When Canada decided to tackle prostitution by adopting “end demand” laws, it was supposed to make sex work safer and healthier.

But precisely the opposite has happened, according to new research presented at the International AIDS Conference in Amsterdam on Thursday.

Researchers from both Canada and France found that prosecuting men who buy sex instead of sex workers – known as the the Nordic model, or “end demand” approach – actually made life worse for sex workers by pushing the trade further into the shadows, making it more difficult to negotiate prices and condom use, and making it less likely that workers would access health services.

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“We still have a criminalization approach, all we’ve done is shift the target to the client,” said Elena Argento, a research associate with the Gender & Sexual Health Initiative of the B.C. Centre for Excellence in HIV/AIDS. “This has made things worse, not better, for sex workers.”

In 2013, the Supreme Court of Canada struck down as unconstitutional the laws prohibiting brothels, public communication for the purpose of prostitution and living on the profits of prostitution. In 2014, a new law, the Protection of Communities and Exploited Persons Act (PCEPA), was introduced that makes it illegal to purchase sexual services, but not to sell them.

Ms. Argento, a PhD candidate at the University of British Columbia, studied 854 cisgender and trans sex workers in B.C.

She found that, post-PCEPA, 18 per cent were not able to access health services when needed, compared to 13 per cent prior to the law. Similarly, 77 per cent accessed sex work support services before the law was changed and that dropped to 69 per cent after the new legislation.

France adopted similar legislation in 2016. Hélène Le Bail, a researcher at Sciences Po CERI in Paris, said the “end demand” approach was supposed to be more progressive but France has seen the same problems as Canada. “It doesn’t matter who you criminalize, it creates stigma.”

Her research, which involved 691 sex workers, showed that “end demand” laws have resulted in an “acute increase in socioeconomic vulnerability.”

Because transactional sex no longer happens out in the open, sex workers have seen a spike in violence and robbery, and it has become far more difficult to negotiate fees and safer sex, she said. “The clients are now taking the risk of prosecution, so they think that gives them more power to demand unsafe sex practices.”

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To make matters worse, Dr. Le Bail said, sex workers are still more likely to be arrested and fined than their clients.

Since the law changed in France, there has been a spike in rates of sexually transmitted infections among sex workers, but it’s too early to say if HIV rates have also increased, she said.

Ms. Argento said the fundamental flaw of “end demand” laws is they assume sex workers are victims and “conflate sex work with trafficking.”

“Full decriminalization of sex work is critical to protecting the health and safety of sex workers,” she said.

Influential organizations such as Amnesty International and UNAIDS also endorse decriminalization, saying it’s the best way to ensure the labour rights and human rights of sex workers are respected.

However, New Zealand is the only country that has done so, making sex work and street solicitation legal in 2003.

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Other countries have a range of laws, ranging from outright prohibition to licensing of sex workers. Canada’s anti-prostitution laws are among the most restrictive in the Western world.