A clinical psychologist and HIV activist, has been part of harm reduction program in Pakistan since 2003. Her work with female sex workers involve HIV prevention testing and treatment services, capacity building, advocacy, research and program development. Bushra was one of the pioneers who started HIV programs for MSM&TGs as-well.

Issue: Sex work in Islamic Republic of Pakistan is Criminalized under section 377, Section 371A and section 371B of the Pakistan Penal Code. Gaps in pro women laws in relation to female sex workers make them vulnerable to face extreme levels of stigma & discrimination violence and other physical and social risks. Sex workers' vulnerabilities pertinent to drug use, HIV&AIDS, violence and other epidemics are still poorly documented and shared for advocacy and programming.
Objective of this abstract is to share learnings with activists, organizations, law makers, duty bearers and donors to effectively understand and respond to FSWs’ situation in relation to their sex work, drug use, human rights’ violations, risks and vulnerabilities to their mental, physical and SRH including HIV&AIDS and STIs.

Setting: BAHAM is working with street-based FSWs in 06 major cities of Pakistan. Through its Outreach teams, BAHAM has reached more than 50,000 FSWs and more than 20000 HIV tests have been conducted more than 140 FSWs are found HIV-positive (58 HIV-positive women injecting drugs out of which 30 have lost their lives).

Key Arguments: Program data suggest 77% FSWs use drugs during sex-worker whereas 71% reported regular use of drugs. Drug use during sex work is highly correlated with partner violence, injuries and abrasive sex are mostly reported with clients of FSWs. FSWs' Poor health status (94.6% mental-health issues, 68.5% physical problems & 77.8% SRH issues) for which 57% never accessed healthcare. Negative effects of sex work include stigma (89.5%), social boycott (44.2%), domestic violence (40%), family disputes (68.8%), relationship problems (78.6%) and malnutrition (55.1%).

Outcomes and application: In Pakistan Targeted advocacy for FSWs' health rights and empowerment is urgently needed. To save lives, resource mobilization for establishing harm reduction, HIV prevention and social justice programs for FSWs are highly suggested.