Sex Workers Deserve Rights Too
07/28/2010
Author Melissa Ditmore on the ramifications of PEPFAR's anti-prostitution policy on sex workers
Since 2003, U.S. government funding to address the HIV/AIDS pandemic has been subject to an anti-prostitution clause forbidding the "promotion of prostitution" by grant recipients. There are few published articles about the effects of PEPFAR's anti-prostitution policy requirement because discussing activities that are not clearly approved under the funding restrictions can jeopardize a program. Funding restrictions imposed by the U.S. have been detrimental to HIV prevention programming for sex workers and compromise their human rights. Moreover, sex workers have faced additional stigma and discrimination by U.S. government-funded programs as a result of the pledge. This has included denial of services, including medical services. Few people are willing to discuss the adverse effects of limiting programming with sex workers because they rely on U.S. funding, in these cases at the expense of some of the people most vulnerable to HIV and human rights violations.
While most project and NGO personnel have been silent, sex workers were very frank about the effects of the pledge during the recent AIDS conference in Vienna where activists chanting "PEPFAR kills sex workers" disrupted a speech by U.S. Global AIDS Ambassador Dr. Eric Goosby.
Sex workers and activists are right to criticize the anti-prostitution pledge. Guidance for the implementation of the anti-prostitution pledge has been unclear. This has led to a chilling effect, as organizations self-censor their speech and activities. At least one large international NGO has stopped seeking HIV-related funding while others have said that they continue to work with sex workers, but cannot scale up programs proven effective.
The sole bit of clarity from government representatives has been that drop-in centers for sex workers are not permitted, and as a result have closed. For some homeless sex workers, the closure of drop-in centers deprives them of bathing facilities and toilets. I do not want to believe that offering those without access to running water and a place to use a toilet in private would be considered "promoting prostitution" by anyone, but that has been one of the effects of closing drop-in centers. Closing sex worker programs, especially drop-in centers, has had a domino effect because drop-in centers made condoms and other safe sex supplies available and functioned as meeting places for peer educators, many of whom were involved in social marketing of condoms and distribution of safe sex materials. The impact on the overall rate of condom use by sex workers have been devastating. This has clear implications for the spread of STIs including HIV.
Some organizations and individuals have tried to push back. Two lawsuits have been filed in the U.S. In the field, some people have tried referring to the anti-discrimination clause when staff turn away sex workers who seek services, like health care. Some programs that have signed the pledge have continued to work with sex workers and have tried to support sex workers self-organizing, but they know the risks and feel able to do this in only very particular situations. For example, one program operates in a very dangerous location with extremely high levels of interpersonal violence, which they feel insulates them from external scrutiny. Many organizations have abandoned programming with sex workers, including anti-violence programs in similarly dangerous places. The limitations felt and imposed by the pledge have clearly been detrimental to sex workers within and beyond the context of HIV/AIDS. The only evidence-based solution identifiable is that the anti-prostitution pledge requirement must be repealed for effective programming with sex workers.
Melissa Ditmore is an independent consultant on gender, development, HIV, sex work and migration. Her most recent book is the co-edited anthology Sex Work Matters.
Yes,I am agree with sex workers having it
own organization for welfare,to raised
the voice but some may change the life
uncondionally slowly. Every person have own
life to live, share with others and get
from others.Proper education and law need
according.
Dr.Prakash Sanchetee MBBS,DMCW,DPH,PGDHH
A-120,Lake Garden,Kolkata,India
(JavaScript must be enabled to view this email address)
— Dr.Prakash Sanchetee on 2010-08-16