Introduction As in many contexts, sex work in Timor-Leste occupies a delicate social, cultural and legal space which can be an impediment to sound human rights-based public health responses for sex workers. As part of a national size estimation of key populations at risk of HIV/STIs in Timor-Leste, this qualitative study explored the nature of these structural factors and their interplay with the implementation of HIV/STI programs for female sex workers (FSW).

Methods Drawing on ethnographic approaches, semi-structured interviews were undertaken using field notes, including recording of verbatim quotes, with 24 FSW and relevant secondary informants across Timor-Leste. Interviews covered the legal, cultural and social context for sex workers. Data were analysed with involvement of author three (a local researcher well-connected to the populations) using an inductive thematic analysis approach where common themes and discrepant cases were coded with attention to the participants’ reported experiences and key events.

Results While experiences varied across participants and districts, many FSW reported family- and community-level stigma, with ‘shame’ and loss of dignity often associated with sex work. In some districts, tara bandu (lit.: ‘to place a ban’), a form of traditional law used to regulate ‘undesirable’ behaviours, had reportedly turned sex work further underground. One particular tara bandu (originally instated to protect women from discrimination and/or sexual abuse) had reportedly been applied to sex work, with social isolation and heavy financial penalties imposed on FSW. Despite the semi-legal status of sex work in Timor-Leste, informants in urbanised settings reported high levels of persecution from law enforcement.

Conclusion Even in a relatively small context such as Timor-Leste, a large variation was reported in the degree to which sex work was accepted. Ongoing social and law enforcement challenges for FSW highlight the need for continued investment in sex work advocacy and community building.

Disclosure of interest statement This project received funding from the Ministry of Health Timor-Leste under a grant from the Global Fund to fight AIDS, Tuberculosis and Malaria. No pharmaceutical grants were received in the development of this study.