Sex Workers in Southern Africa Face Increasing Barriers to Rights, Health Care

CAPE TOWN—Sex workers in Southern Africa are subjected to widespread human rights abuses, according to a report released today by the Open Society Institute. Rights Not Rescue: A Report on Female, Trans, and Male Sex Workers’ Human Rights in Botswana, Namibia, and South Africa documents the experiences of sex workers and their efforts to protect their rights despite overwhelming challenges.

“Sex workers are facing a health and human rights crisis in Southern Africa, yet very little is being done to protect their rights,” said Anna-Louise Crago, co-author of the report.

The report finds that the criminalization of sex work in each of these countries leaves sex workers particularly vulnerable to sexual and physical abuse from law enforcement officials. In all three countries, sex workers say they experience routine violence from police, including rape, physical assault, and having their genitals sprayed with pepper-spray. In Botswana and South Africa, migrant sex workers from Zimbabwe are often subjected to more severe violence from police and border guards.

“The police take our money and rape us without condoms. We are scared to report the rape because we are sex workers, so we are illegal,” said Priscilla, a sex worker in Rustenberg, South Africa.

The widespread abuse, lack of legal protections, and poor working conditions have compromised the ability of sex workers to access HIV prevention and treatment services. Discrimination from health care providers and fear of abuse often prevent sex workers—particularly transgender and migrant sex workers—from seeking care or antiretroviral drugs (ARVs) to treat HIV.

“They don’t treat us like humans at the hospital,” said Rashida, a sex worker from Kasane, Botswana. “Some HIV-positive women choose to die without ARVs rather than go to the hospital.”

In other parts of the world, HIV/AIDS programs that respect the rights of sex workers have proven to be the most successful in reducing HIV rates among sex workers. However, conservative political and religious campaigns, as well as restrictions on foreign aid such as the United States’ “anti-prostitution pledge,” have severely hampered many evidence-based HIV efforts. In Southern Africa, a large proportion of funding directed at sex workers is spent on initiatives aimed at “rehabilitating” them out of sex work.

“So-called rehabilitation projects have not been proven to reduce the spread of HIV, nor have they reduced the number of people engaged in sex work,” said Jayne Arnott, the report’s co-author. “Instead, these types of initiatives further stigmatize sex workers and divert funding from HIV programs that are based on scientific evidence and that respect human rights.”

Despite criminal sanctions and a lack of funding, the report found that sex workers across the region are organizing to protect their rights. In particular, sex workers are calling for law reform and programs to reduce violence and discrimination and create safe working environments that support their ability to enforce condom use.

The report makes some strong recommendations to governments and policymakers such as decriminalization of sex work and increased investment in evidence and rights based health initiatives for sex workers. It also calls on activists and groups working on advancing the rights of sex workers to ensure the meaningful involvement and leadership of sex workers in defining priorities and strategies for (i) achieving recognition of sex work as work, and (ii) ensuring that there is enforcement of sex workers’ human rights and labor rights such as access to fair and safe working conditions.

“All we want is for people to see us as human beings with human rights,” said Caroline, a member of Sisonke, the national network of sex workers in South Africa.