Thursday, April 09, 2009

Stupid, Stupid Laws (part 2)

So I first blogged about stupid sex work laws that didn't do what they were meant to, or just had bad outcomes over here. That was a South Australian story, since I've been living in Melbourne for about a year now, I figured I should write a little bit about the travesty that are the Victorian sex work laws, in particular, mandatory sexual health testing of sex workers.

The testing regime in Victoria, according to the Prostitution Control Act (!) mandates swab tests every month, with blood tests every three months. This practice is supposed to occur, if you have any symptoms of an STI or not, whether you have had a condom breakage or slippage or not, whether you provide penetrative sex services or not. So, as this isn't based on any real risk practice, just whether you charge for a sexual service, so there is an huge waste of clinical resources on this practice.

The strain on clinical services becomes apparent when you attend the Melbourne Sexual Health Centre.

Currently, in order to be seen within 1 hour of attending the clinic, you have to be there upon opening, at 8.40 am.

If you attend before midday, you are likely to be seen within about 3 hours (or have your details taken and asked to come back after lunch when they will be seen in order. If you first show up after lunch, then you will not be seen that day.

Obviously this is due to the enormous strain on the services by sex workers, who for the most part will not have experienced any symptoms or breakages since their last test. I presume that the clinic prioritises people who (once determined after the brief interview with the triage nurse) actually demonstrate some genuine risk of being infected; however, it simply isn’t possible for everyone who needs access to have adequate access to the service, under the current system. For most people, setting aside a significant amount of time out of their day to wait for testing is difficult.

There is a major sexual health clinic in (I think) every capital city of Australia, and although anyone is welcome to visit a private doctor if they have a Medicare card, the benefit of these services is that they are free, reasonably anonymous - you don't need to provide a Medicare card, so presumably you can give a fake name), you can drop in without an appointment, and get testing and treatment by medical staff who are more used to diverse lifestyles, sexual identities and practices than some suburban doctors might be). I’ve now worked in three states, and this is the only time I’ve had to wait longer than about an hour to get in to see a nurse in the major metropolitan sexual health clinic. I can only assume that this bares a direct relation to the fact that this is the only state that does mandatory sexual health testing of sex workers.

Given that their has never been a reported case in Australia of client to sex worker, or sex worker to client HIV transmission, in the more than twenty year history of the virus in this country, given that sex workers have lower rates of sexually transmitted infections than the general population, and higher rates of condom use, this over testing does nothing to protect public health, and only services to stigmatise sex workers. as long as no one is seriously discussing testing clients - or other sexually active adults, this practice is about discrimination based on status. There has been anecdotal evidence for more than a decade now coming out of Victoria that clients are well aware that licensed brothels require sex workers to submit to regular sexual health tests and present certificates of attendance in order to work, and feel emboldened to request services without a condom as a result. So, in fact mandatory testing puts so much more pressure on sex workers, and makes our work so much harder, to keep providing services with a condom, and to protect our OHS.

No comments: