My Take on AIDS 2012. Cheryl Overs Part One
Silence = Death
As everyone knows AIDS 2012 was THE different International Aids Conference for sex workers because of US immigration law and the Sex Workers Freedom Festival in Kolkata it created. The publicity that the Kolkata hub generated worldwide and the support within the HIV community were historic. A clear measure of this was Hilary Clinton’s speech at the opening in which she had to assure the crowd that the US supports HIV programming for sex workers. It was followed by an article in which Melissa Ditmore * explained the limitations of Clinton’s words in the context of the anti-prostitution Pepfar legislation. This is perfect activism. And it wasn’t the only example. All the work and the frustrations were worthwhile.
And work and frustrations there were. The US sex workers worked much harder than we have in previous years when everyone was there and without the reward of being with dozens of sex workers from all over the world. Carol Leigh and Mariko Passion did wonderful performances that said as much about sex workers rights as all the spoken words. I hope the US sex workers would agree that those who were there, from twelve countries I counted, gave all the support possible. I wish we could have done more.
As always the conference was about highs and lows. My conference was very limited because I chaired and presented at many sessions so I will mainly talk about those. This raises a low to start off with – the final day rapporteur sessions were seriously lacklustre. I rely on them to hear about the conference that I always feel I’ve missed and I am sure many other do too. Last time, in Vienna, they were really interesting and useful. So I will leave summing up the overall conference to others. Even my coverage of sex work issues is limited. Anna Forbes, who is a great ally, wrote a blog about sex worker issues in DC and I am sure she will produce a very useful report. http://www.hivhumanrightsnow.org/blog/july-26-2012-aids-2012-daily-summary/ Tracy Quan also wrote about a great piece about sex workers at conferences in general. http://thegloss.com/sex-and-dating/where-were-the-sex-workers-at-the-international-aids-conference-431/.
*Melissa presented research on problems posed by countries accepting PEPFAR funds, which indicated that PEPFAR’s “anti-prostitution pledge” has forced the gradual phase-out of services once available to sex workers, thereby increasing their isolation and making it harder to access preventative or treatment services
Labour Rights: the way
Perhaps the highest point for me was the ILO session in the Global Village ‘A labour rights approach to HIV and sex work.’ This was ILO’s rationale for the session :
‘Sex workers are calling for a new way of HIV programming in which they determine their priorities and needs related to HIV programs. A fundamental goal of sex workers’ organizations is the protection of human rights in the workplace including promotion of safe and healthy workplaces, elimination of sexual harassment and violence and access to social protection schemes’.
Steve Kraus of UNAIDS spoke about the partnerships formed around sex work and set the session up with a distinct sense of expectation and optimism. Noi Apusik spoke about the Can Do Bar in Thailand and we heard what sex workers rights really means in the workplace and in real lives in Thailand and Cambodia. Alice Ouedraogo, ILO director then spoke powerfully affirming that ILO has the same commitment to sex workers as to all other workers. ILO will not discriminate.
The session crossed to Kolkata which was very exciting. As Liz Hilton said, “a wonderful moment occurred when streaming video questions from Kolkata were received during this session. A Thai sex worker (Wi of Empower) in Kolkata asked if she had heard the presentation correctly. She said, “Did you say the ILO accepts sex work is work? We’re not clear if we heard you correctly. We are proud of the work we do. Alice Ouedraogo of the ILO, replied, ‘I did say sex work is an economic activity — sex work is work. There’s no doubt about this. ILO is there to support efforts of sex workers and their organizations.’” This is truly huge news for the sex workers rights movement and the ILO and other UN staff who did the internal work to get us to this point are truly to be congratulated.
There was much more about labour rights in all the other sessions too. I noticed a networking zone session of sex workers involved in labour struggles was one of the longest and most well attended.
