Panelists sharing the effectiveness of “end demand” policies during a press conference at this year’s International AIDS Conference in Amsterdam, the Netherlands, that featured scientific abstracts and input from advocates have suggested research suggests that “end demand” laws are reducing demand for HIV services.
According to the panelists “End demand” laws are being adopted or considered in a growing number of countries.
“Typically, under these laws, sex workers themselves commit no crime, but clients and any third parties are criminalized. Supporters of “end demand” laws have argued that this approach will increase sex workers’ access to essential services, including HIV prevention and care.”
But two studies presented at today’s press conference at the 22nd International AIDS Conference (AIDS 2018) poked holes in this assertion, citing evidence from Canada and France.
“Given the importance of sex workers in the global response to HIV, I think these studies deserve careful consideration,” Linda-Gail Bekker, President of the International AIDS Society and International Chair of AIDS 2018, said. “If ‘end demand’ laws create new barriers to HIV prevention and care, that is a very significant concern.”
In a presentation, Elena Argento of the University of British Columbia on “Analysis of the Protection of Communities and Exploited Persons Act (PCEPA),” a policy adopted by Canada in 2014 that criminalizes sex work clients and third-party advertising
. The analysis revealed substantial evidence that criminalization impedes access to services and support for sex workers, even though an explicit goal of “end demand” approaches is to increase access.
The authors aimed to longitudinally evaluate the impact of the PCEPA on sex workers’ access to HIV care, primary care and community-led and sex worker-led services in Vancouver, Canada.
They looked at a group of women sex workers over time, and found independently verified evidence of significantly reduced odds of utilization of community-driven services and supports after the law came into effect. These include services led by sex workers and indigenous-, migrant/refugee-, women- or youth-specific services.
There was no evidence of increased access to HIV-specific services among sex workers living with HIV following implementation of the new laws. The post-policy period was also correlated with significantly reduced odds of accessing health services when needed.