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In Nigeria and Ghana, HIV prevalence among sex workers is eight times higher than the rest of the population.5 Although sex workers are one of the groups most affected by HIV, they are also one of the groups most likely to respond well to HIV prevention programmes.

Proof of this can be seen in countries such as Cambodia, the Dominican Republic, India and Thailand, where reductions in national HIV prevalence have been helped by initiatives targeting sex workers and their clients.

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In various ways, these factors contribute to their vulnerability to HIV.Migrant sex workers often become the targets of both police and immigration officers, especially those who cross borders (both legally and illegally) and do not have immigration status.Other than facing the criminalisation of sex work, they may also face surveillance, racial profiling, arrest, detention, deportation and other restrictions on mobility imposed by criminal, immigration and trafficking laws.25 As well as selling sex themselves, migrants may become the clients of sex workers as a means of escaping the solitude that often accompanies migration.26 Another way in which HIV, sex work and mobility are linked is through ‘sex tourism’, whereby clients travel between countries seeking paid sex.Even in countries where HIV prevalence is low, trafficked people who are forced to sell sex are highly vulnerable to HIV infection because they struggle to access condoms, cannot negotiate condom use and are often subjected to violence.30 One study conducted among trafficked people in Mumbai brothels in India found that almost a quarter of trafficked girls and women were living with HIV.31 However, many emphasise that the relationship between sex work and human trafficking should not be overplayed as it can lead to false or exaggerated anti-sex work arguments and harmful action by authorities, ultimately undermining HIV prevention for sex workers.32 In fact, evidence suggests that fewer people enter into sex work through trafficking than enter consensually.

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For example, it is estimated that one in five people in the sex trade in Andrah Pradesh, India and one in 10 in Thailand have been trafficked.33 Despite this, policies that conflate sex work and trafficking have dominated approaches to sex work over the past decade.In 2003, the US President’s Emergency Plan for AIDS Relief (PEPFAR) adopted a clause that required funding recipients to explicitly oppose sex work, its legalisation and sex trafficking.

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