Services4SexWorkers
Health

There are no mandatory provisions (e.g. testing, medical exams) for sex workers.

Access to public health care

For uninsured national sex workers, it is very difficult to access public healthcare centres because all services are chargeable. It is important that sex workers have access to free-of-charge and anonymous health services, HIV and other STI testing and treatment, free condoms and lubricants at the only cost-free nongovernmental organisation service provider: AIDS Tugikeskus, which works in collaboration with Tervisekeskus Elulootus medical centre. Incidentally, there are three exceptions:

ARV treatment for all national HIV-positives is free-of-charge and is not dependent on medical insurance. There are special financial resources for ARV treatment and medical follow-up for uninsured persons.

HIV tests and counselling is available in State-supported institutions on an anonymous basis in Tallinn and in the biggest cities in the other parts of Estonia.

Some harm-reduction services (for example, methadone treatment, needle exchange or some rehabilitation drop-in centres) are available for uninsured national  sex workers.

For uninsured migrant sex workers access to public healthcare is also difficult because all services are chargeable. Again, it is important that these sex workers have access to health services, HIV and other STI testing and treatment, free condoms and lubricants at the only nongovernmental organisation service provider: AIDS Tugikeskus, which works in collaboration with the Tervisekeskus Elulootus medical centre, but, unfortunately, there are two exceptions:

HIV tests and counselling is available in State-sponsored institutes on an anonymous basis in Tallinn and in the biggest cities in the other parts of Estonia.

Some harm-reduction services (for example, needle exchange or some rehabilitation drop-in centres are available for uninsured migrants

The ARV treatment for HIV-positive migrants is unavailable because there are no special financial resources for ARV treatment and medical follow-up for migrants. Paid methadone treatment is available for migrants, only if they are in the country legally, with an official permit to stay. The same is true for the uninsured migrant sex worker.

Access to HIV/AIDS treatment

ARV treatment for uninsured national sex workers, to include all insured and uninsured HIV-positives are free-of-charge and is not dependent on having insurance. There are special financial resources for ARV treatment and medical follow-up for uninsured persons, whereas ARV treatment for HIV-positives migrants (insured or uninsured) is unavailable. There are no special financial resources for ARV treatment and medical follow-up for migrants or for uninsured migrant sex workers.

 

Access to harm-reduction programmes

Some harm-reduction services (for example, methadone treatment, needle exchange or some rehabilitation drop-in centres are available for national sex workers, whether insured or uninsured.

Some harm-reduction services (for example, needle exchange or some rehabilitation drop-in centres are available for migrants, whether insured and uninsured. Paid methadone treatment is available for migrants, only if they are in-country legally, with official permission to stay; however, methadone treatment is unavailable for undocumented migrants

Protection from Deportation

No legal regulations exist that prohibit deportation for medical reasons, e.g. if the person is HIV-positive. Therefore, a HIV positive migrant may be deported without recourse to an appeal on medical grounds.

Barriers for nationals and migrant sex workers

The main obstacles for national sex workers are lack of insurance and the lack of trust in the institutions. The main obstacles for migrant sex workers are a lack of trust in the institutions, the lack of medical insurance, and their lack of valid legal residency.

 Since the majority of sex workers are uninsured, practically everywhere healthcare services must be paid for, with the exclusion of the medical services offered in AIDSi Tugikeskus, HIV/Syphilis tests, and the issuance of free condoms in anonymous settings, needle exchange, and ARV treatment for nationals only.