But not to stay upbeat for too long ….this session was the worst as well as the best for me. It was in a curtained area of the Global Village and was on at the same time as the GV opening. There was 40 minutes of non-stop deafening drumming, like the opening of the Olympics, just metres way. It was like torture. It was so unfair for a session that was so important to us. (I did a pretty terrible job on my presentation, so I am extra peeved) It should have been in a proper conference room. More – much more – about the Global Bloody Village later
In a way Aids 2012 was all about new prevention technologies. There is little doubt about the epidemic ending potential of treatment as prevention, microbicides and PREP. Of the two messages I wanted to see come out of the sex worker actions at AIDS2012, the first was that better thinking is needed around sex work and new prevention technologies. That was said far more eloquently than me ( eg by Sue Kippax Tuesday) but I hope it was useful to say it in public about sex workers, so far as I know, for the first time.
‘The risks to sex workers of all genders will be enormous if condoms are replaced by partially effective HIV prevention methods that don’t protect against unwanted pregnancies and STIs – including, drug resistant gonorrhoea. It’s good to talk about an extra tool in the prevention toolkit but it doesn’t fall easily on sex worker’s ears that they will still have to get clients to use condoms. Sex workers know their clients and they know there will be increased demand for sex without a barrier. Clients are already talking on the internet about the “HIV Pill’ that they think is about to liberate them from rubber. Sex workers also understand that they work in an industry and like all businesses, market forces and workplace practices play a greater role in determining what happens than negotiations between individuals. They also know that just as it was for the ‘old’ methods, the cost and responsibility for using the new methods will be on them, not on their clients.
Sex workers’ expertise and sex industries in general has been bypassed so far. The research is mainly about proving that sex workers will use the products that are presumed to be beneficial. The methodology is usually surveys that ask sex workers if they would like a new HIV prevention product. The answer surprises no-one. Of course they would. This is not good enough. I made this point to a dear friend who works for the Gates Foundation when he was unfortunate enough to be spotted in the registration queue and couldn’t escape me. There WILL be follow up.
Law and Policy
The second crucial message for AIDS2012 as I saw it was that we don’t need a legal framework that gets pills or condoms or services to sex workers who work in dreadful conditions. We need a legal framework that enables commercial sex to take place in safe conditions and gives sex workers, including migrant sex workers, the full recognition and protection of the law. I think that as a result of the Global Commission on HIV and the Law ( http://www.hivlawcommission.org/) and the efforts of the NSWP and ILO, this conference marked the turning point where workplace health and safety began to overtake public health and criminal law as the driving forces behind sex work health policy.
This involves the the HIV industry and governments thinking less about the ‘behaviour’ of sex workers as individuals and recognising them as workers and their activities as work. I just caught (despite the noise in the Global Bloody Village ) a fascinating story told by a woman who had worked in a legal brothel in Nevada that exemplified this for me. She said that workers there had to pay some huge fee ( $160 ? ) for a weekly health check. But get this – if you leave the brothel, even to go to the shop, your check is redundant and must be done again. What an illustration of how ugly it can get when public health meets the whore stigma – the workers freedom of movement we know so well from the Universal Declaration is violated; her body is invaded by a forced medical procedure that violate the convention on torture * and she is unfairly confined and fined which of course contravenes Labour conventions and ILO standards. Where are the human rights wallahs when you need them?
Well at least one was praising Nevada because according to her sex work isn’t criminalised there. http://www.rhrealitycheck.org/article/2012/07/30/exclusion-criminals-from-international-aids-conference-nothing-to-celebrate. It is essential that well intentioned and well-heeled NGOs who advocate on sex work issues involve sex workers and that they do the work necessary in their own organisations to understand and institutionally support sex workers full set of demands – asOSI did by producing a clear document in support of decriminalisation. (http://t.co/0tQmyLgC ) And to put it friend-losingly bluntly – organisations that have signed the anti-prostitution pledge should shut up altogether about sex workers ‘right to access services.’ It’s a bit much to see people spouting off about sex workers without disclosing that they are employed by organisations that have signed the anti-prostitution pledge.
