FROM CRIMINALIZATION TO PROTECTION: SEX WORKER HEALTH POLICY REFORM IN INDONESIA

TOWARD A POLYMORPHOUS DISCOURSE IN PROSTITUTION REGULATION

Authors

DOI:

https://doi.org/10.9771/rds.v6i2.66251

Keywords:

Sex Workers, HIV/AIDS, Public Health, Human Rights, Health Policy, Stigma, Prostitution, Harm Reduction, Gender Inequality

Abstract

Based on several studies, sex workers in Indonesia are at high risk of contracting STDs and HIV/AIDS, including mental health. The practice of unprotected sex and limited access to necessary health services and resources often causes these risks. Stigma and discrimination, both structural and social, encompass laws and policies that punish, exacerbate disparities, and discourage sex workers from protecting their health, safety, and well-being. This study aims to analyze health policies related to sex workers in the context of the right to health in Indonesia. The results of the study show that the criminalization of sex workers is contrary to the principles of human rights and public health because it does not offer solutions to structural problems in prostitution.On the contrary, this creates a dead end that does not improve the existing conditions. Prostitution carries high health risks, including HIV infection, as well as negatively impacting mental health and financial stability. The state needs to protect sex workers from health rights violations and violence and implement harm reduction approaches through education and health services. HIV/AIDS prevention policies should focus on public health, not morality, to address gender inequality and the high prevalence of infections.

Downloads

Download data is not yet available.

Author Biography

Aga Natalis, Universitas Diponegoro

S.H., M.H., a lecturer and researcher at the Faculty of Law, Universitas Diponegoro in Semarang, Indonesia. Bachelor’s (2017), Master’s (2018), and Doctoral (2024) degrees in Law from the same institution, with a consistent academic focus on law and gender. E-mail: aganataliss@lecturer.undip.ac.id. Indonésia.

References

Abel, G. (2010). Decriminalisation: A harm minimisation and human rights approach to regulating sex work [Dissertation]. University of Otago.

Alam, N., & Alldred, P. (2021). Condoms, Trust and Stealthing: The Meanings Attributed to Unprotected Hetero-Sex. International Journal of Environmental Research and Public Health, 18(8). https://doi.org/10.3390/ijerph18084257

Anggraeni, S., & Ramadhani, E. R. (2022). Uncertainty of the Right to Health in Indonesia during Covid-19 Pandemic. Journal of Southeast Asian Human Rights, 6(1), 55–71. https://doi.org/10.19184/jseahr.v6i1.30743

Argento, E., Chettiar, J., Nguyen, P., Montaner, J., & Shannon, K. (2015). Prevalence and Correlates of Nonmedical Prescription Opioid Use Among a Cohort of Sex Workers in Vancouver, Canada. International Journal of Drug Policy, 26(1), 59–66. https://doi.org/10.1016/j.drugpo.2014.07.010

Backman, G., Hunt, P., Khosla, R., Jaramillo-Strouss, C., Fikre, B. M., Rumble, C., Pevalin, D., Páez, D. A., Pineda, M. A., Frisancho, A., Tarco, D., Motlagh, M., Farcasanu, D., & Vladescu, C. (2008). Health Systems and the Right to Health: An Assessment of 194 Countries. The Lancet, 372(9655), 2047–2085. https://doi.org/10.1016/S0140-6736(08)61781-X

Beattie, T. S., Smilenova, B., Krishnaratne, S., & Mazzuca, A. (2020). Mental health problems among female sex workers in low- and middle-income countries: A systematic review and meta-analysis. PLOS Medicine, 17(9), e1003297. https://doi.org/10.1371/journal.pmed.1003297

Boci, G. (2019). The Role and The Limits of International Law in Adressing Cultural Practices Harmful to Women and Girls: The Case of Female Genital Mutilation [Master Thesis]. University of Oslo.

Danis, M., & Nayak, R. (2016). Health Policy. In H. ten Have (Ed.), Encyclopedia of Global Bioethics (pp. 1458–1468). Springer International Publishing. https://doi.org/10.1007/978-3-319-09483-0_223

Director General Disease Control and Prevention. (2017). Estimates and Projection of HIV/AIDS in Indonesia 2015-2020. Kementerian Kesehatan Republik Indonesia. https://kpakotabandung.or.id/book/estimates-and-projection-of-hiv-aids-in-indonesia-2015-2020/

Duby, Z., Bergh, K., Jonas, K., Reddy, T., Bunce, B., Fowler, C., & Mathews, C. (2023). “Men Rule… this is the Normal Thing. We Normalise it and it’s Wrong”: Gendered Power in Decision-Making Around Sex and Condom Use in Heterosexual Relationships Amongst Adolescents and Young People in South Africa. AIDS and Behavior, 27(6), 2015–2029. https://doi.org/10.1007/s10461-022-03935-8

Dye, T. (2013). Understanding Public Policy. Pearson.

