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These women are trying to provide for their children and families, so they take the offer.
16 The clients of sex workers act as a 'bridge population', transmitting HIV between sex workers and the general population.
But elsewhere in the region, in countries with significant HIV epidemics among sex workers such as the Philippines, Indonesia and Pakistan, condom use was low.
Most other regions show a similar pattern: a few countries perform reasonably well, while many others fall short.
Sex workers are among the highest risk groups for HIV.
UNAIDS defines sex workers as: Female, male and transgender adults and young people who receive money or goods in exchange for sexual services, either regularly or occasionally.
When I visited a VCT [voluntary counselling and testing] clinic, health personnel were not polite and immediately asked me if I was a sex worker. However, this does not necessarily increase their likelihood of becoming infected with HIV if they use condoms consistently and correctly.11 In 2015, 32 out of 89 countries reporting on the proportion of sex workers using a condom with their last client reported greater than 90% coverage.
This lack of protection leaves sex workers open to abuse, violence and rape, creating an environment which can facilitate HIV transmission.8 To avoid arrest that can involve violence, rape and other trauma, many sex workers try to avoid things that may identify them as sex workers – like carrying condoms or visiting health clinics for check-ups.
9 In addition, the stigma that sex workers face can make it hard for them to access healthcare, legal, and social services.
They may either be afraid to seek out these services for fear of discrimination, or be prevented from accessing them – for instance, if a nurse refuses to treat them after finding out about their occupation. 10 In general, sex workers have comparatively high numbers of sexual partners compared with the general population.
In various ways, these factors contribute to their vulnerability to HIV.
Even though sex work is at least partially legal in some countries, the law rarely protects sex workers.