Incarcerated sex workers and HIV prevention in China: Social suffering and social justice countermeasures

Sex workers in China are routinely coercively detained through administrative mechanisms outside of legal procedures, but very little is known about the anthropologic and public health context of these policies. This biosocial analysis of female Chinese sex worker detention uses ethnographic, legal, and public health data to describe social suffering and countervailing social justice responses among incarcerated sex workers (ISW) in China. Compared to sex workers not detained in China, ISW face substantive inequalities inscribed in physical and psychological suffering. Chinese sex worker detention camp practices may not only systematically increase HIV/syphilis risk among ISW, but also work to narrow women's social spheres of influence, a particularly cruel tragedy in a Chinese social system that highly values social and personal connections. A limited empiric analysis of Guangxi Province STI clinic data shows that cities detaining sex workers have higher mean HIV prevalence compared to cities that do not detain sex workers. While incipient medical and legal movements in China have generated momentum for expanding ISW services and resources, there is still substantial variation in the implementation of laws that ensure basic life-saving medical treatments. Post-incarceration social justice programs for sex workers linking women to essential STI/HIV resources, reconnecting broken social lives, and helping restore interpersonal relationships are urgently needed.