Drug users and sex work

Although injecting drug users constitute a risk group in themselves, there is also an overlap between drug addiction and those involved in sex work. Individuals who fall into both categories are therefore particularly vulnerable to HIV and are perhaps doubly stigmatised. The link between substance abuse and sex work is hard to pinpoint though there are a variety of factors that are common to both including homelessness, unstable family lives, socio-economic deprivation, disrupted schooling, local authority care and co

One study of UK cities found 63% of people who sold sex outdoors did so mainly to pay for drugs. Heroin was the most commonly used drug, with 78% having used it, and just under half the sample had injected drugs in the previous month.³⁰ UNAIDS believes that the spread of HIV in several North African and Middle Eastern countries is being facilitated by a combination of injecting drug use and sex work with one third of IDUs having paid for or sold sex. In Syria 53% of drug users have sold sex, with 40% of these saying they had never used condoms.³¹ One study of Sichuan province, China, reported similar rates, around 56%, of female IDUs who sell sex.³²

IDUs who are sex workers put themselves at risk and also facilitate the transmission of HIV between population groups. Looking at the spread of HIV among the two risk groups in Jakarta, Indonesia, the Commission on AIDS in Asia found that infection levels began to increase within commercial sex networks only after the epidemic among injecting drug users had reached significant levels.³³Sexual risk behaviour related to drug use should not just be considered within the bounds of sex work. While the impact of drugs on sexual behaviour may vary by drug, length of use, sexual identity, and other factors, there are a number of effects related to drug use that could influence unsafe sexual behaviour. HIV transmission may be facilitated among drug users and their sexual partners if the user is sexually stimulated or disinhibited by drugs.

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