Overview of the provision of prevention and testing for HIV and sexually transmitted infections for sex workers in the European Union and European Economic Area

Available data suggest that coverage of prevention programmes tailored to sex workers remains limited, although reporting is sparse and varies across countries. While many countries provide free condoms and lubricants to sex workers, there are still potential improvements to be made in the uptake of testing. There are difficulties in reaching sex workers with pre-exposure prophylaxis (PrEP) for HIV prevention. Even countries that prioritise them for eligibility highlight critical service delivery gaps.  Most EU/EEA countries report laws and policies that criminalise or penalise certain aspects of sex work, including activities related to organising, managing, selling or purchasing sexual services. 

Scientific evidence suggests that such punitive enforcement practices may impede access to HIV and STI prevention testing and treatment by contributing to stigma, fear of sanctions and reduced engagement with health services.  Meaningful involvement of sex workers in service design and delivery, and measures to address stigma and legal barriers is crucial to improve HIV and STI prevention, testing and treatment uptake and outcomes in this key population. Strengthened monitoring systems are needed for countries and stakeholders to have the necessary data to inform and effectively tailor programmes and interventions.