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Table 1 Vulnerabilities of sex workers due to criminalisation: a situation analysis of South Africa and potential effects of decriminalisation

From: Sex work and the 2010 FIFA World Cup: time for public health imperatives to prevail

Vulnerabilities Current situation in South Africa Potential effects of decriminalisation and provision of public-sector services for HIV prevention in sex work settings
Restricted access to health services Lack of specialized services targeting sex workers Formal sex worker clinics and outreach, with active follow-up services
  Scanty and ineffective public and donor funding for HIV prevention in sex work settings Public funding for HIV prevention in sex work settings, and government-led coordination of services
  Condom availability in general primary health clinics, but limited promotion of condoms in sex work settings Targeted condom promotion and provision in sex work settings
  Syndromic treatment of symptoms within general STI services Targeted STI control programmes with STI screening at pre-specified intervals, periodic presumptive treatment and syndromic management
  Limited access to health information and family planning counselling. High rates of unintended pregnancy, increasing number of dependents Planned health promotion activities, with information provision, family planning counselling and contraceptive services
Restricted access to legal protection Laws against gender-based violence are seldom enforced and police do not act on sex worker complaints Sex workers have legal recourse to redress violence
Enhanced ability of police to improve the safety of sex work settings
Unsafe work conditions Unsafe venues Enhanced ability to secure and control sex work settings
  Obtaining clients and negotiation often occurs in alcohol settings Alcohol and paid sex can be delinked
  Difficulties in negotiating safe sex More empowered sex workers enables condom negotiation and client refusal
Stigma Judgemental health care workers Specialized health care workers, trained in sensitive provision of services
Economic Vulnerabilities Despite the threat of fines or imprisonment, women enter sex work in response to demand for paid sex and pressures of providing for dependents, as they have few alternatives No evidence that decriminalisation will increase supply of sex workers or demand for sex work