Faissner, M., Beckmann, L., Freistein, K., Jungilligens, J., & Braun, E. (2024). Healthcare for Sex Workers—Access, Barriers, and Needs. Ethik in Der Medizin, 36(2), 151–168. https://doi.org/10.1007/s00481-024-00815-8

Flanigan, J., & Watson, L. (2019). Debating Sex Work. Oxford University Press. https://doi.org/10.1093/oso/9780190659882.001.0001

Fox, J. A. (2021). International Law After Dark: How Legalized Sex Work Can Comport with International and Human Rights Law. Chicago Journal of International Law, 22(1), 185–222. https://cjil.uchicago.edu/print-archive/international-law-after-dark-how-legalized-sex-work-can-comport-international-and

Gostin, L. (1995). The Formulation of Health Policy by the Three Branches of Government. In Society’s Choices: Social and Ethical Decision Making in Biomedicine. National Academies Press (US).

Haddad, L. B., Tang, J. H., Krashin, J., Ng’ambi, W., Tweya, H., Samala, B., Chiwoko, J., Chaweza, T., Hosseinipour, M. C., Lathrop, E., Jamieson, D. J., & Phiri, S. (2018). Factors Associated with Condom Use Among Men and Women Living with Hiv in Lilongwe, Malawi: A Cross-Sectional Study. BMJ Sexual & Reproductive Health, 44(1), 1. https://doi.org/10.1136/bmjsrh-2017-101825

Hartini, N., Fardana, N. A., Ariana, A. D., & Wardana, N. D. (2018). Stigma toward people with mental health problems in Indonesia. Psychology Research and Behavior Management, 11(null), 535–541. https://doi.org/10.2147/PRBM.S175251

International Labour Organization. (2017). Global Estimates of Modern Slavery: Forced Labour and Forced Marriage. International Labour Organization. https://www.ilo.org/wcmsp5/groups/public/@dgreports/@dcomm/documents/publication/wcms_575479.pdf

Joint United Nations Programme on HIV/AIDS. (2008). UNAIDS Guidance Note on HIV and Sex Work. UNAIDS. https://www.unaids.org/en/resources/documents/2012/20120402_UNAIDS-guidance-note-HIV-sex-work

Joulaei, H., Zarei, N., Khorsandian, M., & Keshavarzian, A. (2021). Legalization, Decriminalization or Criminalization; Could We Introduce a Global Prescription for Prostitution (Sex Work)? International Journal of High Risk Behaviors and Addiction, 10(3), e106741. https://doi.org/10.5812/ijhrba.106741

Kendall, M., & Razli, K. (2010). Indonesia: Sex Work and HIV/AIDS (HIV and AIDS Data Hub for Asia‐Pacific). Joint United Nations Programme on HIV/AIDS (UNAIDS). https://www.aidsdatahub.org/resource/indonesia-sex-work-and-hiv-aids

KOMNAS HAM. (2019). Menyoal Dampak Penutupan Lokalisasi di Indonesia. Komisi Nasional Hak Asasi Manusia Republik Indonesia. https://www.komnasham.go.id/index.php/news/2019/9/24/1170/menyoal-dampak-penutupan-lokalisasi-di-indonesia.html

K’reisa, J. C. (2021). Vocation or Victimization: An Analysis of Legal Models Addressing Prostitution [Thesis]. Seattle Pacific University.

Krüsi, A., D’Adamo, K., & Sernick, A. (2021). Criminalised Interactions with Law Enforcement and Impacts on Health and Safety in the Context of Different Legislative Frameworks Governing Sex Work Globally. In S. M. Goldenberg, R. Morgan Thomas, A. Forbes, & S. Baral (Eds.), Sex Work, Health, and Human Rights: Global Inequities, Challenges, and Opportunities for Action (pp. 121–140). Springer International Publishing. https://doi.org/10.1007/978-3-030-64171-9_7

Marks, S. P. (2013). The Emergence and Scope of the Human Right to Health. In J. M. Zuniga, S. P. Marks, & L. O. Gostin (Eds.), Advancing the Human Right to Health (p. 0). Oxford University Press. https://doi.org/10.1093/acprof:oso/9780199661619.003.0001

Marlina, Suyanto, & Masadi, N. (2010). Perilaku Pekerja Seks Komersial Dalam Penggunaan Kondom Untuk Pencegahan Transmisi HIV/AIDS Di Lokalisasi Teleju Kota Pekanbaru. Jurnal Kesehatan Komunitas (Journal of Community Health), 1(1), 20–31. https://doi.org/10.25311/keskom.Vol1.Iss1.7

