Risk of HIV and illness are the dominant context in which sex work is discussed in India and there is a lacuna of social scientific analysis of sex workers’ lives. HIV interventions negotiated between global actors such as UNAIDS, World Bank, USAID etc, the Indian government, state level AIDS prevention bodies, and the local NGOs, have constructed ‘sex work’ as an epidemiological category rather than treating it as a social concept. Based on fieldwork in HIV prevention NGOs, and participant observation and interviews with sex workers in Chennai, Tamil Nadu, in August 2004-August 2005 to understand the realities of the sex workers lives, this thesis proposes research on sex workers, with specific reference to gender and sexuality. Theoretically the research seeks to answer the question: how to understand agency of vulnerable populations and how do sex workers use agency in oppressive environments? This thesis also engages with the feminist debate of selling sex as profession or as oppression of women’s rights. I argue that sex workers actively negotiate sex work and their lives with the means at their disposal. This is done not only in the context of negotiating the risks of sex work but also in the broader context of other needs, for example money, love and sexual desire. While sexuality is a taboo in India, the analysis contributes to the understanding of discourses of women’s sexuality and the sexual behaviour of sex workers in Chennai. While the women’s experiences are closely knit into the global nexus of the HIV industry, sex work comes across as a complicated knot of poverty, desire, women’s oppression, love, cooption, and motherhood.