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-religion/age -pumping/obstacles to pumping -add graphs

Demographics of sex workers
While demographic characteristics of sex workers vary by region and are hard to measure, some studies have attempted to estimate the composition of the sex work communities in various cities. For example, one study of sex work in Tijuana, Mexico found that the majority of sex workers there are young, female and heterosexual. Transgender people are more likely than the general population to do sex work, particularly trans women and trans people of color. In general, transgender women sex workers have a higher risk of contracting HIV than male and female sex workers and transgender women who are not sex workers. In addition, one study of Indian sex workers found that HIV infection was more prevalent among sex workers under the age of twenty than in older sex workers. In a study of female Indian sex workers, illiteracy and lower social status were more prevalent than among the general female population.

Risk reduction
Risk reduction in sex work is a highly debated topic. "Abolitionism" and "empowerment" are regarded as opposing ways in which risk reduction is approached. While abolitionism would call for an end to all sex work, empowerment would encourage the formation of networks among sex workers and enable them to prevent STIs and other health risks by communicating with each other. Both approaches aim to reduce rates of disease and other negative effects of sex work.

Health
Health risks of sex work relate primarily to sexually transmitted infections and to drug use. In one study, nearly 40% of sex workers who visited a health center reported illegal drug use. In addition, a large proportion of sex workers have contracted an STI, with African-American descent and male gender being among predictors for STIs.

Condom use is one way to mitigate the risk of contracting an STI. However, negotiating condom use with one's clients and partners is often an obstacle to practicing safer sex. While there is not much data on rates of violence against sex workers, many sex workers do not use condoms due to the fear of resistance and violence from clients. Some countries also have laws prohibiting condom possession; this reduces the likelihood that sex workers will use condoms. Increased organization and networking among sex workers has been shown to increase condom use by increasing access to and education about STI prevention. Brothels with strong workplace health practices, including the availability of condoms, have also increased condom use among their workers. Sex workers are unlikely to disclose their work to healthcare providers. This can be due to embarrassment, fear of disapproval, or a disbelief that sex work is important to their health. The criminalization of sex work in many places can also lead to a reluctance to disclose for fear of being turned in for illegal activities. There are very few legal protections for sex workers due to criminalization; thus, in many cases, a sex worker reporting violence to a healthcare provider may not be able to take legal action against their aggressor.

Forced sex work
Forced sex work increases the likelihood that a sex worker will contract HIV/AIDS or another sexually transmitted infection, particularly when an individual enters sex work before the age of 18. In addition, even when sex workers do consent to certain sex acts, they are often forced or coerced into others (often anal intercourse) by clients. Sex workers may also experience strong resistance to condom use by their clients, which may extend into a lack of consent by the worker to any sexual act performed in the encounter; this risk is magnified when sex workers are trafficked or forced into sex work.

Forced sex work often involves deception - workers are told that they can make a living and are then not allowed to leave. This deception can cause ill effects on the mental health of mnay sex workers. In addition, an assessment of studies estimates that between 40% and 70% of sex workers face violence within a year. Currently, there is little support for migrant workers in many countries, including those who have been trafficked to a location for sex.

Advocacy
Advocacy for the interests of sex workers can come from a variety of sources, including non-governmental organizations, labor rights organizations, governments, or sex workers themselves.

Unionization of sex work
The unionization of sex workers is a recent development. A factor affecting the unionization of sex work is that many sex workers belong to populations that historically have not had a strong representation in labor unions. While this unionization can be viewed as a way of empowering sex workers and granting them agency within their profession, it is also criticized as implicitly lending its approval to sexism and power imbalances already present in sex work. Unionization also implies a submission to or operation within the systems of capitalism, which is of concern to some feminists.

The first organization within the contemporary sex workers' rights movement was Call Off Your Old Tired Ethics (COYOTE), founded in 1973 in San Francisco, California. Many organizations in Western countries were established in the decade after the founding of COYOTE. Currently, a small number of sex worker unions exist worldwide. One of the largest is the International Union of Sex Workers, headquartered in the United Kingdom. The IUSW advocates for the rights of all sex workers, whether they chose freely or were coerced to enter the trade, and promotes policies that benefit the interests of sex workers both in the UK and abroad. Many regions are home to sex worker unions, including Latin America, Brazil, Canada, Europe, and Africa.