*Seriously. It’s because medical ethics were codified into the treaty that was created in the aftermath of the Nuremburg trials and the Nazi medical experiments.
It seemed to me that the sessions on sex work in what is increasingly being called ‘the main conference’ were better than previous conferences. It is worth looking at the online abstracts and videos. The session Is Sex Work, Work ? ( http://globalhealth.kff.org/AIDS2012/July-26/The-Oldest-Profession.aspx) aimed to ‘provide the basis for the legal, policy, labour and public health rationale for creating an enabling environment in which sex work is integrated into communities as simply another occupation’ It included speakers from sex workers groups, the International Labour Organisation and Deanna Kerrigan of Johns Hopkins University who spoke about the large scale study ‘The Nature and Scale of the Burden of HIV on Sex Workers’. That is the study that has established that female sex workers are at 14 times more risk than other women. That headline masks the complexity of the study which is the largest analysis ever done of research on HIV and sex work. Meta-analysis like this is by definition only as good as the studies it reviews. I remember many of the studies that went into this analysis from when they were published, mainly because sex workers protested against many of them. I am sure the authors of this study would agree that much of the research on sex work has been very poor. Nevertheless I think the size and rigour of this analysis means its conclusions are pretty right, with the exception of data about the 100% Condom Use Programmes in Asia which were an academic beat-up , or ‘bullshit’ in the language of Robert Carr’s legacy. Anyway sex workers should read it – those who subscribe to medical journals that it is. Others can read a summary at http://www.aidsmap.com/Female-sex-workers-have-14-times-the-risk-of-having-HIV-as-other-women/page/2457223
There were some excellent posters too. Several posters recorded successful anti-violence campaigns and police liaison work. One of the poster discussion sessions was particularly interesting. A study in India looked at whether sex workers were being pushed to engage in sex without condoms for more money but found that sex workers received more for engaging in safe sex with regular clients. The session also looked at how services are provided. There was a definite theme of the public health professionals wanting to take testing closer to sex workers, including to their workplaces. Sex workers in the audience were very sceptical about how that can be done without causing harm.
I didn’t find as much as I had hoped for about migrant sex workers, perhaps because they have been invisibilised by the trafficking paradigm that classifies them as trafficked women. We all know that huge amounts of money are being made by anti-trafficking organisations, celebrities, journalists and academics ( sex workers track this on a Facebook Group called My Favorite Abolitionist) Less discussed is the invisibilisation of male and transgender sex workers and their re-classification as MSM. This is a key part of the anti-trafficking agenda because the gender analysis that sustains the paradigm depends on casting men as abusers and rapists and women as victims that lack agency. This gender codswallop can only apply if the term sex worker means biological females. There is a profit element too. Categorising sex workers as MSM opens up new HIV funding streams. I am amused to see MSM reports these days illustrated with pictures of ‘most at risk MSM’ who are people that have gone to a lot of trouble to not be Men at all. More than one senior gay rights activist bemoaned the cultural changes the inclusion of transgender women who work as sex workers bought to the MSM pre-meeting. Others loved it. Watch that space.
This speaks to a broader issue. I noticed during my plenary presentation that there was a lot of applause when I said ‘Communities exist in real life not as epidemiological categories configured around HIV funding.’ What I should have said is communities should exist in real life… The fact is they don’t and it’s not only the HIV funders fault. I wonder how many new ‘networks’ were formed in the last month that will be demanding a ‘seat at the table’ – which means at least a few airtickets and perdeims, if not an office and a salary or two. I imagine the mention of the Robert Carr fund for ‘networks’ will have created a significant spike in the network birthrate. I hope those administering Robert’s fund don’t fall for that ‘bullshit’. In part two I will talk about the Robert Carr memorial session, other sessions and posters, the Global Bloody Village and more, including why AIDS 2012 was my last contribution to HIV/sex workers rights activism.
Entry filed under: health, HIV and AIDS.