SEX WORK AND THE LAW - HIV/AIDS Data Hub

and support services to sex workers. There are documented cases of successful HIV
prevention programmes among sex workers that have been undermined by ‘rescuing’ of
sex workers in Cambodia, India, and Thailand. 40
100% CUPs
100% CUPs have been implemented in Cambodia, China, Indonesia, Lao PDR, Mongolia,
Myanmar, the Philippines, Thailand, and Viet Nam. Implementation approaches have varied
in each country. A number of sex worker organizations have expressed concerns about
the coercive nature of some 100% CUPs, such as registration and testing requirements. 41
The extent to which programmes rely in compulsion varies.
Findings and conclusions
100% CUPs sometimes require compulsory registration of sex workers, mandatory health
examinations, and usually require monitoring of sex workers by health authorities or
police. 42 Registration of sex workers is intended to ensure that sex workers attend clinics
for testing. Registration can ensure that participating sex workers are not subject to police
harassment (e.g., for carrying condoms) and can access free STI testing and treatment.
However, this does not benefit those who work on the streets or outside participating
establishments, and registration may lead to breaches of privacy rights. In some cases the
registration process has involved collection of photographs of sex workers and personal
information to create cards to document clinic visits and health status.
Health promotion programmes based on community empowerment approaches that are
led by sex workers are more likely to avoid human rights violations and result in sustained
HIV prevention outcomes than models that rely on mandatory provisions and coercion. It
is important that the design of condom programmes includes human rights protections,
measures to prevent corruption and police abuses, and efforts to ensure participation
of sex workers in the design and evaluation of programmes. In some settings where the
social and legal climate towards sex workers is hostile, it may not be feasible to design a
100% CUP model with adequate human rights protections. Although 100% CUPs have
demonstrated that they can be very effective in reducing HIV and STI incidence among sex
workers and their clients, the range of concerns relating to human rights violations that
have been raised by community groups means that alternative condom programming
models need to be considered.
A research team has developed Sex Worker Empowerment Guidelines that critique 100%
CUP approaches and propose an alternative model based on community empowerment. 43
The UNAIDS Advisory Group on HIV and Sex Work has made the following observations
about 100% CUPs:
Some programmes have been successful in helping to change the norms and practices
around sex work by sex workers, with a subsequent effect on rates of HIV infection.
The 100% condom use programme initiated in Thailand in the early 1990s, is one such
40 Canadian HIV/AIDS Legal Network (2007) A Human Rights-based Commentary on UNAIDS Guidance Note:
HIV and Sex Work (April 2007), p.13-14.
41 Network of Sex Workers Projects (2003) The 100% Condom Use Policy: a Sex Workers’ Rights Perspective;
Longo P., Ditmore M. (2003) 100% Condom Use Programs: Empowerment or Abuse? Research for Sex Work Vol.
6: 3-5.
42 Canadian HIV/AIDS Legal Network (2007) op cit, p.12.
43 Mgbako C., Gabriel M., Garr L., Smith L. (2008) Sex Worker Empowerment Guidelines: An Alternative HIV/AIDS
Intervention Approach to the 100% Condom Use Programme. Sangram.
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