9. Access to health insurance and HIV treatment for all – also for undocumented sex workers!

The lack of health insurance is one of the biggest health hurdles. Many people in sex work are affected by this, especially undocumented people from third countries, but also many people from the EU. In order to promote the health of sex workers, it is therefore necessary that the barriers for entering or returning to the public health insurance system are dismantled, as a way of giving undocumented migrants and people with few financial resources means to access health insurance coverage. The health insurance for all would not only improve the state of health of many people. This measure would also be cost-effective – because prevention is cheaper than treatment and intervention. 

At the same time, the nationwide expansion of Clearingstellen to clarify insurance cover is essential, to support the placement of as many people as possible into the regular healthcare system. In addition, the Residence Act must also be amended in order to enable undocumented people to apply for medical services from the social welfare office – without having to fear deportation due to the transmission of their data to the immigration authorities.HIV treatment must be guaranteed for all people with HIV, including those without health insurance. HIV treatments not only save the lives of infected people, they also prevent transmission to other people. This demand therefore arises both from the human right to healthcare and the need to prevent new HIV infections. How HIV therapy can be organized for people without health insurance is shown by the “HIV therapy for people without health insurance“ of the City of Hamburg, which is implemented by the Center for HIV and Sexually Transmitted Infections in Altona (CASAblanca). People living with HIV, without access to health insurance, for whom there is no other option for HIV treatment, are offered the antiretroviral therapy as well as accompanying examinations and medical care. This regional offer is successful, but not sufficient. There is an urgent need for implementation that is enshrined in law across all federal states, for example by the Public Health Department within the framework of § 19 Infection Protection Act.