Preventing HIV/STDs, as well as sexual and physical violence, are interconnected occupational health and safety concerns for sex workers. Given the right circumstances, men and women who choose to work in the sex industry can experience greater economic freedom and higher standards of sexual health than others in their communities. The Network of Sex Work Projects (NSWP) is an organization linking sex worker health programmes around the globe. It has found that the incidence of HIV/STDs among sex workers is lowest when they have control over their work conditions, access to condoms, lubricants and other safe sex materials and, significantly, when their basic human and legal rights are respected.

Discussions of violence against sex workers must differentiate between consensual involvement in the sex industry and forced trafficking. Unfortunately, the opinions of men and women working in the sex industry are not sought by organizations against sex trafficking. Consequently, some antisex trafficking groups promote strong sanctions against prostitution as the solution.

Nevertheless, significant evidence indicates that antiprostitution laws actually facilitate violence and abuse against sex workers and may increase the sex workers' risk of contracting HIV and other STDs. For example, sex workers often report that law enforcers take advantage of laws against prostitution to demand money or sex. The problematic nature of police enforcement also means that sex workers are reluctant to report crimes, including rape, or to seek medical treatment. Significantly, migrant sex workers, whether they are documented or undocumented residents, are reluctant to report any abuse to the authorities for fear of being deported or charged with criminal activities. In general, strict enforcement of antiprostitution laws marginalizes sex workers from services that could help them avoid abuse and promotes an environment in which sex workers are forced take risks to avoid detection and arrest. Street-working prostitutes who attempt to avoid police "street sweeps" may, for example, spend less time getting to know their clients before they agree to go with them. Or they may be afraid to carry sufficient condoms with them in case their safe sex tools are used as evidence by the police.

Under these circumstances, peerbased initiatives promoting sex worker participation in service provision and programme management play a central role in assisting sex workers. For example, in many parts of the world, sex workers' organizations and networks have alerted workers to potentially dangerous situations and helped them avoid people, places and practices that might have put them at risk. Sex worker projects have helped break down stereotypes that prevent prostitutes from receiving the help they need. Policesex worker liaison projects in countries such as Scotland and Australia have led to higher levels of reporting of crimes against sex workers, including rape and physical violence. The liaison projects have also led to collaborative solutions to problems, including neighbourhood concerns about the way the sex industry operates. In many different countries and regions, sex workers are creating innovative ways to prevent violence, reduce the incidence of HIV/STDs, and promote better sexual health for themselves and the community in general.

Melissa Ditmore and Penelope Saunders, c/o Network of Sex Work Projects, 10 Danbury Street, Islington, London N1 8JU, United Kingdom; Tel/Fax: 44-171-354-1664; e-mail: sexworknet@gn.apc.org