Hesperian Health Guides

Working for Change

In this chapter:

Negotiating condom use

In order to get more clients to use condoms, they must believe that it is best for them and their sex partners to prevent STIs, including HIV. This kind of education is best done at the community level.

As a sex worker, you can help by joining with other sex workers to make condom use the expected practice. If you all agree to tell your clients that condoms protect their health and yours, and to require condom use, then clients will be more likely to use condoms.

Get together with other sex workers and use role-plays to practice negotiating condom use with clients

a woman showing a condom to a man who has his arm around her

When you are with clients, your attitude is important. If you are confident and have information ready, you are more likely to convince a client that condom use makes good sense. Here are some ideas:

  • Explain that condoms can:
– protect both of you from disease.
– make him less likely to pass on STIs to other partners.
– make the pleasure last longer.
  • Assure clients that you will still make sex good for them.
  • If you offer oral sex, learn to put the condom on with your mouth.

A sex worker in Duala, Cameroon, tells how she and her coworkers protect themselves:

In the discotheque where I work, we understand the risk to our health and our lives from HIV and AIDS, so all the girls are given condoms. We teach our clients that it is in their own interest to protect themselves. Most clients now agree. We make sure that the act will be enjoyable, so they will come back for more.


But there are always those men who think that by not using condoms, they are being “real men.” That going “live” is getting the real thing. We almost always find that after a guy has tried without luck to get 4 or 5 of us to have unsafe sex, he will either just leave or agree to see if he can have just as much pleasure with a condom on.


If he insists on unsafe sex, we gather together and chase him out! We do not like to lose clients, but we value our lives and our health. Slowly, things are changing. Where we work, using condoms has become the smart thing.

four women thinking about what they want
DECENT INCOME
FOOD + SHELTER
FREEDOM FROM VIOLENCE
PROTECTION FROM STIs + HIV
Sex workers are organizing to improve their lives.
They want the same things as everyone else.

Strength through organizing

“I used to work in a club where we didn’t always use condoms. There was a lot of pressure NOT to. So I left. Now I work in a house where condoms are the RULE. It saves me a lot of worrying and arguing.” —Anita

Because of their low status, sex workers sometimes feel unworthy and unable to make changes in their lives. When working alone, it can be very difficult for sex workers to make clients use condoms or to protect themselves from violence. But in many places, sex workers have learned that by working together they have more power to make the changes necessary to improve their lives. In some places, sex workers are organizing to improve their working conditions by insisting that their clients use condoms or organizing against mistreatment from police. In other places, sex workers, with the help of others in their community, have started programs to learn new skills so they will be less dependent on sex work.

Here are some ideas that sex workers from around the world have shared about how they are working together and working with others to make their lives better.

Teach each other how to make your work safer. Talk with other sex workers about:

  • how to use condoms to prevent STIs, including HIV, and how to get treatment for STIs when necessary.
  • family planning methods—how to get them, and how to use them.
  • how to choose clients and stay safe while working.
  • how to support each other in refusing inappropriate demands from clients.
  • how to limit the time a sex worker spends with clients.


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Organize for greater safety. Working together and supporting each other can help sex workers reduce the threat of violence from clients, police, and pimps. Join with other sex workers to plan how you can support and protect each other.

Around the world, organizations led by sex workers are fighting for the right to work, the right to respectful health care, and the right to live without threats of violence and abuse from the police and others. Decriminalizing sex work makes it easier for sex workers to focus on social issues and health, such as STI prevention and treatment.

Learn new skills. You can work to organize programs that teach reading and writing or job skills. Sometimes sex workers can teach each other new skills, or it may be possible to get help from people in your community who can be teachers.

a woman talking as she combs another woman's hair
I told him “No condom, no sex” and now that I earn some money doing hair, I can say “no” and still pay my bills.

A sex worker with other skills can earn money doing other jobs. This gives someone more choice in which clients to take and more ability to refuse clients that do not feel safe.

Create a loan fund. A group of sex workers in Nairobi, Kenya, pooled their money to create a loan fund for their members. Many use the fund to pay their children’s school fees. Other groups have used loan funds to help each other set up small businesses so they can earn money in other ways besides sex work.

The community can help

a man and two sex workers standing near a sign that says, "condoms required for your safety and ours"

Community members can help sex workers organize for safer working conditions. You can:

  • demand laws that punish those who exploit sex workers. This includes brothel owners, pimps and middlemen, police, clients, and drug pushers.
  • pressure police to stop violent treatment of sex workers.
  • work for laws that encourage condom use by clients of sex workers. For example, in Thailand, the Ministry of Health requires sex workers to use condoms. If they do not, the brothel can be shut down or have to pay a fine. This law has helped sex workers to insist upon condoms. This protects the sex workers, their clients, and the community.


You can also work to prevent children from being sold or forced into sex work:

  • Talk with families in your community about the traffickers who trick parents into selling their children into service in other countries.
  • Provide help, such as jobs, counseling, and a place to stay, for children who run away from their families. With your help they will not be forced to sell sex to survive.


This page was updated:22 Jan 2024