In unionizing, many sex workers face issues relating to communication and to the legality of sex work. Because sex work is illegal in many places where they wish to organize, it is difficult to communicate with other sex workers in order to organize. There is also concern with the legitimacy of sex work as a career and an activity that merits formal organizing, largely because of the sexism often present in sex work and the devaluation of sex work as not comparable to other paid labor and employment.

Non-governmental organizations (NGOs)
NGOs often play a large role in outreach to sex workers, particularly in HIV and STI prevention efforts. However, NGO outreach to sex workers for HIV prevention is sometimes less coordinated and organized than similar HIV prevention programs targeted at different groups (such as men who have sex with men). This lack of organization may be due to the legal status of prostitution and other sex work in the country in question; in China, many sex work and drug abuse NGOs do not formally register with the government and thus run many of their programs on a small scale and discreetly.

While some NGOs have increased their programming to improve conditions within the context of sex work, these programs are criticized at times due to their failure to dismantle the oppressive structures of prostitution, particularly forced trafficking. Some scholars believe that advocating for rights within the institution of prostitution is not enough; rather, programs that seek to empower sex workers must empower them to leave sex work as well as improve their rights within the context of sex work.

Peer support and counseling
Peer support techniques can be used before, during, and after pregnancy to encourage exclusive breastfeeding, particularly among groups with low breastfeeding rates. Breastfeeding peer counselors, who are ideally women who have breastfed who can provide information, support, and troubleshooting to mothers, have been shown to have a positive effect on the breastfeeding rate in American Indian populations. Peer counseling has also been found to be effective at increasing breastfeeding initiation rates and breastfeeding rates up to three months after birth in Hispanic populations in the United States. In addition, peer counseling can be effective in encouraging not only exclusive breastfeeding, but also breastfeeding rates in combination with formula, or "any breastfeeding".

Peer counseling has been found to have a strong effect on breastfeeding initiation and duration in developing countries such as Bangladesh and in areas where home births are more prevalent than hospital births. When combined with nutrition support, particularly the WIC program in the United States, the presence of peer counselors can have a significant effect on incidence of breastfeeding among low-income women.

Support during and immediately after childbirth can also help women initiate and continue breastfeeding while working through common concerns relating to breastfeeding. This support can be non-medical, as doula care is. Culturally sensitive care (for example, care from a peer of a similar ethnic background) may be most effective at encouraging high-risk women to breastfeed.

Lactation consultants
Lactation consultants are health care professionals whose primary goal is to promote breastfeeding and assist mothers with breastfeeding on an individualized or group basis. They work in a variety of health care settings, including hospitals, private doctor's offices, and public health clinics. Lactation consultants are board-certified by the International Board of Lactation Consultant Examiners. The majority of lactation consultants hold a certification in another healthcare profession, often as a nurse, midwife, dietician or physician. However, there is no specific post-secondary education required to become a lactation consultant.

In low-income contexts, interventions by breastfeeding consultants can be effective in promoting breastfeeding among high-risk populations. In one study, while exclusive breastfeeding rates were low in both control and intervention groups, black and Latina low-income women who had prenatal and postnatal support from a lactation consultant were more likely to breastfeed at 20 weeks than women who had not accessed this support. In general, lactation consultants give a greater proportion of positive feedback to mothers regarding breastfeeding than either physicians or nurses do; the amount of positive advice that a first-time mother receives regarding breastfeeding from any health care provider can influence her likelihood to continue breastfeeding for a longer period of time.

Ethnicity and breastfeeding promotion
Breastfeeding initiation and duration varies significantly by race and ethnicity. The National Immunization Survey in the United States found that while 73.4% of all women in the United States initiated breastfeeding, only 54.4% of black, non-Hispanic women and 69.8% of American Indian and Alaska Native women did. White non-Hispanic women initiated breastfeeding 74.3% and Hispanic women had an initiation rate of 80.4%. However, one study conducted in found that in a low-income environment, foreign-born black women had a similar breastfeeding rate to Hispanic women; both of these rates were higher than that of non-Hispanic white women. In addition, native-born black women had a somewhat higher rate of breastfeeding than white women.