Marmot, M. (2005). Social Determinants of Health Inequalities. The Lancet, 365(9464), 1099–1104. https://doi.org/10.1016/S0140-6736(05)71146-6

Minton, H. A. M., Mittal, M., Elder, H., & Carey, M. P. (2016). Relationship Factors and Condom Use Among Women with a History of Intimate Partner Violence. AIDS and Behavior, 20(1), 225–234. https://doi.org/10.1007/s10461-015-1189-5

Mulati, T. S., Indarto, & Ratnasari, P. (2016). Perilaku Pekerja Seks Komersial Terhadap Pencegahan Penyakit Menular Seksual Di Lokalisasi Kalinyamat Bandungan. Jurnal Kebidanan Dan Kesehatan Tradisional, 1(1), 40–47. https://doi.org/10.37341/jkkt.v1i1.28

Nampewo, Z., Mike, J. H., & Wolff, J. (2022). Respecting, Protecting and Fulfilling the Human Right to Health. International Journal for Equity in Health, 21(1), 36. https://doi.org/10.1186/s12939-022-01634-3

Natalis, A., Purwanti, A., & Asmara, T. (2023). Determining Appropriate Policies for Prostitution Reform in Indonesia: Evaluating Harm Reduction Versus Harm Elimination Strategies. Journal of Southeast Asian Human Rights, 7(2), 176–213. https://doi.org/10.19184/jseahr.v7i2.37952

Neave, M. (1988). The Failure of Prostitution Law Reform. Australian & New Zealand Journal of Criminology, 21(4), 202–213. https://doi.org/10.1177/000486588802100403

Novita, D. I., Karo, M. B., Tambaip, T., & Ekawati, E. A. (2022). Prevalensi dan Karakteristik Pasien Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) Di Kabupaten Merauke Periode Tahun 1992-2021. Prosiding Pengabdian Kepada Masyarakat Poltekkes Kemenkes Tasikmalaya, 2(2), 165–172. https://doi.org/10.37160/ppkm.v2i2.136

Olong, H. A. K. (2007). Tangan kuasa dalam kelamin: Telaah homoseks, pekerja seks, dan seks bebas di Indonesia. Insist Press.

Panneh, M., Gafos, M., Nyariki, E., Liku, J., Shah, P., Wanjiru, R., Wanjiru, M., Beksinska, A., Pollock, J., Gwala, D., Oside, D., Kamene, R., Watata, A., Atieno, A., Njau, F., Njeri, E., Orobi, E., Lwingi, I., Jama, Z., … The Maisha Fiti Study Champions. (2022). Mental health challenges and perceived risks among female sex workers in Nairobi, Kenya. BMC Public Health, 22(1), 2158. https://doi.org/10.1186/s12889-022-14527-5

Platt, L., Grenfell, P., Meiksin, R., Elmes, J., Sherman, S. G., Sanders, T., Mwangi, P., & Crago, A.-L. (2018). Associations Between Sex Work Laws and Sex Workers’ Health: A Systematic Review and Meta-Analysis of Quantitative and Qualitative Studies. PLOS Medicine, 15(12), 1–54. https://doi.org/10.1371/journal.pmed.1002680

Pulerwitz, J., Amaro, H., Jong, W. D., Gortmaker, S. L., & Rudd, R. (2002). Relationship power, condom use and HIV risk among women in the USA. AIDS Care, 14(6), 789–800. https://doi.org/10.1080/0954012021000031868

Restar, A. J., Tocco, J. U., Mantell, J. E., Lafort, Y., Gichangi, P., Masvawure, T. B., Chabeda, S. V., & Sandfort, T. G. M. (2017). Perspectives on HIV Pre- and Post-Exposure Prophylaxes (PrEP and PEP) Among Female and Male Sex Workers in Mombasa, Kenya: Implications for Integrating Biomedical Prevention into Sexual Health Services. AIDS Education and Prevention, 29(2), 141–153. https://doi.org/10.1521/aeap.2017.29.2.141

Sanders, T., & Campbell, R. (2014). Criminalization, Protection and Rights: Global Tensions in the Governance of Commercial Sex. Criminology & Criminal Justice, 14(5), 535–548. https://doi.org/10.1177/1748895814543536

Santos, B., Siqueira, I., Oliveira, C., Murray, L., Blanchette, T., Bonomi, C., da Silva, A. P., & Simões, S. (2021). Sex Work, Essential Work: A Historical and (Necro)Political Analysis of Sex Work in Times of COVID-19 in Brazil. Social Sciences, 10(1), 2. https://doi.org/10.3390/socsci10010002

Sihombing, J. P. T., & Hutagalung, K. R. (2011). Gambaran Kecemasan pada Pekerja Seks Komersial (PSK) di Bandung. Maranatha Journal of Medicine and Health, 11(1), 56–63.

