WASHINGTON – For Honoring Individual Power & Strength, or HIPS, Thursday afternoons means bringing sexual health services and resources to the local D.C. community. Stationed on a street corner just a block away from their H Street offices, volunteers and staff provide a safe space and items such as condoms to feminine sanitary products to clean syringes to pop-in HIV testing directly to sex workers in the D.C. community.
Where sex workers lack access due to personal and financial constraints, HIPS supplies vital sexual health services and bridges the gap for residents who might otherwise go without.
Established in 1993, HIPS started by conducting night-based outreach and hotline counseling to young women engaged in sex work in partnership with the Centers for Disease Control and Prevention (CDC).
Now 32 years later, HIPS offers more than Executive Director Cyndee Clay could have ever imagined.
“I started out as an outreach volunteer back in the day. I started out as an outreach volunteer in 1995, helping a couple of people each week. And now, we’re serving 15,000 people a year. It’s a lot for us to manage. But we continue to serve through our overnight outreach program which is out on the streets talking to sex workers…counseling and support for folks. We have our drop-in clinic and a workforce development program specifically targeting young folks who do sex work,” Clay said.
But while HIPS does this work to connect these workers to resources, there is one necessity they lack the funds and bandwidth to address: housing.
“We wish we could do more as an organization. There were plans to expand our work beyond a clinic. Like a ‘HIPS House’ and an on-staff counselor at all times…With everything that’s happening right now in the federal government, we have a target on us right now. We had to halt that type of planning and programming. We can only do so much without getting at the core of the problems sex workers face,” Clay explained.
HIPS acknowledged that sex workers often faced challenges such as abuse, substance use, violence, housing instability, and poverty, with limited access to government support. In 2020, D.C. sex workers were denied coronavirus-related relief funds. Organizations like HIPS stepped up to support the population during the pandemic.
Today, HIPS’ biggest challenge is curbing the number of sex workers who contract STIs, a figure that is rising in the district according to D.C. Health’s HIV/AIDS, Hepatitis, STD, and TB Administration.
While HIPS may not be able to address every issue faced by sex workers, the organization aims to reduce the impact of these challenges gradually, working toward safer conditions for those involved in sex work.
Stable housing may provide a more sustainable solution by addressing the root causes that increase vulnerability to both mental health challenges and sexually transmitted infections (STIs), even as access to sexual health services remains essential.
“Having a place called home can do so much for the psyche and body, even if that housing is only temporary,” said Seble Kassaye, a Georgetown University professor and epidemiologist specializing in the spread of HIV among women.
Kassaye explains while advancements and treatments have increased in effectiveness, the cost of this type of medical attention is too high for sex workers. Adequate housing and affordable sexual health care, in combination, can lower rates of STI infection.
“Here in Washington D.C., the majority of women with HIV are Black women…and trans women are a part of that group too. And on top of that, a lot of them are [sex workers]. They’re way less likely to have stable housing and have high levels of drug use. They’re vulnerable to the power and social structures at play in our world. So just imagine what providing those basic needs of a roof over one’s head and food in the fridge. Imagine what those things can do,” she said.
As an epidemiologist at George Washington University’s District of Columbia Center for AIDS Research, much of Kassaye’s research has demonstrated a strong link between housing instability and HIV.
“Sex workers who can be affected by homelessness are five times as likely to become infected with HIV than those who have a clean, safe place to stay. Homelessness is also directly related to many of those other high-risk behaviors that can make it harder to escape the cycle of doing sex work in order to live,” she said.
This idea of housing at the root of elevating the well-being of sex workers is the main focus of nonprofits in metropolitan cities like D.C.
Housing Works, a New York City-based charitable organization, combats housing instability and AIDS by advocating for housing as healthcare. With 12 housing residents across New York, Housing Works distributes living spaces for free or at low cost.
“With stable housing and healthcare services, many of the people we serve, including sex workers, report improved mental health and more consistent engagement with medical care. And that’s across the board with the 20,000 people we serve each year. These behavioral changes are not just individual wins. They ripple outward and uplift whole communities,” said Elizabeth Koke, senior director of brand strategy at Housing Works.
While the efforts of organizations like Housing Works and HIPS is essential and often lifesaving, there are limitations to what they can do—especially without legislation to protect the physical safety of sex workers.
“Funding and capacity are major constraints. We rely on a patchwork of grants, donations, and government contracts. That means services are subject to political shifts or budget cuts, which affects how many people we can house or treat…There’s also the issue of long waitlists because demand typically far exceeds supply,” Koke said.
