Between a rock and a hard place: sex work, sexual health and the law in the French context


Nancy Nzeyimana Cyizere, Université Toulouse - Jean Jaurès & Institut national d'études démographiques (Ined)

This communication is part of a doctoral research examining the vulnerabilities to HIV and aids of black people in continental France, whether natives or immigrants. To question the role of several environmental and psychosocial factors in the exposure to the risk of primary contamination to HIV or to a health deterioration towards AIDS, we conducted 70 interviews between January 2022 and February 2023 in the Paris (N=48) and Toulouse (N=22) metropolitan areas, with health and social sector “Professionals” and black “Individuals” aged 18 and above. On one hand, we questioned Professionals’ practices as a factor of improvement in access to health and social services or, on the contrary, of disadvantage. On the other hand, we questioned Individuals’ opinions and experiences with HIV (retrospective and current), their general health trajectories and their living conditions. Researchers and policy-makers alike have often understood sex workers’ overexposure to HIV (and other sexually transmitted infections) as an occupational hazard. Yet on the field, Individuals and Professionals alike identified nation-wide policies penalizing sex work and international migration (especially from the Global South) as the main culprits. Initially the 2016 law that penalizes the use of sex work has degraded their working conditions and their sexual health. Indeed, as (male) clients now take legal risks to visit sex workers, many insists on genital penetration with no condom. Despite being aware of the potential consequences or their sexual health, fewer sex workers are able to refuse these demands as the decline in the number of clients has reduced their income. Furthermore, the precarization of sex work affects workers unequally depending on their social and legal constraints. In particular, those who are in an unlawful situation regarding their administrative residency status are more sharply affected. First, they cant access legal employment meaning that their options for earning a livelihood are particularly limited. Secondly, they live with an acute fear of being identified by the police, arrested, detained and deported from France, which impede on their use of key resources such as associations and health centers. The ideologies that have shaped the current situation — described as catastrophic by community-based associations — have emerged from two different fields of political mobilization in contemporary France. The French state’s position on sex work aims to eradicate it from the territory and is first and foremost carried by a subset of feminist activists (called “abolitionist”), for whom sex work is the expression of patriarchal domination. The State’s anti-immigration policies result from the normalization of xenophobic and racist discourses in the media and the political class — such as “migrants abuse public resources”, “they don’t want to integrate” or “their culture is not compatible with ours” — that have created an “immigration problem” (“problème de l’immigration”), that ever more closed-off borders should help resolve. To understand the current gaps in the prevention, screening and treatment of HIV among sex workers, it is indispensable to analyze how the legal framework impacts their working conditions. The restrictive legal frameworks around sex work and international migration exacerbate any pre-existing social inequalities between clients and workers, as the latter’s earning potential and bargaining power have crumbled.

This paper will be presented at the following session: