Best practices and challenges to sex worker community empowerment and mobilisation strategies to promote health and human rights

Abstract

Sex workers face a number of health and human rights challenges including heightened risk for HIV infection and suboptimal care and treatment outcomes, institutional and interpersonal violence, labour rights violations, and financial insecurity. In response, sex worker-led groups have been formed and sustained across geographic settings to address these challenges and other needs. Over the last several decades, a growing body of literature has shown that community empowerment approaches among sex workers are associated with significant reductions in HIV and other sexually transmitted infections. Yet legal and policy environments, as well as funding constraints, have often limited the reach, along with the impact and sustainability, of such approaches. In this chapter, we first review the literature on community empowerment and mobilisation strategies as a means to collectively address HIV, violence, and other health and human rights issues among sex workers. We then utilise two case studies, developed by the sex worker-led groups APROASE in Mexico and Ashodaya Samithi in India, to illustrate and contextualise community empowerment processes and challenges, including barriers to scale-up. By integrating the global literature with context-specific case studies, we distil lessons learned and recommendations related to community empowerment approaches among sex workers.