Guide to Australian HIV Laws and Policies for Healthcare Professionals

Sex work

Many people have either worked as a sex worker or engaged sex workers’ services. Estimates suggest many thousands of people engage in sex work in any given year. The Australian Institute of Criminology cites estimates of 1,500 to 10,000 working in NSW at any one time, though many of these estimates count only female sex workers. The Western Australian Government’s Prostitution Law Reform Working Group cites an estimate of some 1200 to 1700 sex workers operating in WA (Prostitution Law Reform Working Group[2] 2007).

The number of clients of sex workers during any given year is not known. Three Australian studies have found that approximately one in every six or seven men admit to having paid for sex at least once. Richters et al., found 2% of men surveyed reported paying for sex in the last year [7]. Woodward et al go further by ‘say[ing] with confidence that at least one in every 30 men has sex with a sex worker during any given year and there are some indications that the true figure is substantially higher’.

Sex workers and their clients do not constitute a ‘discrete’ section of the population. They are members of the general community. Consequently, sex work-related laws, regulations and practices are relevant to general practice and to health care professionals’ duties regarding the sexual transmission of HIV. In that context, it is important to note adoption at a very high-rate of safe sex practice as an occupational health and safety response in the Australian sex industry, and consequently the minimal risk of HIV transmission at a population level.

Sex work laws and regulations are state based with assorted sex work practices variously decriminalised, legalised or criminalised across different jurisdictions. Some legislation is enforced: other is infrequently applied. Importantly, in addition to sex work related laws, HIV-related laws relating to non-commercial sex also usually apply to sex during commercial sexual encounters.

1. Sex Services Premises Planning Advisory Panel. Sex services premises: Planning guidelines. Sydney: NSW Department of Planning, 2004.

2. Prostitution Law Reform Working Group, Prostitution Law Reform for Western Australia, Office of the Attorney General, Government of Western Australian. Sydney; 2007.

3. Victorian Medical Practioners Board (2008) Dr Cindy Yau Fung Lee Wong [2007] 1 MPBV 1.

4. Jenkins, M. (2008) ‘Sex worker purposely spread STD’ The Australian. 18 January 2008.

5. Jeffreys J (2009) 'Sex work: criminalisation and control' in Cameron S & Rule J (eds) The Criminalisation of HIV Transmission in Australia: Legality, Morality and Reality, National Association of People Living with HIV/AIDS.

6. Rissel CE, Richters J, Grulich AE and de Visser RO (2003). Sex in Australia: ... Experiences of commercial sex in a representative sample of adults. Australian and New Zealand Journal of Public Health, 27, 2. Pitts MK, Smith AMA, Grierson J, O’Brien M and Misson S (2004). Who Pays for Sex and Why? An Analysis of Social and Motivational Factors Associated with Male Clients of Sex Workers. Archives of Sexual Behavior, 33, 4. Woodward C, Fischer J, Najman J, Dunne MP. Selling Sex in Queensland 2003.

7. Richters J, de Visser RO, Badcock PB, Smith AMA, Rissel C, Simpson JM, Grulich AE. Masturbation, paying for sex, and other sexual activities: the Second Australian Study of Health and Relationships. Sex Health. 2014;11:460–470.