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 |
| Â | 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 |
| Â | 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 |
| Â | 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 |
| Â | 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 |
| Â | Obtaining clients and negotiation often occurs in alcohol settings | Alcohol and paid sex can be delinked |
| Â | 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 |