Immigrant status in the United States is a predictor for breastfeeding adherence. In particular, the Hispanic paradox plays a role in the high breastfeeding rates observed among Hispanic/Latina women in the United States. Breastfeeding initiation rates among this population are higher for less acculturated immigrants; Hispanic women who have been in the United States for longer are less likely to breastfeed. This disparity does not depend on age, income level, or education level; more acculturated Hispanics are likely to cite the same reasons for bottle-feeding as native-born white women do. In many cases, the connection that Hispanic women feel to their culture and its values can strongly influence their decision regarding breastfeeding.

Access to prenatal care, socioeconomic status, cultural influence, and postpartum breastfeeding support all influence the differing rates of breastfeeding in different ethnic groups. In the United States, black women are more likely than white women to report that they "prefer bottle-feeding" to breastfeeding, and they are also more likely to be low-income and unmarried and to have lower levels of education. The decision to bottle-feed rather than breastfeed is of similar importance to low birth weight in predicting infant mortality, particularly in regards to the black-white infant mortality gap. Thus, breastfeeding promotion initiatives focused on black women should emphasize education and encourage black women to prefer breastfeeding to bottle-feeding.

Socioeconomic influence
Socioeconomic status of mothers likely has a larger influence on breastfeeding adherence than race or ethnicity, as many women who are members of groups with low breastfeeding rates also have a low socioeconomic status. Among women born in the United States, women who are wealthier are more likely to breastfeed. In addition, employment can influence the decision to breastfeed. When either parent was unemployed or held a lower-status occupation (such as labor or sales), their children were more likely to never have breastfed. In addition, women with public insurance or with no health insurance are more likely to never have breastfed their children, as are women who receive WIC.

The time commitment of exclusive breastfeeding is also an economic constraint. The time required per week to breastfeed rather than bottle-feed or feed solids to children can be a significant burden for women without other childcare or who need to spend this time doing paid work. However, some evidence suggests that the long-term benefits of exclusive breastfeeding outweigh the short-term costs. In the United States, workplace policy surrounding breastfeeding and parental leave often does not reflect these benefits. In addition, women are often unable to risk the loss of their jobs or loss of income due to breastfeeding adherence, so bottle-feeding is the best solution for the short-term.

La Leche League
Main article: La Leche League International

La Leche League International was founded in 1956 after breastfeeding rates in the United States dropped to about 20%. Today, La Leche League has groups in all 50 states and many countries worldwide. Its goals include promoting understanding of breastfeeding as a part of development and providing support and education for breastfeeding mothers. La Leche League utilizes peer support groups in breastfeeding promotion in addition to supporting World Breastfeeding Week and other breastfeeding promotion initiatives. All La Leche League support group leaders have been specially trained and accredited in breastfeeding support. La Leche League also operates an online help form, online discussion forums, and podcasts to enable remote access to breastfeeding support resources.

Baby Friendly Hospital Initiative
Main article: Baby Friendly Hospital Initiative

The Baby Friendly Hospital Initiative (BFHI) is an initiative of the World Health Organization and UNICEF that seeks to encourage initiation of breastfeeding among mothers who give birth to their children in hospitals. Facilities that achieve its "Ten Steps to Successful Breastfeeding" and implement the International code of Marketing Breast-milk Substitutes can be recognized as a Baby-Friendly facility by the BFHI. In the United States, accreditation by the BFHI allows facilities to approach the Healthy People 2020 breastfeeding initiation goals. Worldwide, facilities that fulfill the requirements of the BFHI have been able to greatly increase their breastfeeding initiation rates among patients. The guidelines of the BFHI have also been effective in increasing breastfeeding initiation rates among populations that typically have lower incidences of breastfeeding, such as black women. In one study, the rate of infants exclusively breastfeeding more than quintupled over a four year period upon the implementation of the BFHI.

Breastfeeding promotion entities and projects by country
Haider, Rukhsana, et al. "Training peer counselors to promote and support exclusive breastfeeding in Bangladesh." Journal of Human Lactation 18.1 (2002): 7-12. http://espace.library.uq.edu.au/view/UQ:297064 http://www.ingentaconnect.com/content/ben/cpr/2012/00000008/00000004/art00010 https://wfpha.confex.com/wfpha/2012/webprogram/Paper9498.html Prelacteal feeding in Bangladesh - super interesting! definitely put some of this in