Sex workers' health and wellbeing depends on more than individual choices. It relies on access to affirming sexual and reproductive healthcare, mental health support, and safe working conditions - all shaped by legal frameworks, policy responses and social attitudes. Sex workers are experts in our own health, we are leaders in peer education and have been delivering successful health promotion in Australia for decades. But structural barriers still stand between us and the non-judgemental care we need.
Sex workers in unceded Australia have been at the forefront of sexually transmissible infection (STI) and HIV prevention since the late 1970s. At that time, most forms of sex work were criminalised, brothels were regularly raided, and condoms could be used as evidence of “prostitution” in court.
When HIV emerged and our friends, lovers and communities started dying, science was still catching up. Sex workers, gay and bisexual men and people who inject drugs understood that something linked to unprotected sex and shared injecting equipment was causing these deaths, and we acted before formal public health responses.
From the early 1980s, sex workers organised to form peer organisations such as the Australian Prostitutes Collective and later the Sex Workers Outreach Project New South Wales (SWOP NSW), one of the first sex worker organisations in the world to receive government health funding. These organisations have since partnered with health departments, sexual health clinics and researchers to design, deliver and evaluate evidence-based Blood Borne Virus (BBV) and STI prevention and health promotion initiatives.
PUBLISHED APRIL 2026
ADVOCACY RESOURCE
This resource highlights decades of sex worker leadership in HIV and STI prevention, the proven success of peer-led health promotion and the importance of decriminalisation, sustainable funding and meaningful partnerships in protecting the health and wellbeing of sex workers and our communities.
The early days of COVID-19 felt strangely apocalyptic. Supermarket shelves were stripped bare, entire aisles emptied of toilet paper, and no one quite knew what was coming next. Public health crises like these emphasise gaps in the system, and reveal the vital role of peer-led organisations in shaping effective responses.
When COVID-19 hit, sex workers were quick to adapt, share harm reduction advice and mobilise community support, long before governments recognised the impacts on our work. As many sex workers were excluded from government assistance, Scarlet Alliance and our member organisations coordinated a national response, raising over $180,000 in donations, distributing 760 crisis payments and delivering multilingual health resources, safer sex packs and peer support.
Our organisations also worked directly with health departments to develop practical, evidence-based public health responses. In the Northern Territory, the government adopted COVID-safe guidelines developed by SWOP NT with support from Scarlet Alliance.
When mpox cases emerged among Sydney sex workers in 2025, SWOP NSW responded just as quickly, coordinating targeted outreach, vaccination and stigma-free healthcare in partnership with NSW Health. Within weeks, vaccination rates were high and the outbreak was contained.
From COVID-19 to mpox, sex workers have shown that we know how to protect our communities. When governments recognise, resource and work alongside peer organisations, public health responses are more trusted, responsive and effective.
Sex worker peer education means education, health promotion, support and information delivered by sex workers for sex workers. Peer education happens through outreach, workshops, community events, online and print resources, and one-on-one support. These approaches reach communities that mainstream services often do not. It works because it’s non-judgemental, community-led and grounded in lived experience.
PUBLISHED APRIL 2026
ADVOCACY RESOURCE
This resource explores the proven benefits of sex worker-led peer education in improving sexual health, strengthening community connections and reducing barriers to support. It calls for sustainable funding, meaningful sex worker engagement and greater investment in peer-led programs that protect our rights, health and wellbeing.
Red Book Online is our national sex worker-led resource hub, providing practical, accessible information on sexual health, safer sex, workplace safety, rights and wellbeing. Developed by sex workers, for sex workers, Red Book supports informed decision-making, harm reduction and safer working practices through trusted, relevant and non-judgemental information.
Red Learning Hub (formerly SANTP) is our national training and capacity-building program for sex worker peer educators and organisations. Through self-paced learning modules, group sessions and individual support, the program builds skills in peer education, health promotion, advocacy, community development and sex worker rights, strengthening peer leadership across Australia.
Sex workers negotiate terms, manage risk and enforce boundaries, all without breaking the fantasy. This is skilled, deliberate work, yet our expertise is often overlooked, and we are treated as risks rather than recognised as experts.
In reality, clients often see us as “sexperts”, asking questions about sexual health and safer sex that they might never ask a doctor. This puts us in a unique position to share accurate, non-judgemental information about HIV, STIs, safer sex practices and testing, reaching people who might otherwise never engage with health promotion. Decriminalisation and peer-led programs are essential to recognising this expertise and creating the conditions for us to share our knowledge safely and effectively.
PUBLISHED APRIL 2026
ADVOCACY RESOURCE
This resource explores how criminalisation, stigma, discrimination and gaps in healthcare provider training create barriers to sexual and reproductive healthcare for sex workers. It calls for accessible, confidential and stigma-free services, stronger protections for bodily autonomy and greater investment in peer-led healthcare that supports our health, safety and wellbeing.
These barriers have serious negative health outcomes for sex workers. Sex workers may delay or avoid healthcare, including STI screening and treatment, cervical screening and discussion about contraception. Sex workers who avoid disclosing their work due to stigma or privacy concerns may access multiple services. This creates gaps in medical history, poor continuity of care, and missed opportunities for more holistic sexual and reproductive health support.
Partnerships, not rescue, deliver results. Scarlet Alliance will keep working to remove the barriers standing between sex workers and the healthcare we’re entitled to, and to make sure the partnerships that built Australia’s world-leading HIV and STI outcomes are backed with the funding and recognition they deserve. Sex worker representation on bodies like the Blood Borne Viruses and Sexually Transmissible Infections Standing Committee ensures our expertise shapes national health strategy, not just our participation in it. To keep building on this record, sex workers are calling for:
Explore more of our research, submissions and advocacy on sex worker health and wellbeing, peer-led health promotion, access to healthcare, workplace health and safety, and the policies that impact our communities.
