Citation

Rekart ML. Lancet 2006; 366(9503): 2123-2134.

Affiliation

British Columbia Centre for Disease Control, University of British Columbia, Vancouver V5Z 4R4, BC, Canada. michael.rekart@bccdc.ca

Copyright

(Copyright © 2006, Elsevier Publishing)

DOI

10.1016/S0140-6736(05)67732-X

PMID

16360791

Abstract

Sex work is an extremely dangerous profession. The use of harm-reduction principles can help to safeguard sex workers' lives in the same way that drug users have benefited from drug-use harm reduction. Sex workers are exposed to serious harms: drug use, disease, violence, discrimination, debt, criminalisation, and exploitation (child prostitution, trafficking for sex work, and exploitation of migrants). Successful and promising harm-reduction strategies are available: education, empowerment, prevention, care, occupational health and safety, decriminalisation of sex workers, and human-rights-based approaches. Successful interventions include peer education, training in condom-negotiating skills, safety tips for street-based sex workers, male and female condoms, the prevention-care synergy, occupational health and safety guidelines for brothels, self-help organisations, and community-based child protection networks. Straightforward and achievable steps are available to improve the day-to-day lives of sex workers while they continue to work. Conceptualising and debating sex-work harm reduction as a new paradigm can hasten this process.