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Harm reduction has long been considered a , to drug use that and infectious disease鈥攁dverse consequences exacerbated by the war on drugs. However, few people know that this compassionate, community-centered approach has applications beyond substance use, including reducing potential adverse consequences associated with . 

For decades, people in the sex trade have been raising awareness about on their livelihoods and well-being. Their demands have largely remained the same: Sex workers want , the , and an environment that allows them to when it happens. 

Unfortunately, the rampant criminalization of sex workers and their clients has remained a barrier to these basic human rights. However, , an anthology that I edited, suggests an immediate step: Bolster harm reduction within the sex trade to arm sex workers with the knowledge and resources necessary to prevent and respond to violence and exploitation within their work and personal lives.

Shame is not a productive agent of change, and robbing people of resources only decreases their chances of survival.鈥�

As I write in the book, harm reduction is 鈥渢he understanding that shame is not a productive agent of change, and robbing people of resources only decreases their chances of survival.鈥� Sometimes, harm reduction can include providing safety supplies, such as condoms, lube, sanitizer, boric acid, and bad date lists. Other times, harm reduction can include safety planning and ensuring there鈥檚 community accountability and room for self-care. Harm reduction can also include broad access to low-income and affordable housing, safe drug-consumption spaces, and rights-based policy reforms. Harm reduction is a 鈥渂lueprint for survival and the belief in something beyond survival,鈥� I write. 鈥溾�楯ust say no鈥� isn鈥檛 as effective as 鈥榃hat do you need to be OK?鈥欌��

Currently, the war on sex trafficking is the dominant sociopolitical approach to the sex trade in the United States. Most local, state, and federal conflate consensual sex work with sex trafficking, thereby pushing sex work underground, where trafficking, , and are actually more likely to occur. Most everything the mainstream media tells us about sex trafficking is and , including the number of people being trafficked. When social services count consensual sex workers as sex trafficking survivors, it , further stigmatizing sex workers and endangering those who are victims of trafficking.

In contrast, consent, self-agency, and sex worker leadership are central to harm reduction. 

Harm-reduction programs that center sex workers鈥攊ncluding in Baltimore; , a Black trans-led advocacy organization in New York City; and Aileen鈥檚, a peer-centered organizing and hospitality space for sex workers in Seattle鈥攐ffer individualized care and classes that help sex workers navigate police harassment and other forms of state violence. These organizations also offer occupational health and safety supplies; meet sex workers where they are, whether on the street or online; and provide peer support free of shame, stigma, and sensationalism. In these programs, sex-trafficking survivors self-identify as such and are connected to additional services as requested. 

Body Autonomy illustrates the ways in which sexuality and sexual labor have been colonized and weaponized against women, femmes, and queer and trans people of color. It includes antidotes from healers of the global majority that encourage us all to reclaim the sanctity of our bodies and our bodily autonomy. 鈥淚f everyone on Earth felt fulfilled, healed, whole 鈥� or at least knew how to access a platform for healing 鈥� the world would be a different place,鈥� Melodie Garcia, an erotic service provider, harm reductionist, and writer, says in her piece in Body Autonomy. 鈥淚t is absolutely true that people can find this through sex, kink, art, and drugs.鈥�

The truth is marginalized sex workers, including sex workers of color, transgender sex workers, undocumented sex workers, and sex workers with disabilities, in the sex trade, from criminalization to sex trafficking. When policies and social services are with these populations, who are the most marginalized, in mind, everybody benefits. 

As the consensual sex workers I worked with for Body Autonomy affirm, sex work is work鈥攁nd it is neither inherently disempowering and exploitative, nor is it inherently empowering and glamorous. Like most work, it can often be a combination of all these characteristics and more. If we as a society can embrace this truth, then we can work toward a world where compassion, care, and collaboration are prioritized. 

In order to keep sex workers safe, we must re-learn and re-frame concepts of public safety and public health, uplift compassion, and consider new worlds. Embracing harm reduction can help get us there. 

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Justice Rivera (she/they, ella/elle) is a queer Jew Rican writer and harm-reduction consultant based in San Juan, Puerto Rico. She is collector, co-author, and editor of Body Autonomy: Decolonizing Sex Work and Drug Use (Synergetic Press, April 2024), and is working on her memoir, Candy Coated. She speaks English and Spanish. Follow them @justicerivera_writes, and her consulting work via Reframe Health and Justice @harmreductionfemmes.

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