In some states, working as a sex worker living with HIV or an STI is criminalised. Where this is the case, rapid testing could mean that sex workers become immediately criminalised upon receiving a positive or ‘reactive’ result. Although a reactive result is not a diagnosis and should not mean instant criminalisation, a reactive result could foreseeably lead to presumptions about the HIV status of the sex worker, with a number of ramifications. The process of waiting for confirmatory testing, especially if the rapid test is administered in a workplace environment, where the health professional is aware the person is a sex worker, or in a remote or rural environment where we may not be anonymous, raises issues around the person’s legal work status, confidentiality, prosecution, discrimination and stigma. In a workplace environment, a reactive or indeterminate result will immediately place a person’s occupation, career and income at stake. This is regardless of whether individual workers practice safer sex, cater to specifically HIV positive clients, or offer non-penetrative services. This risk is compounded because sex workers as a population are more likely to receive false reactive results. There are serious ramifications of rapid testing for sex workers in jurisdictions where working with HIV/STIs is criminalised.
