Preventing HIV

Focus on Key Population

Protecting the health and human rights of vulnerable and marginalized groups is both an end in itself and an essential element of tackling the AIDS epidemic.

From a human-rights perspective, UNFPA is committed to helping those who are most disenfranchised. On a practical level, prevention activities aimed at key populations can curtail the spread of the disease into the general population, especially in countries where HIV is low and concentrated among certain sub-groups. In all contexts key populations include sex workers, men who have sex with men, injecting drug users and transgender people. In such settings, specific interventions to reach those at highest risk should be combined with broader efforts.

UNFPA supports a variety of programmes for key populations. In 2005, UNFPA was given lead responsibility within UNAIDS for HIV prevention among sex workers.

Sex Workers

Sex workers include female, male and transgender adults, over the age of 18, who receive money or goods in exchange for sexual services either regularly or occasionally, and who may or may not self-identify as sex workers. There are many reasons why people sell sex including: poverty; to financially support children, parents and other family members; lack of job opportunities; gender inequality; low levels of education; and humanitarian emergencies, post-conflict situations.

Less than 2 per cent of global HIV prevention funding for HIV is spent on sex work – despite their disproportionate HIV risk, the vulnerability sex workers face, and the fact that HIV prevalence rates among sex workers are much higher than the general population in most countries.

Sex workers face multiple risks, including social marginalization, violence and poor health. These factors adversely affect the ability of sex workers to adopt safer sexual practices, including consistent condom use. Sex workers need access to appropriate, affordable and accessible comprehensive HIV/STI prevention and treatment programmes as well as sexual and reproduction health services free from stigma.

Sex workers around the world identify stigma, discrimination and violence as three of the greatest challenges they face. Health-care providers, law enforcement officers, the judiciary, clients and managers of sex work establishments, and the community have a shared responsibility to ensure that sex workers have access to the services they need, free from harassment, victimization and imprisonment.

The UN Secretary-General has called on all countries to honour their commitments to enact or enforce laws outlawing discrimination against people living with HIV and key populations at higher risk of HIV infection, including sex workers, stating that in countries with legal protections and the protection of human rights for sex workers, many more have access to services.

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