The national health system in Italy ensures that all its citizens have access to the public health care service by the issuance of health cards. Access to public health centres is dependent on one’s capacity to pay for the services. Nationals unable to afford to pay for a service or who earn less than the minimum social salary fall into the category of the underprivileged.  The underprivileged enjoy the right of access to healthcare services free of charge. The same is true for all legal migrants who are employed.

Most migrant sex workers are not legal migrants and,  as a consequence, are uninsured. They can apply for the special health card for irregular migrants (STP or Temporarily Present Alien card) that guarantees treatment in hospitals and healthcare centres for illegal migrants. Treatment is either free or payable, depending on the nature of the treatment.

Uninsured and undocumented sex workers can apply for the STP card, which guarantees access to primary health treatment.

We must also underscore that the Government has attempted to modify the law that provides for minimum health assistance for irregular immigrants (Article 35 of the Bossi-Fini legislative decree on immigration 286/98). For now, the government has been unsuccessful in this attempt to abolish or to drastically reduce minimum healthcare and treatment; however, the proposal to abolish any sort of assistance, whilst obligating doctors to report irregular immigrants to the authorities.


Access to HIV/AIDS treatment

Access to HIV/AIDS treatment

A test for HIV is voluntary and is carried out only with the consent of the patient who must be assured of counselling.

HIV/AIDS treatment is open to all national citizens :

Uninsured migrant sex workers have free access to HIV/AIDS treatment.

By law, uninsured and undocumented sex workers have free access to HIV/AIDS treatment.

All illegal immigrants, to include uninsured/undocumented migrants, are entitled to urgent treatment in hospitals or healthcare centres, particularly if treatment is deemed essential and there will be permanency of disease/infection in order to safeguard the public from contagious diseases.

Healthcare and treatment is guaranteed to uninsured illegal/undocumented migrants for pregnancy, healthcare for minors, vaccinations, and the prophylaxis and diagnosis of infectious diseases.

At the moment, very often, in addition to other bureaucratic hurdles, public health services are not being given adequate financial assistance and therefore are unable to provide treatment for irregular migrants. Moreover.  many migrant have  now become very fearful and ask for assistance only if their condition is desperate.

Harm Reduction and Drug Treatment

Generally, with or without insurance, nationals who are drug users have access to harm reduction programmes. There is no distinction for nationals who are sex workers. Nationals that are drug users with residency declared in any given town can be included in a vocational job placement programme, housing, etc.

The same as above applies to migrant drug using sex workers with insurance.

Undocumented migrants, even without a STP card, can access harm-reduction programmes, which are limited to the basics and do not include job placing, housing, etc.

Although drug addiction is considered a pathology and therefore gives the right to obtain a permit of stay for ill health, hardly anyone in this condition applies for it because this of permit does not consent its bearer to work. A HIV+ person cannot be deported to his/her country of origin if  treatment there is not guaranteed.

Since August, a specific desk has been open at ANLAIDS to register acts of discrimination against HIV+ migrants because assistance and treatment is not being given and expulsion is against the law.