Sex worker activists are among the most at risk defenders of human rights in the world, facing multiple threats and violent attacks, an extensive investigation has found.

The research, published today by human rights organisation Front Line Defenders, found that their visibility as sex workers who are advocates for their communities’ rights makes them more vulnerable to the violations routinely suffered by sex workers. In addition, they face unique, targeted abuse for their human rights work.

Drawing on the experience of 300 individuals in Tanzania, Kyrgyzstan, El Salvador and Myanmar, the report focuses on cases of sexual assault, threats from managers and clients, raids on homes and offices, physical attacks and police surveillance endured by sex workers undertaking human rights work.

The services the activists provide to fellow sex workers include: negotiating access to brothels, conducting gender rights training, offering legal and health counselling, reporting experiences of violence, and campaigning for freedom of movement and free choice of employment for those seeking to leave sex work.

Erin Kilbride, research and visibility coordinator at Front Line Defenders and lead author of the report, said: “Sex worker rights defenders take extreme personal risks to protect their communities’ rights to access justice, healthcare, housing and food, while responding to the immediate threats of police and domestic violence, discrimination, criminalisation and structural poverty.”

Often these activists were the only people able and willing to provide health education in locations in which sex was sold, the report found. They ensured treatment for sex workers who would otherwise be left with crippling injuries and life-threatening illnesses.

Activists’ role in creating community networks and defending sex workers’ right to assemble were also highlighted in the repot. “Coming together, even in private, is a radical, resistant, and dangerous act for defenders whose very identities are criminalised,” it said.

Defenders interviewed said they had been subjected to violations above and beyond what are typical for sex workers in their area. These included torture in prison, threats by name on the street, targeted abuse on social media and demands for sex in exchange for an advocacy meeting with a police commissioner. They also faced attacks from clients.

Ismail (not his real name), a sex worker activist in Tanzania, had to have hospital treatment for two months after he was gang-raped in a hotel room by a long-term client and four other men.

Ismail’s client had never been violent towards him before. In the weeks before the attack, the client had found out about Ismail’s human rights work and had started asking about it.

“He repeatedly told me that being gay was fine, and being a sex worker was fine, but that I had to stop my activism. He knew about the human rights workshops and trainings I do. He said this was promoting sex work to other people, especially kids,” he said.

During the assault, the client continually referenced Ismail’s activism, saying that it was his fault that people were becoming sex workers.

In Tanzania, sexual assaults in detention by the police have become a common occurrence for sex workers. They are often forced to perform sex acts in exchange for release. But human rights defenders have also been forced to perform sexual acts in order to secure other sex workers’ release. If they refuse, they are often tortured. One woman was given electric shocks after she refused to perform sex acts during a one-week detention related to her human rights work.

In El Salvador and other countries, physical attacks by clients and managers began after they learned about a sex worker’s activism, said the report.

In Myanmar, police followed activists to brothels to conduct raids during human rights trainings. Some activists had been forced to change where they sell sex because police surveillance increased after they became known for their human rights work.

Activists were often belittled at police stations in front of the sex workers they had tried to help. Htut, an outreach worker for Aye Myanmar Association, a network of sex workers, said: “[The police] let us in to the stations but then use rude words, take money from us, insult us, embarrass us, and made me feel bad about myself. It feels like they want to prove to the other sex workers that being an advocate is a humiliating thing.”

In Kyrgyzstan, sex workers have been paid or threatened by the police to help entrap rights defenders when they go to an area to distribute health supplies.

Despite the overwhelming evidence that sex worker activists have been under threat for their human rights work, much of it is dismissed by people ranging from the police to their own families, who assume such attacks are a result of being a sex worker.

Kilbride said: “Human rights defenders who are sex workers themselves are the best, and sometimes the only, activists and communities workers qualified and capable of accessing the most dangerous locations in which people sell sex.

“The targeted attacks they experience – ranging from sexual assault in detention to raids on their homes and offices – are indicators of how powerful their human rights work is.”

• Some of the sex worker activists interviewed in the report will be taking part in an online event at 3pm (GMT) on 12 August

• In the UK, Rape Crisis offers support for rape and sexual abuse on 0808 802 9999 in England and Wales, 0808 801 0302 in Scotland, or 0800 0246 991 in Northern Ireland. In the US, Rainn offers support on 800-656-4673. In Australia, support is available at 1800Respect (1800 737 732). Other international helplines can be found at ibiblio.org/rcip/internl.html