Services4SexWorkers
Health

We have no mandatory provisions for sex workers. In France, recently there has been a tendency to reduce the scope and coverage of public health insurance and to decrease the coverage for certain medicines.

 

France have two main medical coverage systems for unemployed or low income people.

Universal Medical Care

Universal medical care is for low-income people (migrants or others) who have lived and worked on a regular basis in France. It covers 80% of medical care and treatment costs and from 30% to 60% of drugs and pharmaceuticals for any person who lives in France in regularity and has low income, exclusive of coverage by other health insurance, and who has worked in a legally recognised job for at least three (3) months. If a person has very limited resources, he enjoys the right to complementary universal medical care coverage.

However, there are exceptions to these rules, such as long-term infections, HIV-positive care treatment, and those persons who have been officially assigned an 80% handicap¾most HIV-positive patients are included¾enjoy total coverage.

EU citizens without social insurance were formerly included in the universal medical care system; however, since 23 November 2007, these persons are covered only by the national medical aid programme, which covers both illegal migrants and EU citizens that are present in national territory for periods of less than three months.

 

National Medical Aid Programme

The national medical aid programme is for illegal migrants and EU citizens, who reside occasionally in France for short periods of time and like the illegal migrants they as well are considered undocumented. It was created in January 2000, and since then, migrants have to prove that they have been living in France without interruption for more than 3 months in order to take advantage of this programme. Constructive proof of a stay exceeding 3 months may be furnished by documentation like contracts, entry visas, and so on.

For stays shorter than 3 months a person is covered by the availability of urgent or emergency health care. However, many migrants are subjected to de facto rejection from this system.

The NMAP grants total coverage of medical care and hospital services at conventional rates, including medical examination, supplementary examinations, nursing care, pregnancy, dental and hospitalisation, where necessary. However, this insurance does not cover eyeglasses, medical prostheses and apparatuses. According to the law, the NMAP also allows access to all doctors, but, in reality, some of them refuse these patients, which is something that usually occurs with many gynaecologists.

For emergency cases, health care is free-of-charge, wherever there is a risk to life and limb of a patient or for the patient with a long-lasting deterioration of his or her health, or for the patient with a contagious disease, HIV, tuberculosis, etc., and prevention examinations are made during and after pregnancy and abortions.

 

Access to harm reduction programmes

For those who cannot are ineligible for the NMAP, they have free access to gynaecological care and treatment, HIV- and STI-testing and treatment, contraception, and mental health care at nongovernmental organisation (NGOs) or at the services centres of free clinics, especially for HIV- and STI-testing. Harm-reduction programmes are mainly managed by NGOs and the access to their programmes is dependent on their coverage by area and availability of funds.

NGOs run several harm-reduction programmes which are accessible without any insurance, even for undocumented persons and they perform such things as delivery of methadone, the exchange of needles, and provide drug counselling and treatment.

 

Access to hiv/aids treatment

National and migrant sex workers, legalised or not, have free access to HIV- and STI-testing and treatment, which is free-of-charge, is carried out voluntarily and remains anonymous, provided that this testing is done in the special centres, called CIDAG, Centre d’Information et de Dépistage Anonyme et Gratuit (Free and Anonymous Information Centre of Research). HIV/AIDS infection is considered a long-lasting illness, and those infected get free care and enjoy 100% coverage.

 

Protection from deportation

According to the law, a migrant, who is in dire need of medical care and treatment, whose deportation would place this person’s life at risk, which constitutes a risk of exceptional gravity, or would result in a long-lasting deterioration of this person’s health, and who would not have access to proper and adequate medical care in the country of origin, can get a temporary residence permit of 1 year, renewable for every subsequent year of his or her illness. However, since last year the trend has been to limit the number of such residence permits. There is no fixed list of illnesses that would permit the granting of a temporary residence permits, and the outcome is always dependent on the country of origin, where a valid evaluation of true and real access to healthcare and treatment services are not taken into account. Today, there is no real protection from deportation for even an HIV-positive person.