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The role of sex work laws and stigmas in increasing HIV risks among sex workers

Author

Listed:
  • Carrie E. Lyons

    (Johns Hopkins School of Public Health)

  • Sheree R. Schwartz

    (Johns Hopkins School of Public Health)

  • Sarah M. Murray

    (Johns Hopkins School of Public Health)

  • Kate Shannon

    (University of British Columbia)

  • Daouda Diouf

    (Enda Santé, Senegal)

  • Tampose Mothopeng

    (People’s Matrix Association)

  • Seni Kouanda

    (Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso, Institut Africain de Santé Publique)

  • Anato Simplice

    (ONG Arc-en-Ciel, B.P.)

  • Abo Kouame

    (Ministère de la Sante et de l’Hygiène Publique)

  • Zandile Mnisi

    (Ministry of Health)

  • Ubald Tamoufe

    (Metabiota. Avenue Mvog-Fouda Ada, Av 1.085, Carrefour Intendance BP)

  • Nancy Phaswana-Mafuya

    (North-West University, Potchefstroom Campus, Private Bag X6001 Potchefstroom)

  • Bai Cham

    (Actionaid, Banjul The Gambia)

  • Fatou M. Drame

    (Enda Santé, Senegal
    School of Social Sciences. BP: 234 - Saint-Louis, Nationale 2, route de Ngallèle)

  • Mamadú Aliu Djaló

    (Enda Santé, Guiné-Bissau. Bairro Santa Luzia, Rua s/n)

  • Stefan Baral

    (Johns Hopkins School of Public Health)

Abstract

Globally HIV incidence is slowing, however HIV epidemics among sex workers are stable or increasing in many settings. While laws governing sex work are considered structural determinants of HIV, individual-level data assessing this relationship are limited. In this study, individual-level data are used to assess the relationships of sex work laws and stigmas in increasing HIV risk among female sex workers, and examine the mechanisms by which stigma affects HIV across diverse legal contexts in countries across sub-Saharan Africa. Interviewer-administered socio-behavioral questionnaires and biological testing were conducted with 7259 female sex workers between 2011–2018 across 10 sub-Saharan African countries. These data suggest that increasingly punitive and non-protective laws are associated with prevalent HIV infection and that stigmas and sex work laws may synergistically increase HIV risks. Taken together, these data highlight the fundamental role of evidence-based and human-rights affirming policies towards sex work as part of an effective HIV response.

Suggested Citation

  • Carrie E. Lyons & Sheree R. Schwartz & Sarah M. Murray & Kate Shannon & Daouda Diouf & Tampose Mothopeng & Seni Kouanda & Anato Simplice & Abo Kouame & Zandile Mnisi & Ubald Tamoufe & Nancy Phaswana-M, 2020. "The role of sex work laws and stigmas in increasing HIV risks among sex workers," Nature Communications, Nature, vol. 11(1), pages 1-10, December.
    • Handle: RePEc:nat:natcom:v:11:y:2020:i:1:d:10.1038_s41467-020-14593-6
    DOI: 10.1038/s41467-020-14593-6
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