My Take On Aids 2012 Part 2 Cheryl Overs

22/08/2012 at 17:07 Leave a comment

Everyone says the International Aids Conference is too big and that’s obviously true but I experience that as the IAC being a victim of its own success. Any frustration I felt at AIDS 2012 was down to there being too much fascinating and important information at the conference to take in. That the great information is accompanied by the pointless and the misguided is a relatively minor annoyance and not the fault of the IAC anyway.  I went to less than half of the sex work sessions, let alone sessions on the many other topics  I’m interested in.  I didn’t even  get to the important presentations from Johns Hopkins University who have conducted an analysis of all the studies on sex work available to date.  (THACD0 503 & 502) 

I could have spent a couple hours each day reading posters. Instead I just noticed some really important work presented there as I rushed past simultaneously skim reading, eating a sandwich and texting.  It was great to see there was a presentation on aging sex workers, which is a neglected issue, but I couldn’t get to that either (TUAD0305). I noticed a study by WHO and Johns Hopkins University that analysed studies of microfinance and concluded that they don’t appear to impact HIV outcomes for a number of groups including female sex workers. (THPE279).  I also noticed a contradictory study in Ethiopia that claimed that sex workers in income generating programmes are far less likely to provide unprotected sex than others (THE529) But hang on – those programmes are all linked to provision of condoms, information and STI care. Nothing in the study seems to disaggregate that.  (Oh – it’s by an organisation thats signed the pledge.  Say no more.)  Text sent, sandwich almost finished, let’s look for a good study before the next session.  An account of Sanklap’s ( Karnataka India’s) models of community empowerment for sex workers (THPE280) fits the bill. A study of sex workers children in Bangladesh ( THPE352) in the next aisle looks good too.  Pity its one of two studies I spot that categorize children under 15 as sex workers.  This hides the issues faced by children and young people who are selling sex and distorts understandings of adult sex work.  (see THPE405 for an example)   Intelligent approaches to the issue of young people and sex work are yet to emerge.  Later I meet a terrific UNICEF person who says the same thing and tells me about UNICEF’s determination to change that.  The IAC – highs and lows. 

I also missed an important session on the UN Periodic Review which some people claim can help make governments more accountable for how they treat sex workers (WEWS10). This was an important session because the UN requires sex workers to endorse the Review making it the fruit at the top of the policy tree.  This kind of session is crucial to enable sex workers to understand and participate meaningfully in complex discussons about AIDS policy.  

Speaking of trees and fruit, I didn’t get to the sessions on the use of condoms as evidence.  That wasn’t because of my scepticism about the value of campaigning around this low hanging fruit at the IAC.  I say low hanging fruit because it’s hard to imagine anything easier that getting an AIDS conference to agree that police shouldn’t confiscate sex workers condoms.  I worry that the publicity generated around police and condoms might leave the impression that this is a central demand by sex workers.  The root of the condom/police problem ( and many others)  is the criminalisation of sex work. If the laws are removed all the fruit, from high to low, can be removed.  Until then of course getting police to behave responsibly remains a cornerstone of local advocacy for dozens of sex work projects, particuarly in the US.  Human Rights Watch and others are to be commended for helping with that.  It would also help if Human Rights watch would support sex workers demands for decriminalisation.  http://www.aidsmap.com/Criminalising-condom-possession-by-sex-workers-is-a-global-trend/page/2448677/

I also worry that focus on sex workers and condoms as evidence is a precursor togreater  involvement of police and army in HIV prevention for sex workers  ( GIPA for sex workers ! ) Several presentations and posters urged this.   Police: part of the solution?  Not on the planet I call home. More thinking and less cheerleading is needed there.   

Some of that thinking has been done by the Global Commission on HIV and the Law whose session I did manage to attend.  It is very significant that this is the first time such an influential body has recommended removal of all criminal laws against sex workers and sex businesses.  http://globalhealth.kff.org/AIDS2012/July-24/The-Global-Commission.aspx.  For me the Commission report is evidence of what a long way we have come since 2007 when UNFPA and UNAIDS  attempted  to establish abolition of sex work as its policy.  (see Ahmed A  (2011) Feminism, Power, And Sex Work In The Context Of Hiv/Aids: Consequences For Women’s Health Harvard Journal of Law and Gender, Vol. 34, No. 1 and the response of sex workers http://sexworkpolicy.wordpress.com/ ) How it is used remains to be seen. I suspect  much of that will be up to sex workers themsleves because the NGOs that don’t have their logo on it are unlikely to push it. 

I found less at the conference than I expected about preparing for the roll out of new ARV based prevention technologies. Several of the abstract presentations addressed the issues in very specific contexts.  There was almost nothing about them in the context of sex work.  One poster ( WEPE282) looked at acceptability of HIV protective microbicides to female sex workers and their private partners ( the men are keener than the women) But like most studies on this subject  it dismissed  ‘old prevention’ by simply stating that sex workers have difficulty using  condoms  before launching into an account of the feasibility of introducing less effective methods to replace them.  I reiterate the point that it’s not enough to ask sex workers if they would like a new prevention product. 

I did hear a couple of presentations I was particularly interested in by popping in and out of sessions, although I think that’s rude to the other speakers.   One such presentation was Sue Kippax  from Australia addressing gay men’s concerns around ARV based prevention. I went to that because, although I am convinced that the researchers preparing for new prevention around sex work are getting it wrong, I am not sure what they should do to get it right.  Sue’s work is really worth watching.  

There was little information on sex workers access to HIV treatment but plenty on testing,  including the unsurprising fact that it is the most common intervention for sex workers (WPE104). Sadly I also saw several presentations that were very murky round the edges about the voluntariness of testing.  At least approaches like that of Sint Maarten, mandatory weekly HIV tests and lectures for sex workers, are clear. (TUPE 377)

If you are thinking ‘what about male sex workers ? ’ don’t. They are an endangered species in HIV world. You have to read between the lines of the “MSM’ data to learn about male sex work.  (TUPE 353 Dominican Republic was an exception and there were others)  

Transwomen were much more visible in the program this year. I was fascinated to see an abstract session on transgenders in which all speakers were transgender.  How amazing to compare this with female sex worker sessions where it is very rare indeed to see a sex worker present.  There is no point complaining about this. The IAS insists the abstract selections are blind and has statistics to prove that there is enough sex worker content in the conference. 

I didn’t get to the demonstrations or march to the White House.  Fortunately we have wonderful pictures of the gorgeous young things that did.

To be continued

Entry filed under: research.

My Take on AIDS 2012. Cheryl Overs Part One My Take on AIDS 2012 Part 3 Cheryl Overs

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