Table 1 |
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Vulnerabilities of sex workers due to criminalisation: a situation analysis of South Africa and potential effects of decriminalisation |
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Vulnerabilities |
Current situation in South Africa |
Potential effects of decriminalisation and provision of public-sector services for HIV prevention in sex work settings |
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Restricted access to health services |
Lack of specialized services targeting sex workers |
Formal sex worker clinics and outreach, with active follow-up services |
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Scanty and ineffective public and donor funding for HIV prevention in sex work settings |
Public funding for HIV prevention in sex work settings, and government-led coordination of services |
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Condom availability in general primary health clinics, but limited promotion of condoms in sex work settings |
Targeted condom promotion and provision in sex work settings |
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Syndromic treatment of symptoms within general STI services |
Targeted STI control programmes with STI screening at pre-specified intervals, periodic presumptive treatment and syndromic management |
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Limited access to health information and family planning counselling. High rates of unintended pregnancy, increasing number of dependents |
Planned health promotion activities, with information provision, family planning counselling and contraceptive services |
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Restricted access to legal protection |
Laws against gender-based violence are seldom enforced and police do not act on sex worker complaints |
Sex workers have legal recourse to redress violence Enhanced ability of police to improve the safety of sex work settings |
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Unsafe work conditions |
Unsafe venues |
Enhanced ability to secure and control sex work settings |
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Obtaining clients and negotiation often occurs in alcohol settings |
Alcohol and paid sex can be delinked |
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Difficulties in negotiating safe sex |
More empowered sex workers enables condom negotiation and client refusal |
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Stigma |
Judgemental health care workers |
Specialized health care workers, trained in sensitive provision of services |
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Economic Vulnerabilities |
Despite the threat of fines or imprisonment, women enter sex work in response to demand for paid sex and pressures of providing for dependents, as they have few alternatives |
No evidence that decriminalisation will increase supply of sex workers or demand for sex work |
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Richter et al. Globalization and Health 2010 6:1 doi:10.1186/1744-8603-6-1 |
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