Members Present: Marcy Thompson (Co-Chair), Rasheed Ford (Co-Chair) Freddy Molano, Vanessa Decamps, Marcy Sedlacek, Steven Wilcox, Arthur Fitting, John Schoepp, Susan Mellender, Maria Rodriguez
DOHMH, PHS, NYS, CHAIN, and Other Staff Present: Doienne Saab, David Klotz, Alyssa Prince, Lilian Ha, Devon Price, Audrie King, Maiko Yomogida, Kimbirly Mack, Sara Kramer, Ho Ki Mok, Adrianna Eppinger-Meiering
Agenda Item #1/2:
Introductions/Moment of Silence/Minutes/Announcements:
Rasheed F. opened the meeting with new and existing attendee introductions. A moment of silence was held. The July meeting minutes were approved with no changes. Doienne S. welcomed Rasheed Ford as the new co-chair for the Cmte.
Dr. Devon Price, Senior Researcher at the NYC Health Department’s HIV Prevention Programs – Research and Evaluation Unit presented on the background and information on the recruitment efforts of the Black and Latina Women’s Sexual Health Survey.
Agenda Item #3:
Presentation – Background to the Needs Assessment Committee and 2024-2025 Workplan
Doienne S. provided an overview of the Committee’s background, objectives, and member expectations, along with a recap of the NAC activities completed from 2022 through July 2024. She outlined the 2024–2025 workplan, emphasizing the Committee’s focus on the following activities:
i. Finalizing recommendations to improve equitable access to RWPA services for those involved in sex work
ii. Receiving an introduction to the CHAIN Study
iii. Updating on the HIV Serious Mental Illness Workgroup’s recommendations
iv. Exploring the intersection of living with HIV, substance use, and engagement in Chemsex
v. Receiving an update from the Recipient on the availability of an online directory for locating RWPA services.
Presentation – Language Matters: Destigmatizing Sex Work
Audrie King, Director of STI Policy from the NYC Health Department’s Bureau of Hepatitis, HIV, STIs provided an introductory presentation on the sex work basics and the importance of using destigmatizing sex work language when describing the profession and the people involved in this line of work. She described that sex work is work and how we talk about sex work matters and impact how sex workers are viewed, their safety and the policies that are created. She explained that sex work looks different by person and situation and if that the nuances of consent which can incorrectly equate sex work with trafficking and sexual exploitation. Sex work is not one type and can include pornography, escorting, cam work, cybersex, dancing, phone sex, etc. She discussed that sex work should not be sensationalized, that we should not assume that all sex workers are victims and that we should not stay silent when someone stigmatizes sex workers. She encouraged the Cmte. to be aware of their own unconscious bias about se work, recognize the unique life experiences of each individual sex worker and educate yourself about sex workers’ experiences and issues.
Audrie King, Director of STI Policy at the NYC Health Department’s Bureau of Hepatitis, HIV, and STIs, gave an introductory presentation on the fundamentals of sex work and emphasized the importance of using non-stigmatizing language when discussing the profession and the people involved. She stressed that “sex work is work” and highlighted how the way we talk about it affects how sex workers are perceived, their safety, and the policies that are created.
Audrie K. explained that sex work varies by individual and situation, and there are important nuances around consent that can lead to the incorrect conflation of sex work with trafficking or sexual exploitation. She described that sex work encompasses a range of activities beyond street-based, including pornography, escorting, cam work, cybersex, dancing, and phone sex.
Audrie K. emphasized that sex work should not be sensationalized, and we should avoid assuming all sex workers are victims. Additionally, she urged the Committee to speak out against the stigmatization of sex workers, be mindful of their own unconscious biases, recognize the unique experiences of each sex worker, and educate themselves about the challenges and issues sex workers face.
Presentation – Drafted Recommendations to Support Sex Workers
Doienne S. shared the drafted recommendations for providing appropriate, affirming, safe, and culturally safe RWPA services for those involved in sex work. She described the process used to develop the recommendations which included compiling knowledge from literature reviews and presentations delivered to the NAC from May to Oct. Several big picture themes were drafted and shared during each meeting, including sex work criminalization, client-centered care and autonomy, harm reduction and improvement and engagement strategies to develop each of the recommendations.
