OTTAWA—A new study published in the respected medical journal Lancet says the decriminalization of prostitution could avert nearly a third of HIV infections among prostitutes and their clients over the next decade.

The study, led by a Canadian researcher, examined all published epidemiological data about HIV — the virus that causes AIDS — among sex workers over the past six years. One of a series of seven papers to examine HIV among sex workers globally, it was presented at 20th International AIDS Conference currently underway in Melbourne, Australia.

“Decriminalization of sex work would have the single greatest effect on the course of HIV epidemics across all settings studied, and could avert at least a third of HIV infections among sex workers and their clients in the next decade,” says the study.

Kate Shannon, an associate professor in medicine at University of British Columbia and the lead Canadian author, told the Star that the research clearly shows Canada is taking the wrong approach in moving to criminalize the purchase of sex and maintaining certain narrowed criminal prohibitions on those who sell sex.

The study showed police harassment “can directly influence HIV acquisition risk by forcing female sex workers to rush transactions with their clients, forgo condoms or engage in risky sexual practices, or by displacement … to isolated or hidden venues, where they have less ability to control transactions (e.g., client selection, types of sexual acts or condom use).”

“This evidence really clearly confirms what we’ve been hearing from sex workers and from academics: that criminalization is putting sex workers at (risk of) huge harms for violence and health and human rights,” Shannon said.

The Conservative government is accelerating parliamentary study of Bill C-36, its proposed legislation regarding prostitution.

“It’s a huge step backwards, Bill C-36,” Shannon told the Star. “It’s really time to listen to science and move past the flawed consultation process that’s been happening over the last few months.”

Shannon said the greatest benefits would come from removing client violence and police harassment from the equation and increasing access to safe workspaces for sex workers. Outreach efforts to distribute condoms or improve access to medical treatment are not enough.

“You try to eliminate one form of violence without addressing these things, (it) won’t have a big impact on the epidemic, whereas if you can remove criminal sanctions targeting sex workers and therefore reduce violence (from clients and police), you have much larger impacts on the epidemics.”

Worldwide, the study shows, female sex workers “are disproportionately affected by the HIV pandemic.”

In many high-income countries and regions, such as Canada, the U.S. and Europe, epidemics that initially escalated in people who inject drugs shifted in the mid-1990s to female sex workers.

Researchers looked at what is called “structural determinants” of the disease — that is, the effects of violence by clients and police, access to effective antiretroviral therapy and the role played by legal regimes and police actions in the epidemiology of HIV.

Despite decades of research and programs, the role of these factors in reducing or boosting the disease among female sex workers is “poorly understood.” Most of the available data comes from Asia. There’s very little from areas where HIV is hitting hardest, such as sub-Saharan Africa, Russia and Eastern Europe.

The researchers looked specifically at Canada, India and Kenya.

“In Canada and Kenya, where sexual violence has an immediate and sustained effect on non-condom use, elimination of violence by clients, police and strangers could avert 17-20 per cent of HIV infections among female sex workers and their clients over the next decade.”

Most striking, the study said, decriminalization of sex work “would have the greatest effect on the course of HIV epidemics across all settings, averting 33 to 46 per cent of HIV infections in the next decade.”

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The Conservative government held rare summer hearings last week into Bill C36, and heard from many evangelical supporters of the bill, who made up about a third of the government’s witnesses.

The government has claimed the proposed legislation has wide support among Canadians. However, the Star reported last week that Canadians are deeply split on the issue.