Deputy Director and Senior Fellow, Global Health Policy Center
The theme of this year’s International AIDS Conference is “Human Rights, Right Now.” Speakers -- from those featured at the opening ceremony and in the plenary sessions to those in the oral abstract meetings -- have emphasized the importance of protecting human rights as a means of addressing the worldwide HIV/AIDS epidemic. And on Wednesday night thousands of conference delegates, along with residents of Vienna, marched through the city streets chanting, “What do we want? Human Rights. When do we want them? Now!” After dancing its way along the Ringstrasse to the rhythms of a samba band, the gathering of t-shirt clad and poster-bearing marchers ended in the center of Vienna, where speakers demanded greater contributions by the government of Austria to the Global Fund and enjoyed a performance by singer Annie Lennox, UN International Goodwill Ambassador for AIDS.
One group that participated actively in the march and which is represented in conference sessions as well as at the conference’s Global Village, where non-governmental organizations and civil society groups showcase their work, is commercial sex workers. During Sunday night’s opening session a group gathered under the red umbrellas that symbolize the sex workers’ movement shouted “sex workers’ rights are human rights” and demanded “decriminalize sex work, now.” Over the past few days commercial sex workers have spoken about their experiences advocating for greater attention to human rights in the context of HIV/AIDS within Global Village meetings. And in this morning’s plenary session Meena Saraswathi Seshu, General Secretary of Sampada Grameen Mahila Sanstha in India, who offered the Jonathan Mann Memorial Lecture, described the work of her organization in helping sex workers to serve as advocates for their own rights and needs. One issue that has emerged in several discussions is the fact that while sex workers have strongly supported the efforts of other vulnerable groups, such as MSM or IDUs, in their effort to secure legal protections and to promote anti-discrimination legislation, some groups advocating for sex workers’ rights feel they have not enjoyed reciprocal support.
A session this morning offered an opportunity to explore efforts by and on behalf of commercial sex workers to promote human rights with respect to HIV/AIDS prevention and treatment in diverse contexts. Speakers from Peru, India, Ukraine, and Canada offered their perspectives on the global effort to protect the rights of commercial sex workers, followed by a lively exchange with audience participants. Key topics of discussion included community mobilization around sex workers’ rights, opportunities for policy reform, and the prospects for the decriminalization of sex work where it is considered to be illegal.
Carmen Murguía, of the Universidad Católica in Peru, described the efforts of a multi-sectoral group including representatives of academic institutions, the government of Peru, and international organizations, to identify the barriers to addressing the needs of female and transgender commercial sex workers regarding HIV/AIDS and human rights and to develop solutions to the challenges facing commercial sex workers in Peru. Murguía noted that sex work is neither legal nor illegal in Peru; as a consequence, most of the population views sex work as illegal, resulting in considerable discrimination and prejudice against women and transgender people who exercise sexual commerce. She stated that in Peru the security forces – the police and the military – receive no training with respect to sexual diversity or homophobia and frequently engage in abusive practices that violate sex workers’ rights. Consulting and collaborating with sex workers themselves, the multi-sectoral group developed in a strategy for improving the prospects for ensuring respect for women and transgender people engaged in commercial sex in. According to Murguía, they mapped zones of sex work in four Peruvian cities, trained over 100 sex workers as leaders in advocacy issues, created a model for educating security agents regarding human rights, HIV/AIDS and sex work, and proposed national level legislation to protect sex workers’ rights.
The effects of the United States government’s requirement that international organizations receiving funding through the President’s Emergency Plan for AIDS Relief (PEPFAR) avoid supporting initiatives that “promote prostitution,” also known as the “prostitution pledge,” was the subject of the presentation by Dan Allman of the University of Toronto Dalla Lana School of Public Health. The requirement that recipients of U.S. PEPFAR funds both implement a policy opposing prostitution and sex trafficking and comply with a policy prohibiting advocacy to legalize prostitution or sex trafficking was incorporated into PEPFAR practices in 2005. It was later integrated into the 2008 legislation re-authorizing PEPFAR. In the fall of 2005 several U.S.-based advocacy groups sued the United States’ PEPFAR implementing agencies, charging that the pledge violated Constitutional First Amendment guarantees; in 2006 a federal judge ruled that U.S.-based organizations receiving PEPFAR funds were exempted from the pledge on First Amendment grounds, but the pledge remains relevant for non-U.S.-based agencies engaged in HIV/AIDS prevention and treatment work overseas. In the spring of 2010 the U.S. Department of Health and Human Services issued guidance regarding the actions PEPFAR recipients must take to ensure compliance with the anti-prostitution and sex trafficking policy.
