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I’m finally in Thailand celebrating our Development Marketplace for Innovation award from the World Bank Group and the nonprofit Sexual Violence Research Initiative (SVRI) to prevent gender-based violence. Just one month ago, our team members, consisting of Sex Workers IN Group’s (SWING) leaders, Surang Janyam and Chamrong Phaengnongyang, and Mahidol University researcher, Dusita Phuengsamran, were at the awards ceremony in Washington DC, humbled by the words and encouragement of World Bank Group President Jim Yong Kim. Today, half a world away, at SWING’s colorful conference space, the passion for violence prevention that infused the awards ceremony is still with us.

Why violence prevention and response for female sex workers? Most people think of HIV, if anything, when they think about female sex workers. Few realize the profound and disproportionate risk this population faces for physical and sexual gender-based violence. Their homicide rate is approximately 17 times higher than that of women in the general population. Our team’s past research found that 15% of female sex workers in Thailand reported experiencing physical or sexual violence in the past week alone, up to 20% for women in urban Bangkok, and 29% for those working out of the relative safety provided by venues. Perpetrators include partners, police, pimps, and clients.

The health implications are also profound, such as increased risk for poor sexual and reproductive health, even sexually transmitted infections like HIV. But female sex workers remain underserved by traditional violence prevention and support programs, and have little access to justice where sex work is criminalized and marginalized. Trauma-informed care, which anticipates and responds to the likelihood of violence and trauma in populations highly affected, is key for female sex workers given this profile. Precisely because female sex workers are so hidden and underserved, we are thrilled to have the support of the World Bank in tackling the challenge of gender-based violence prevention and support.

Energy sweeps through the room as we finalize plans for project implementation and evaluation research. Our challenges: implement quickly, balance reach to the population with the depth and level of support necessary for healing and safety promotion, and provide a meaningful response to violence that doesn’t leave our outreach staff burned out. Most fundamentally, our goal is to empower women to reduce harm, promote safety, and seek justice when needed.

Women must believe that their safety and rights are worth defending – even when the odds feel stacked against them for involvement in sex work. Clients and police need these messages too. We must create an environment that tells women they do not deserve to be abused, that someone cares about their safety and well-being.

We are invigorated, inspired, and challenged to transform a world that perpetrates violence and blames victims to one in which freedom, safety, health and human rights prevail for all.

Written by Michele R. Decker, Johns Hopkins Bloomberg School of Public Health


  Michele R. Decker is an Associate Professor in the Department of Population, Family and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health. She directs the Women’s Health and Rights Program of the Center for Public Health and Human Rights. A social epidemiologist by training, her research focuses on gender-based violence including epidemiology, prevention and response, and implications for sexual and reproductive health, including HIV.  She works with sex workers and other high-risk populations, domestically as well as in South and Southeast Asia, sub-saharan Africa, Eastern Europe and Central Asia. Follow @MicheleRDecker.

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