What works to reduce violence agains sex workers

A person in the dark looking into the camera

Aidsfonds used a three- interventions model (the so-called Hands Off model) to reduce violence against sex workers. The three key interventions of the model are: building a strong sex worker movement with rights awareness, setting up rapid emergency response systems through paralegals and peers, and turning the police into an ally. An independent study shows that where the Hands Off model has been implemented, working on social and structural determinants of HIV has worked and violence has reduced.


HIV prevalence in Southern Africa is among the highest in the world, with every 1 in 5 people living with HIV. Sex workers are at a particularly high risk of being infected. Hands Off operated in Botswana, Mozambique, Namibia, South Africa and Zimbabwe. In these countries HIV prevalence among sex workers can be up to four times as high as among the general population. As evidenced by a regional survey carried out at the beginning of the Hands Off programme, police were among the major perpetrators of violence. Violence was fuelled by prejudice and by the criminalisation of sex work and restrictive or ambiguous by-laws. Sex workers tended to be reluctant to report violence for fear of discrimination and further attacks. The logistics of crisis response mechanisms was often lacking, and legal assistance was out of reach for most sex workers.

A number of sex worker-led networks have long been active in the region. However, partly as a result of the criminalisation of their work, their ability to mobilise and to raise rights awareness among peers was limited, as was their organisational capacity.

What we did

1. Strengthening civil society: develop sex worker movements with strong rights awareness
Based on the principle of ‘Nothing for us, without us’ Aidsfonds and in-country partner NGOs supported sex worker-led networks across Southern Africa with the development of tools and skills that made
their organisations stronger. Work was done in areas including governance structures and management capacity, through increased sex-worker participation, training, learning exchanges and mentorship. Five networks have since been formally registered, which increases their access to domestic and donor funding. And all sex worker-led networks are both larger and more organised. Sex workers are more inspired to share information and build a common understanding of their profession and rights.

Civil society organisations representatives during a Hands Off meeting A group of people discussing something over a flip chart

2. Setting up rapid emergency response systems through paralegals and peers
Aidsfonds supported the set up of emergency response systems that in-country partners put in place. Paralegals are trained as first responders and advisers, and equipped with phones whose numbers are made available to sex workers across a particular area. Any new case is documented. Depending on the nature of the incident, the police is alerted, and legal and health services get involved. Partners
follow up on care given, make sure that the survivor is looked after and bring cases to court. This has led to an end of the culture of impunity around violations against sex workers. Sex workers across the region report that where emergency response systems are in place, relations among sex workers have also improved.

Paralegal educating a peer on health & rights Two women in short dresses in a street

3. Turning the police into an ally – Make policing work for sex workers
One of the protagonists in ensuring safety and security for sex workers should be the police. However, evidence shows that police is among the major perpetrators of violence. Past experience shows that simply blaming the police does not work. Developing new ways of working with law enforcement in the future is an integral part of the Hands Off model. In South Africa, cooperation between COC, Hands Off in-country partners, and the national police has even been formalised. Partners in Mozambique have managed to arrange regular meetings with police officers in the capital, Maputo. Improved relations between sex workers and police has led to more sex workers reporting violence. Conversely, developing a targeted strategy by working with vulnerable communities allows the police to better pursue their stated aims.

Exercise from the Dignity, Diversity and Policing training A wall with photos

What has changed?

Violence has been reduced in every area where the Hands Off model was implemented by Aidsfonds 14 partners. This has happened across the Hands Off countries by working constructively with the police and ensuring strong civil society representation in the followup of cases. As one sex worker from Zimbabwe says: ’Now they [the police] really do listen, it’s no longer the same as in previous time. The programme helped in stopping the harassment we were subjected to by the police…’ Increases in access to justice have been secured in several countries and 27 community-led response systems were set up. In Botswana, interventions such as the establishment of a community-led response, training of paralegals, opening up of safe spaces and a helpline have resulted in more cases of violence being reported. A similar effect has been achieved in South Africa through cooperation with the police. Equally, paralegals in newly-established emergency response teams across Southern Africa are referring cases of violence to the police and the courts. Three strategic litigation cases have been won, setting a precedence for sex workers’ justice.

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What we’ve learned

To achieve long-lasting change it is important that all three components of the Hands Off model are implemented. For example, there where partners did not engage with police, reduction of violence against sex workers was limited. Some other things we learned:

Directly investing in communities is key. To maximise the effectiveness of sex worker movements, it is important to invest in the governance and management capacity of sex worker-led organisations
Involve sex workers in or during all stages of the programme. This gives ownership and support of the programme, leading to succes
Emergency response is most effective when led by the community. To reduce community violence, you need to engage with community leaders, religious leaders and the media
Police engagement needs to be rolled out as much and as far as possible. It is important to engage with police at all levels, from national-level decision-makers, to local-level police.

Public health and human rights, they go hand in hand.
Sisonke staff member South Africa