6. Sex workers need to be better reached

The prerequisite for promoting the health of sex workers is that they are aware of support measures and health services and that they are both able and willing to make use of them – in short: that sex workers are reached. Various structural factors (such as criminalizing laws or a pandemic such as COVID-19) can impair this, because existing contacts between those seeking advice and services break off. This can be exacerbated through individual vulnerability factors such as illegalization (especially as an undocumented person), financial precariousness and thus reduced (time) resources, language barriers, illiteracy, etc.

In the focus groups, several features of services were described as beneficial. From this we derive recommendations for facilities that provide services for sex workers (especially in the area of health):

  • Nationwide outreach counselling services and mobile services (e.g. HIV/STI tests).
  • Working at eye level with peer multipliers (sex workers who transfer knowledge in their communities) with the possibility of payment.
  • Outreach services and flexible opening hours of facilities based on the needs of the target groups (e.g. evening services at health and advice centers) and consultation hours without appointments.
  • Facilities should clearly emphasize that services can be used anonymously so that people who are illegalized can also use them. If necessary, the independence of the services from laws such as the Prostitutes Protection Act must be emphasized so that sex workers can make use of them.
  • Multilingual medical and counseling services and a multilingual online presence.
  • Cooperation at local level between health authorities, counselling centers (especially in the areas of sex work, addiction and human trafficking), HIV service organizations and peer projects for the mutual transfer of knowledge, to advertise the services and to organize joint services such as Information events. Government agencies must commit to maintain anonymity.

Create attractive offers, for example PrEP and HIV therapy for people without health insurance, group-specific spaces for self-help and mobile HIV/STI testing services.