How governments should address sex work is a topic of current debate in Rwanda and other countries. Some constituencies propose harsher punishment of sex workers as the cornerstone of an improved policy. We argue that an adequate policy response to sex work in the Rwandan context must prioritize public health and reflect current knowledge of the social determinants of health. This does not imply intensified repression, but a comprehensive agenda of medical and social support to improve sex workers’ access to health care, reduce their social isolation, and expand their economic options.
Evidence from social epidemiology converges with rights-based arguments in this approach. Recent field interviews with current and former sex workers strengthen the case, while highlighting the need for further social scientific and epidemiological analysis of sex work in Rwanda. Rwanda has implemented some measures that reflect a rights-based perspective in addressing sex work. For example, recent policies seek to expand access to education for girls and support sex workers in the transition to alternative livelihoods. These policies reinforce the model of solidarity-based public health action for which Rwanda has been recognized.
Editors note : This article argues that the best way to reduce HIV among sex workers is to divert funds from proven interventions aimed at reducing unprotected commercial sex and reallocate it to girls education and rehabilitation. It prevents no evidence that these activities that aim to eliminate or reduce all sex work can reduce the size and nature of the HIV epidemic in Rwanda in the available timeframe.
Binagwaho, A.; Agbonyitor, M.; Mwananawe, A.; Mugwaneza, P.; Irwin, A.; Karema, C..