"Female, male and transgender adults and young people who receive money or goods in exchange for sexual services, either regularly or occasionally.
Even though sex work is at least partially legal in some countries, the law rarely protects sex workers.
Around the world, there is a severe lack of legislation and policies protecting sex workers who may be at risk of violence from both state and non-state actors such as law enforcement, partners, family members and their clients.13 For example, a sex worker who is raped will generally have little hope of bringing charges against their attacker.
This lack of protection leaves sex workers open to abuse, violence and rape, creating an environment which can facilitate HIV transmission.14 In some countries, police use the possession of condoms as evidence of sex work, further impeding sex workers’ efforts to protect themselves.
In other cases, sex workers are simply powerless to negotiate safer sex.
Clients may refuse to pay for sex if they have to use a condom, and use intimidation or violence to force unprotected sex.8 They may also offer more money for unprotected sex – a proposal that can be hard to refuse: "Sex workers have told us that when they ask a client to use a condom, he offers double the price to have sex without the condom.
These women are trying to provide for their children and families, so they take the offer." The clients of sex workers also act as a 'bridge population', transmitting HIV between sex workers and the general population.High HIV prevalence among the male clients of sex workers has been detected in studies globally.10 11 12 Sex workers are often stigmatised, marginalised and criminalised by the societies in which they live, and in various ways, these factors that contribute to their vulnerability to HIV.In Nigeria and Ghana, HIV prevalence among sex workers is eight times higher than for the rest of the population.4 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.Sex workers often share common factors, regardless of their background, that can make them vulnerable to HIV transmission.5 In general, sex workers have comparatively high numbers of sexual partners compared with the general population.However, this does not necessarily increase their likelihood of becoming infected with HIV if they use condoms consistently and correctly.6 In 2012, 44 countries reported a median condom use of 85%, up from 78% in 2009.7 In some cases, sex workers have no access to condoms, or are not aware of their importance.