This discussion paper was commissioned by OSI’s Sexual Health and Rights Project for an international gathering held June 2006 in Johannesburg, South Africa, about the impact of laws, policies, and law enforcement practices on sex workers? health and human rights.NGOs, agencies, and funders who work with people in sex work have used different frameworks, such as harm reduction and human rights, to guide their work. This document provided a basis for discussion of the pros and cons of these approaches. This was achieved by reviewing the ways harm reduction strategies and rights-based frameworks have been developed in various regions of the world, clarifying terms, noting strengths and weaknesses, and finding common ground for future work.