Sex workers in Ukraine face even greater health risks after war

When the air-raid warning sirens fell silent, Olena left the shelter and walked back to the sidewalk, waiting for customers looking for sex. As the Russian bombs fell, social workers noticed a reduction in HIV treatments. The people who needed them disappeared from the streets.

When soldiers approached Tetiana, usually armed, they often asked for discounts that she didn’t have the heart to deny. “The soldiers would say ‘Tania, come for an hour,'” she says, but then ask for more time. “I end up going and entertaining them all night for the same money.”

The Russian invasion affected all cities, industries and professionals in all sectors in Ukraine, killing thousands of civilians and forcing millions more to flee their homes. People who sell sex, an especially vulnerable group even in peacetime, are at even greater risk of poverty, coercion and ill health, say sex workers and social workers.

And that situation has consequences in Ukraine’s fight to stop the spread of HIV.

In the country, one of Europe’s biggest pre-war sex tourism destinations, prostitution is illegal but widely tolerated. According to the government-run Public Health Center of Ukraine, the sex industry was large, involving an estimated 53,000 professionals.

The war sharply reduced the income of these professionals and affected assistance programs to combat drug addiction and HIV treatment. Before the invasion, the country had a large number of people with the virus, and the fight against HIV was one of the priorities of the health service.

According to the health center, a third of people who before the war were entitled to assistance to combat disease and drug addiction were no longer receiving this help in the Northern Hemisphere summer of 2022. The war has undone years of progress towards safer practices.

But several sex workers — who consented to interviews on the condition that only their first names be used, out of concern for family members and fear of the police — said they needed the job to survive. “On the first day of the war I didn’t come here,” said Olena, interviewed on a road near Kamianske in central Ukraine. “But on the second day, yes.”

Another woman, Liudmila, said that she now charges US$6 (R$30) an hour, half of what she was paid before the war. “Even my regular customers couldn’t come to me because they didn’t have any money,” she said.

Several professionals said that the military mobilization of hundreds of thousands of men changed the profile of their activity. Soldiers invaded cities and weapons were everywhere.

Liudmila claims that some soldiers have been kind, bringing tips and flowers. On the other hand, Olena says that she does not get into a car if there is more than one man in the vehicle, and Tetiana said that some refuse to pay the agreed price. “Sometimes someone promises me $12 [R$ 60]I do my job, but he only pays me $7 [R$ 35]. He says ‘I’m earning less now’, and I say ‘so don’t come looking for me’.”

The war greatly reduced the number of foreign clients, says a professional named Rita, who is raising two small children. Vlada, who works at the same brothel and said he helps support his mother and siblings, said he went from having 18 customers a day to about seven.

“In the past, customers tipped us so well that we forgot to pick up our paychecks,” she says. “Now, after giving half to the owner of the house, we only get $40 [R$ 203].”

Denis lives in the capital Kiev and works mainly with gay men. He said that in the first weeks of the war he went to live in a subway station, avoiding the bombings, but without earning anything. Even afterward, movement was slow. “People are mentally exhausted,” he said. “They’re fed up with these air raid sirens. They have other priorities than going out with me.”

To try to make up for lost income, Denis now seeks to help social workers, whose meager resources have been sorely depleted by the war. In Dnipro, the charity Virtus has registered 2,300 sex workers. But, according to a social worker, Irina Tkachenko, a much larger number arrived in the city fleeing the fighting. “It takes time to build trust.”

As supply chains are not functioning normally, social workers have fewer condoms and fewer syringes to distribute to prevent sharing by drug users.

One of the biggest concerns of social workers is the spread of HIV. Treatment with antiretrovirals helps reduce transmission, but in the last 12 months around 40 of the treatment centers in the country have stopped working, in half of the cases because they were damaged by bombs.

Another woman named Tetiana, a social worker who has worked with sex workers in Kamianske for 15 years, distributes what she can and recommends people to continue taking their medicine.

“We make a big effort to teach people how to take care of themselves,” she said. “I know everyone like I’m your mother, but they often don’t listen to me. I stay here and try to protect them.”