So this week I went to hospital. Let’s be clear – I hate hospital. I don’t like being stuck in one place, following often pointless (no smoking) rules, or answering to people who treat me like an object rather than a person. If I’m really sick I’ll go. But I have to be really sick.
So this week I get a migraine. Not unusual. I have had migraines regularly since I was a teenager. Never been hospitalised for one. But this one just kept getting worse, beyond anything I have ever had. Until I am lying on the floor unable to move and a friend called an ambulance. So I go to hospital. The hospital pumps me full of medication (including largactil) that while it did not eliminate, helped the pain. The medication also rendered me inarticulate, easily confused and clumsy – basically it made me ‘high’. This will become important later. Because it means I lost the ability to conceal certain facts about myself.
I am a sex worker. Often I cannot conceal this fact in medical settings. As a Victorian sex worker I am subject to mandatory sexual health testing once every three months – regardless of the fact that over twenty years of medical research in Australia (click here to download latest research findings) shows that sex workers have lower rates of STI’s than the general public and higher compliance in prophylaxis use (condoms!). Because I have had interactions with police (no kidding my job used to be illegal) and medical staff, it is written into some of my medical records that I am a sex worker. If I am in a setting where these records are accessed then I have no choice about my status as a sex worker being part of any conversation. It is usually a big part of the conversation.
But I did not expect my status as a sex worker to be part of the conversation when I was in hospital this week. No prior hospital records or medical records had been accessed. No other doctors had been called. I was simply a patient presenting with a migraine.
Then the hospital got me ‘high’, legally high of course, and one of the neurology staff asked “so what do you do?”. And that was it. All my usual answers went unused; that I work for a NGO (also true), that I am self employed (just leaving out the “as a sex worker” part), that I work as a lobbyist (I talk to enough politicians that it feels like it).
Because if someone asks “what do you do?” when you’re high the natural reply is to tell the truth. So I said – “I’m a sex worker” and proceeded to chat about it with them for 15 minutes. Including when they asked “are people prejudice about it?”, I said “hell yes, all the time”. But I probably wasn’t expecting them to give me a specific example of prejudice right then. Which they did.
After our little chat the doctor wandered off for a few minutes then came back to say – “so now we’ve realised that we need to do an HIV test on you” and I asked “this is because I told you I’m a sex worker isn’t it?” and they replied (looking embarrassed) “uh, yeah”. I then stated “well I suppose what I want doesn’t really matter at this point?” and at that the doctor looked away.
Problems with this:
1) I was not in a state to make or be able to give informed consent to being STI/HIV tested
2) That (1) being the case this constitutes a forced STI/HIV test
3) Given that there is HIV criminalisation for sex workers in Victoria this puts me or any other sex worker treated in this manner in a position of potential instant criminalisation.
This is yet another example of the stigma and discrimination that sex workers live with daily. But it is not just another example. Medical professionals have power in society generally – over individual patients lives, through professional associations, through their status as a doctor – but in Victoria the State gives immense power to medical professionals over the lives of sex workers. Power to test sex workers for STI’s/HIV – despite knowing we have demonstrably lower rates than the general population. Power to prevent sex workers from working if we test positive – despite knowing condom compliance rates in the sex industry exceed 99% and that not all sex work involves “sex”. Finally, power to cause sex workers to be jailed for testing positive to HIV as a sex worker (a strategy which demonstrably discourages STI/HIV testing).
This is not okay.
Want to join me in telling the Victorian Government it’s not okay?
Email the Victorian Health Minister – David Davis – firstname.lastname@example.org
Feel free to include a link to this Blog (or not) and make sure to note that sex workers should have the same rights, human rights, labour rights and access to health care and right to refuse health care and testing as other members of the community.