Formalizing labor, facilitating health: The impact of a community-led cooperative bank on sex worker well-being

Given significant links between poverty and HIV, microfinance has been proposed as an HIV intervention, particularly with sex workers, for whom sexual risk is directly tied to earning potential. However, microfinance has been critiqued for perpetuating an informal labor market lacking organized labor protection (healthcare, sick-leave, etc.). This study analyzes a cooperative bank that is partnered with a sex workers’ union to examine whether this banking model transcends traditional microfinance by facilitating individual and community labor protections. The impact of labor protection on health outcomes is discussed.

Utilizing community-based participatory research, 80 semi-structured interviews were conducted with bank staff and members. Staff was asked about bank services and the bank's role in the community. Members were asked about bank participation experiences. Interviews were analyzed using grounded theory method.

Results indicate that the bank provides labor protection by 1) generating an individual financial safety net enabling sex workers to, for example, reject clients refusing condoms, 2) undermining economic exploitation by community power-brokers, 3) pooling community resources to provide non-income contingent health and social welfare programs responsive to community ethics and need, and 4) financially and symbolically supporting political mobilization demanding professional labor rights, including formalized health benefits.

Informality of sex work labor has been associated with violence, marginalization, and HIV risk. Labor protection facilitated by this banking model advances sex workers beyond a survival paradigm, allowing workers to prioritize health at the individual, community, and socio-political levels. Such a program should be conceptualized as a community-based alternative to neoliberal microfinance.