Singer, R. B., Johnson, A. K., Crooks, N., Bruce, D., Wesp, L., Karczmar, A., Mkandawire-Valhmu, L., & Sherman, S. (2021). “Feeling Safe, Feeling Seen, Feeling Free”: Combating stigma and creating culturally safe care for sex workers in Chicago. PLOS ONE, 16(6), e0253749. https://doi.org/10.1371/journal.pone.0253749

Somawinata, Y., Saputra, D. N., & Hikmattullah, H. (2021). Penegakan Hukum Pidana Terhadap Prostitusi Pada Masa Pandemi Covid-19. Al Ahkam, 17(1), 20–31. https://doi.org/10.37035/ajh.v17i1.4650

Spotose, T. (2013). Vulnerability of Male Commercial Sex Workers to Hiv/Aids. HIV & AIDS Review, 12(1), 1–3. https://doi.org/10.1016/j.hivar.2012.12.001

Spratt, K., Fihir, I., & Surjadjaja, C. (2007). Implementing 100% Condom Use Policies in Indonesia: A Case Study of Two Districts in Jakarta. USAID Health Policy Initiative. http://www.healthpolicyplus.com/archive/ns/pubs/hpi/Documents/398_1_Indonesia_Cup_Case_Study_FINAL_2_28_08.pdf

Suhendi, A. (2011, May 26). Ketahuan Ayah Jadi PSK, Suherti Akhiri Hidup. Tribunnews.Com. https://www.tribunnews.com/metropolitan/2011/05/26/ketahuan-ayah-jadi-psk-suherti-akhiri-hidup

Suud, M. (2019). The Existing Policy on Prostitution in Indonesia: A Retrospective Evaluation. Journal of Urban Sociology, 2(1), 4–15. https://doi.org/10.30742/jus.v2i1.607

Suyanto, B., Hidayat, M. A., & Wadipalapa, R. P. (2020). Sexual Exploitation and Violence of Prostituted Children. Masyarakat, Kebudayaan Dan Politik, 33(2), 134–146. https://doi.org/10.20473/mkp.V33I22020.134-145

United Nations International Children’s Emergency Fund, The Joint United Nations Programme on HIV/AIDS, & World Health Organization. (2002). Young People and HIV/AIDS: Opportunity in Crisis. United Nations Children’s Fund, UNAIDS, World Health Organization. https://genderandaids.unwomen.org/en/resources/2002/11/young-people-and-hivaids-opportunity-in-crisis

Vanwesenbeeck, I. (2005). Burnout Among Female Indoor Sex Workers. Archives of Sexual Behavior, 34(6), 627–639. https://doi.org/10.1007/s10508-005-7912-y

Vanwesenbeeck, I. (2017). Sex Work Criminalization Is Barking Up the Wrong Tree. Archives of Sexual Behavior, 46(6), 1631–1640. PubMed. https://doi.org/10.1007/s10508-017-1008-3

Weitzer, R. (2022). Sex For Sale: Prostitution, Pornography, and Erotic Dancing. Taylor & Francis.

WHO. (2012). Prevention and Treatment of Hiv and Other Sexually Transmitted Infections for Sex Workers in Low-and Middle-Income Countries: Recommendations for a Public Health Approach. World Health Organization.

Downloads

Published

2025-12-29

How to Cite

NATALIS, A. FROM CRIMINALIZATION TO PROTECTION: SEX WORKER HEALTH POLICY REFORM IN INDONESIA: TOWARD A POLYMORPHOUS DISCOURSE IN PROSTITUTION REGULATION. Revista Direito e Sexualidade, Salvador, v. 6, n. 2, p. 1–41, 2025. DOI: 10.9771/rds.v6i2.66251. Disponível em: https://periodicos.ufba.br/index.php/revdirsex/article/view/66251. Acesso em: 8 jan. 2026.

Issue

v. 6 n. 2 (2025) | Revista Direito e Sexualidade

Section

ARTIGOS

License

Copyright (c) 2025 Authors

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

 

  1. This Journal reserves the right to direct normative, spelling and grammatical alterations in original works, with the intention of maintaining the standard worship of the language, respecting the authors' style.
  2. The exclusive opinions by the authors are their sole responsibility.
  3. The licensing rights used by the journal are the Creative Commons Attribution 4.0 International License.
  4. Copyright belongs exclusively to the authors. Sharing (copying and distributing the material in any medium or format) and adaptation (remixing, transforming and re-adapting the original work for all purposes, including commercial) are permitted, provided that due credit is given for the initial publication in this journal.
  5. Authors are permitted and encouraged to publish and distribute their work online after publication, as this can increase the impact and citation of the published work (See The Effect of Open Access).