To illustrate the confusion among many PEPFAR funding recipients regarding the prostitution pledge and to demonstrate its negative effects on the provision of prevention and treatment services to sex workers, in particular, Allman presented a “case story,” or a fictional narrative based on interviews with a variety of people knowledgeable with the implementation of PEPFAR funds in various world regions. He noted that the study revealed that there is considerable uncertainty among organizations receiving PEPFAR funds regarding their interactions with sex workers. Some groups, for example, do not realize that although they must officially oppose prostitution and sex trafficking, they may still provide prevention and treatment services to patients seeking care and should not discriminate against sex worker patients within clinic settings. The study revealed that many groups have decided to refuse providing HIV/AIDS prevention, testing, and treatment services to sex workers altogether in order to avoid any possibility of failing to comply with the pledge. The study also demonstrated that many NGO implementers receiving PEPFAR funds believe the pledge prevents information-sharing among groups that seek to work at the intersection of HIV/AIDS prevention and human rights. Allman and colleagues concluded that, in the end, the anti-prostitution pledge appears to reinforce the stigmatization of and discrimination against sex workers in the locales in which they are most vulnerable to HIV/AIDS and violation of their rights.
In her discussion of legal efforts to decriminalize sex work in India, Amritananda Chakravorty of the Lawyers’ Collective on HIV/AIDS in New Delhi signaled reason for “renewed optimism” in the South Asian context. Referring to India’s 1956 Immoral Traffic Prevention Act (ITPA), which followed British colonial law in criminalizing brothels, living off the earning of sexual commerce, procuring, and the exercise of sexual commerce in public places, Chakravorty described efforts by commercial sex workers in India to organize over the last two decades around the principle that “sex work is work.” When the government of India sought to reform the ITPA in 2006, planning to criminalize the presence of men in brothels as well as sex trafficking, Chakravorty said sex worker organizations resisted and challenged the bill on legal, public health and community rights grounds. She stated that the 2009 ruling in the Naz Foundation case in India, which decriminalized adult consensual same sex behaviors, has served as an inspiration for commercial sex workers, who hope to continue to raise questions of sexual rights in the Indian judicial context. Regardless of the outcome of pending challenges by sex workers to government efforts to criminalize clients, as well as other issues, Chakravorty noted that the process of engaging in collective action has empowered Indian sex workers, many of whom have entered formal spaces and engaged with the legal system for the very first time.
Irina Mishyna of Ukraine offered a presentation regarding the efforts of commercial sex workers in Ukraine to organize in defense of their rights. Supported by the International Alliance on HIV/AIDS in Ukraine, women working in sexual commerce in twenty-eight cities across the country have mobilized collectively to protest government actions closing drop-in centers and treatment clinics for sex workers. To date the group has trained leaders within the sex work community to better advocate for their rights and to work with their peers to improve efficiency and efficacy within the movement, based on the idea that the entire community benefits when the voices of all citizens are heard and the rights of all are respected.
During the discussion period following the panel presentations, members of the audience raised several questions about the current state and future of the U.S.-required “prostitution pledge” and offered examples from their own experience regarding efforts to help sex workers organize to defend their rights. There was consensus that it is important to gather evidence regarding the effects of the pledge with respect to HIV/AIDS prevention and treatment goals in order to present a convincing case for policy reform. Participants also raised concerns about the potential for sex workers and those who advocate for sex workers’ rights to participate in the next International AIDS Conference, which is scheduled to take place in Washington D.C. in July of 2012. Noting that U.S. immigration law appears to prohibit the issuance of visas to those who have engaged in sex work or who are suspected of having engaged in sexual commerce during the previous decade, some speakers and audience participants advocated raising the issue with the International AIDS Society, which is organizing the meetings, in order to ensure greater participation and contributions by one of the social sectors most vulnerable to HIV/AIDS.