- Theme – Sex Work Criminalization
- The Recipient should emphasize to RWPA providers the importance of patient/client privacy, confidentiality, and informed consent. RWPA providers are encouraged to make the disclosure of a patient’s profession optional and must never disclose this information to others, including authorities, nor document it in the patient’s chart. It is crucial that RWPA providers collaborate with the patient to ensure they are comfortable with any information being recorded or documented during their visit.
- The Recipient should provide RWPA providers with the necessary resources and tools to deliver services in a way that protects and upholds the human rights of all sex workers (see: UNAIDS released statement in solidarity with sex workers) .
- The Recipient should ensure that RWPA providers are trained on non-discrimination and the rights of sex workers to access high-quality, non-coercive care, while also guaranteeing confidentiality and informed consent (suggested resource: Amnesty International Policy on State Obligations to Respect, Protect and Fulfil the Human Rights of Sex Workers).
- The Recipient should encourage RWPA providers to inform their clients about the anonymous reporting tool from the NYC Commission on Human Rights, which can be used to report instances of discrimination in businesses, workplaces, housing, or public accommodations (see online form or call (212) 416 – 0197). Additionally, encourage RWPA providers should also be encouraged to promote the NYC Health Department’s LGBTQ Bill of Rights to both providers and clients.
- Assign a Recipient staff to regularly attend NYC Health Department Sex Work/er Workgroup (WG) meetings to stay informed on strategies, legal developments, and policy issues (e.g., DecrimNY, Sex Worker Protection Act) related to the health and safety of sex workers in the NY EMA.
- Theme – Patient-Centered Care and Patient Autonomy
- The Recipient should ensure RWPA providers coordinate real-time training calendars and resources focused on crisis counseling, psychological first aid, and trauma-informed care for all RWPA provider staff. These trainings will help staff understand the specific behavioral and mental health needs of sex worker clients (as outlined in the NY EMA Framing Directive).
- Theme – Harm Reduction
- RWPA providers should have free naloxone kits, drug testing strips and other drug checking reagents for Fentanyl or Xylazine available at their sites and provide clients with training on how to use harm reduction materials. RWPA staff should also receive training on overdose prevention education. For more information on obtaining kits, strips, or trainings, visit nyc.gov/naloxone ; https://oasas.ny.gov/prevent-overdose ; NYS AIDS Institute .
- RWPA providers should provide and make available safer sex and hygiene kits and materials to clients who express a desire or need. Suggested items can include a variety of condom options (e.g., internal, external, lubricated, un-lubricated, non-latex, flavored, vary sizes and brands), lube packets, tampons, band aids/finger cots, Q-tips, snacks, travel-size – handi-wipes, hand sanitizer, mouth wash, toothbrush/paste, pipes for drug use rather than syringes e.g., safer smoking supplies are essential items to include in sex worker kits at their agency locations.
- Improve and Strengthen Engagement
- Recommend that RWPA providers engage and consult with community-led sex work organizations and programs to gain insights, enhance engagement within this population for reducing sex work-related stigma and harm (see slide 9 for suggested programs).
- The Recipient should develop and distribute a comprehensive list of community-led sex worker advocacy groups, organizations, and programs to connect clients seeking additional services and support within the community (see slide 9 for suggested programs).
Members confirmed with the Recipient that occupation data is not asked on RWPA intake forms to maintain patient confidentiality. Members offered feedback on the recommendations, specifically regarding the use of precise language to clarify intentions and purpose. It was noted that RWPA providers should not single out a client’s perceived RWPA services individuals based on their profession, as this could be seen as stigmatizing or offensive. It was instead recommended that all RWPA services be offered to all clients, which the Recipient confirmed is done during client intake appointments.
Overall, members expressed that the drafted recommendations accurately captured the literature review and information shared during the presentations in May and June on the topic of sex work.
Doienne S. reminded members that she would finalize the recommendations and present a final version to the full Planning Council during the December meeting.
Agenda Item #4:
Adjournment
In closing, several members expressed their gratitude for the hard work that went into the planning and facilitation of the NAC meetings through the planning year cycle. There being no more discussion, the meeting was adjourned.
