Chacham Alessandra S, Diniz Simone G, Maia Mônica B, Galati Ana F, Mirim Liz A
Associate Professor, Department of Social Sciences, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte MG, Brazil.
Reprod Health Matters. 2007 May;15(29):108-18. doi: 10.1016/S0968-8080(07)29292-4.
The sexual and reproductive health needs of sex workers have been neglected both in research and public health interventions, which have almost exclusively focused on STI/HIV prevention. Among the reasons for this are the condemnation, stigma and ambiguous legal status of sex work. This paper describes work carried out by two feminist NGOs in Brazil, Mulher e Saúde (MUSA) in Belo Horizonte and Coletivo Feminista Sexualidade e Saúde in São Paulo, to promote sexual and reproductive health for sex workers. MUSA's project "In the Battle for Health", was begun in 1992; sex workers were trained as peer educators and workshops were offered on self-care for sex workers and their clients. In São Paulo, the Coletivo project "Get Friendly with Her", begun in 2002, offers clinic consultations and self-care workshops on sexuality, contraception, STI/HIV prevention and self-examination. Health care needs during menstruation and unhealthy vaginal practices led to promotion of the diaphragm as a contraceptive, for prevention of reproductive tract infection and to catch menstrual blood. Meeting the sexual and reproductive health needs of sex workers depends on the promotion of their human rights, access to health care without discrimination, and attention to psychosocial health issues, alcohol and drug abuse, and violence from clients, partners, pimps and police.
性工作者的性健康和生殖健康需求在研究和公共卫生干预中一直被忽视，这些研究和干预几乎都只专注于性传播感染/艾滋病毒的预防。造成这种情况的原因包括对性工作的谴责、污名化以及其法律地位的模糊。本文介绍了巴西两个女权主义非政府组织开展的工作，在贝洛奥里藏特的妇女与健康组织（MUSA）以及在圣保罗的女权主义性与健康集体组织，旨在促进性工作者的性健康和生殖健康。MUSA的“健康之战”项目始于1992年；性工作者被培训为同伴教育者，并为性工作者及其客户举办了自我护理工作坊。在圣保罗，始于2002年的集体组织项目“与她友好相处”提供临床咨询以及关于性、避孕、性传播感染/艾滋病毒预防和自我检查的自我护理工作坊。月经期间的医疗保健需求以及不健康的阴道护理习惯促使推广子宫托作为一种避孕方法，以预防生殖道感染并接住经血。满足性工作者的性健康和生殖健康需求取决于促进她们的人权、不受歧视地获得医疗保健，以及关注心理社会健康问题、酗酒和药物滥用，还有来自客户、伴侣、皮条客和警察的暴力行为。
