Susan Gichuna found in her study of sex workers in Kenya that during COVID a six-month disruption in HIV

supplies and treatment in sub-Saharan Africa is estimated to lead to 471,000–673,000 AIDS-related deaths in a year. This neglect constitutes structural violence and reproduces cycles of disadvantage, as vulnerability to HIV has enforced the stigma that sex workers are conduits for disease, further hindering sex workers’ access to healthcare services during COVID.

Furthermore, access to contraception is one of the most crucial aspects of healthcare for sex workers, and this accessiblity is still limited worldwide, as many countries have defunded and criminalised birth control and abortion services. In a decade of austerity, the reduction of specialist services has led to a crisis in provision of health and support services for sex workers, exemplifying the ways in which disparities are manufactured to enforce hegemony. Planned Parenthood is one of the largest providers of sexual and

reproductive healthcare worldwide whose services were hugely impacted by COVID-19; they were forced to close 5 633 clinics and community-based care outlets across 64 countries. 47 million women in 115 low and middle income countries were in a position at the beginning of the pandemic where they could lack access to modern contraceptives if COVID-19 restrictions, specifically lockdowns, continued for 6-months—for many this has become a reality. It is estimated that this restriction will result in about seven million unplanned pregnancies. These statistics are exceptionally concerning considering that 41 countries have scaled down contraceptive care services and 23 countries have reduced availability of abortion care services during the pandemic, closures which will disproportionately impact sex workers.

In Australia, government responses to COVID have consistently disproportionately impacted sex workers. Access to federal income support was limited on a large scale by many sex workers’ difficulty to provide proof of employment and income documentation as well as the fear of legal repercussions, discrimination, or increased surveillance of their workplace after disclosing their sex work to a government body. Furthermore, both JobKeeper and JobSeeker were not extended to visa holders, thus completely denying support to migrant sex workers. As an extension of this, many sex workers are facing greater housing instability, as under most jurisdictions, discrimination against sex workers in the housing sector is either explicitly lawful or enabled by lack of access to anti-discrimination protections. The Australian response to COVID-19 has been heavily reliant upon policing, which has been felt heavily by sex workers. In Sydney CBD, police used their increased powers the morning they came into effect by the Public Health Act to target massage parlours, resulting in several sex workers from migrant backgrounds being the first people in New South Wales to receive COVID-19 fines. To adapt to police targeting, many sex workers are faced with the choice between working safely and employing harm reduction measures and avoiding law enforcement, placing them at even greater risk to COVID-19.

COVID has not created these disparities, these injustices are been long standing forms of structural discrimination against sex workers globally, the only change has been their amplification and acceleration to a devastating extent for these communities. These inequities are considered acceptable by institutions and governments because they fit perfectly into their own stigmatised biases against sex work which need to be dismantled.