Posts tagged ‘universal access’

Sex work and HIV: Only rights can stop the wrongs

The UK Government is currently running a consultation on its institutional relationship with UNFPA (United Nations Population Fund) and UNAIDS (Joint United Nations Programme on HIV/AIDS). For sex workers and their allies this is timely indeed.

UK Government supports sex workers rights

The UK Government has a strong record of supporting sex workers’ right to health – for example the current DFID AIDS strategy acknowledges that sex workers are vulnerable to HIV infection and associated human rights abuses in many developing countries. Of sex workers and other vulnerable groups they state,

‘They are more likely to be living with HIV than the general population, are less able to deal with the impact of the epidemic and are most likely to be failed by existing policies, programmes, support and services. This is a direct result of their unequal position in society and the negative effects of gender inequality, harmful sexual norms, stigma and discrimination, and economic need and status.’

The document goes on to suggest that it is more difficult to reach sex workers with health interventions because national authorities deny their existence or make sex work illegal. Sex workers rights advocates and their networks wholeheartedly agree with this position and argue that legal and policy frameworks that protect workers’ rights in the sex industry and their human rights, including health and safety at work and ensure access to services, are the best way to reduce their vulnerability to HIV.

UNAIDS Guidance steers away from UN stance

Unfortunately recent policy guidance from UNAIDS, led by UNFPA, has appeared to shy away from previous UN statements on the central importance of respecting, protecting and fulfilling the rights of sex workers in programmes and policies related to sex work and HIV.

Rather than pressing a harm reduction approach the April 2007 UNAIDS Guidance Note: HIV and Sex Work places a strong emphasis on strategies to reduce the number of women who sell sex by encouraging sex workers to leave the sex industry and preventing young women taking up sex work. Unfortunately, despite little evidence that this approach can lead to the reductions in numbers of sexual partners required to slow HIV epidemics, a number of governments have adopted it, especially in Africa. The result is that resources are allocated away from the other crucial components of comprehensive prevention and care or ‘combination prevention’ targeting large numbers of sex workers to moderately successful income generating projects for a very small number.

UNAIDS approach condemned

Another focus of the Guidance Note is reduction of demand for sex work as an HIV prevention strategy by criminalising or otherwise repressing the purchase of sexual services. Human rights advocates have condemned this approach, which is sometimes called the Swedish model, as it can increase the risks of HIV for sex workers by driving sex work underground and limiting the choice of working conditions and the choice of clients.

Trafficking laws need review

The conflation of sex work with sexual exploitation and human trafficking has led to laws aimed at eliminating sex industries and ‘rescue and rehabilitation’ operations of ‘victims of sexual exploitation and human trafficking’ throughout the developing world, often led by evangelical Christian organisations. Changes to the legal framework on trafficking have undermined HIV prevention and care programming and generated human rights abuses, most recently in Cambodia as well as many other countries including Korea, Nigeria, India and The Philippines.

Sex workers recognise the importance of combating human trafficking and argue that to identify and help the real victims, trafficking must be delinked from consenting adult sex work. They also argue that adult sex worker communities can play a vital role in programmes to reduce trafficking along with HIV and cite impressive achievements where that has been the case.

A call for more evidence-based policy analysis

At a meeting in April at IDS Meena Seshu, who works with one of India’s most successful projects for sex workers Sangram in India, said that the gulf between the thinking of the sex workers’ networks and that of the US government, the UN and HIV/AIDS donors has occurred in a relative vacuum of independent scholarship on sex work.

Sex worker rights activist and researcher Cheryl Overs has commented,

‘Despite 20 years of the HIV pandemic, various conferences, declarations, programmes and publications reliable research and policy analysis of sex work and prostitution as a gender, human rights and public health issue is lacking. Too often the information upon which sound policy and effective, rights based programmes could be built is not produced, not disseminated or simply not listened to.’

In the case of the UNAIDS Guidance Note it appears to be a case of evidence ignored as sex workers took part in consultations leading up to its creation and have launched a high profile campaign to prevent the Guidance being adopted by UNAIDS and to have it amended to reflect learning and experience in this area. Since action at the International AIDS Conference in Mexico last month it appears that UNAIDS may be becoming more receptive to their argument. However, the role of key international donors and partners, such as the UK Government, will be decisive in promoting a research and policy environment that shapes evidence based rather than ideologically driven responses to sex work and HIV and human trafficking in the developing world.


01/12/2008 at 18:15 Leave a comment


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