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Focusing primarily on a public HIV/AIDS prevention clinic, this paper considers the changing relationship between sex workers and the Costa Rican state, demonstrating that the state’s approach to policing the sex industry has been defined by a shift from collective repression to neoliberal individualism. Instead of the indiscriminate sanitary raids and mass incarceration of the past, waiting for health care has come to play a central role in how sex workers interact with the neoliberal state. This individualized waiting is also about class, in that those who can afford it turn to private sector health care and therefore move out of the domain of the state altogether. The previous equality of collective repression has been replaced with the inequality of individuality. Significantly, this move toward making sex workers into individuals accountable for their own health has included undocumented migrants. But the individualizing effect of neoliberal state formations has occurred specifically within the public health sector, as the state does make an important distinction between sex workers in its use of immigration raids at San José’s most notorious sex tourism business. Neoliberal rationalities of sexual governance ultimately separate and differentiate, and this paper demonstrates the ways in which neoliberal state power operates both through the mundaneness of waiting at the HIV/AIDS prevention clinic and through the spectacle of immigration raids. Thinking about how the Costa Rican state has approached the control of sex work demonstrates the inconsistencies and contradictions of neoliberal governance, and the selectivity of neoliberal state-formation.