[health menu] XI International Conference on AIDS
July 7-12, 1996

Alexander, Priscilla
North American Task Force on Prostitution, NYC, NY, USA

Liz Highleyman
COYOTE, San Francisco, CA, USA

Catherine La Croix
COYOTE, Seattle, WA, USA


Occupational Safety and Health Regulations as an HIV/AIDS Prevention Strategy in the Context of Sex Work


Prostitution is either a crime or half-legal/half-illegal, everywhere in the world, and sex workers often have little control over working conditions, unless they work independently, and no legal recourse to combat abuse. Lack of control, power, and autonomy are associated with high risk behavior and/or the inability to adopt safer sex and/or drug use practices. Although many governments have implemented harm reduction, needle exchange, and condom promotion, few have addressed the central issue of sex workers' control over their work.

Occupational Safety and Health Hazards

Safety/health hazards associated with sex work include:
  1. physical problems such as repetitive stress injuries from performing fellatio and hand jobs; bladder/kidney infections from improperly performed vaginal intercourse; foot and back problems from standing/walking on high heels;

  2. violence from clients, police, and managers;

  3. stress from working in an illegal market, without paid sick leave, workers' compensation or disability insurance, paid vacation, or a minimum wage;

  4. drug and alcohol dependency related to client demand and/or job related stress.

Occupational Safety and Health Responses

  1. Workplace regulations governing sick leave, vacation, hours worked, workers' compensation, disability insurance, social security, and health insurance for workers in the sex industry;

  2. training in sex work skills to reduce the likelihood of repetitive stress injuries, bladder/kidney infections, and stress;

  3. self-defense training to improve workers' ability to recognize warnings of violence, and/or defend themselves;

  4. regulations governing the size of the workspace, ventilation, access to running water, electricity, linens, provision of condoms and lubricants;

  5. grievance procedures/mediation to resolve disputes between workers and managers, resolve sexual harassment conflicts.

Clinics/Drop-in Centers

  1. Establish sex workers' occupational safety and health clinics, with general as well as sexual and reproductive health care, mental health services, drug and alcohol treatment, and physical therapy, augmented with legal assistance, support groups, and possibly child care.

  2. Open drop-in centers in stroll districts where street workers can get condoms, emotional and legal support, information about dangerous clients, and referrals to other agencies.

  3. Support the organization of trade unions, street-based workers' associations, and professional guilds.

  4. Offer skills evaluation, re-training, and related services to help prostitutes prepare for other work, school, and other vocational changes.

P. Alexander
2785 Broadway, Apt. 4L
New York, NY 10025-2834, USA
Tel/Fax: +1-212-866-8854
Email: pja14@columbia.edu

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Created: July 16, 1996
Last modified: July 17, 1996

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