In the vibrant coastal city of Pattaya, Thailand, a young model elegantly swirled a calf-length cape on stage. At first glance, the garment seemed crafted from shaggy sheepskin, an odd choice for Pattaya's tropical climate. However, a closer look revealed an unexpected material – hundreds of dangling prophylactics. This wasn't just a fashion show; it was the "Condom Fashion Show," a daring centerpiece at a recent United Nations-led consultation tackling a grave issue – sex workers and HIV, the virus causing AIDS.
Unlike typical international conferences, this consultation brought sex workers from eight countries, including Cambodia, China, Fiji, Indonesia, Myanmar, Pakistan, Papua New Guinea, and Thailand, as active participants, not just runway models. This inclusion recognized the vital role sex workers play in confronting an epidemic that still sees 350,000 new infections annually in Asia. A 2008 United Nations report identified "men who buy sex" as a major driving force behind Asia's HIV epidemics, estimating that around 10 million Asian women engage in sex work, serving 75 million men with an additional 50 million regular partners.
A crucial strategy in curbing HIV transmission is ensuring sex workers have access to, know how to use, and consistently use condoms. However, the UN estimates that only a third of Asia's sex workers are reached by HIV-prevention programs. In some countries, possessing condoms can be misconstrued as evidence of prostitution, leading to harassment and detention.
Despite their frontline role in the fight against HIV, sex workers are often excluded from air-conditioned conference halls where officials and NGOs discuss their challenges. Language barriers, coupled with condescension and disdain, contribute to this exclusion. Sex workers are frequently perceived as the problem rather than part of the solution.
Thailand's early success in combating AIDS, particularly through the "100% condom-use program" in the early 1990s, is well-known. However, the danger now is complacency. The most effective prevention initiatives involve sex workers themselves, with their ability to educate and assist peers surpassing that of international organizations or governments.
Myanmar, often not associated with progressive policies, boasts a successful HIV-prevention scheme. Population Services International, an international NGO, operates a "peer-to-peer" network with 18 drop-in centers staffed mostly by former or current sex workers. This initiative led to a significant drop in HIV prevalence among sex workers from over 30% in 2000-06 to 18% in 2008.
However, challenges persist. Sex workers face stigma and abuse from authorities, with the police often being the worst perpetrators. Cambodia, recognized for reducing HIV prevalence through a condom-use program, witnessed the closure of brothels in 2008 due to a law on "the Suppression of Human Trafficking and Sexual Exploitation." This led to increased dangers for sex workers, including physical violence and sexual assault by the police.
The anti-trafficking industry exacerbates these challenges. While its goals are justifiable, the assumption that all sex workers operate against their will oversimplifies a complex reality. Many migrant sex workers choose this profession for personal reasons, such as the desire to work independently or earn higher incomes.
Two fundamental issues continue to hinder efforts to support sex workers. Firstly, in most places, sex work remains illegal and socially frowned upon. Arguments for or against decriminalizing prostitution are ongoing, but until a resolution is reached, sex workers will remain vulnerable to arbitrary abuse.
Secondly, the campaign against human trafficking has overshadowed discussions about sex work. While its goals are commendable, this campaign reinforces the assumption that all sex workers are victims. In reality, many have made independent choices to pursue this profession.
The Pattaya consultation aimed to change the narrative. Sex workers sought recognition as autonomous individuals capable of making their own choices. They demanded to be treated with basic human dignity, challenging stereotypes and advocating for their right to be heard. The battle against HIV in Asia is far from over, and the inclusion of sex workers in these critical discussions is a step towards a more comprehensive and effective strategy.
