Here are two press reports on the meeting on sex work last week.
HIV prevalence among sex workers in Myanmar may have 'decreased' due to better data, deaths, decreased incidence, or a combination of these three. Attributing the decrease to the activities of PSI is risky.
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Asia HIV prevention programmes fail to reach sex workers
15 Oct 2010 13:05:00 GMT
Written by: Thin Lei Win
BANGKOK, Oct 15 (AlertNet) - National AIDS programmes in Asia often fail to prioritise those most of risk of infection and need to work on more targeted HIV prevention schemes to stop the disease from spreading, the regional director of the UN agency in charge of HIV/AIDS prevention said.
Aid agencies say sex work is one of the main drivers of AIDS in the region, home to the second largest number of people living with HIV after sub-Sahran Africa.
Sex workers are extremely vulnerable, with HIV prevalence among this group reaching 20 percent in some countries even though adult HIV prevalence in Asia is less than 1 percent for all countries except Thailand.
"In Asia, national AIDS programmes often fail to prioritise those most at risk of infection," Steve Krauss, regional director of UNAIDS, told AlertNet. "Hardly any country is devoting significant resources to programmes with sex work, for men who have sex with men and drug users."
In a first for the region, government officials from eight countries and staff from United Nations agencies this week joined sex workers in Pattaya near Bangkok to hear first-hand experiences and look at ways to review policies and laws that keep sex workers from accessing HIV services.
A 2008 report by the Asia Commission on AIDS highlighted the potential scale of the problem. It said an estimated 10 million women sell sex to 75 million men in Asia, who have intimate relations with a further 50 million people.
Yet, only one out of three sex workers are reached by HIV prevention programmes. This is partly because financial resources on such programmes are shockingly low.
UNAIDS say programmes targeting sex workers and their clients account for between 0.1 and 10 percent of money spent on AIDS between 2007 and 2009 in six countries (Cambodia, Fiji, Indonesia, Myanmar, Pakistan and Thailand).
OLDEST PROFESSION
Sex work has been called the oldest profession in the world, yet it is also one of the most discriminated and criminalised.
"The ongoing reality of stigma and discrimination are driving the epidemics in this region," Krauss said. "Sex workers face discrimination from so many angles and actors and this is a serious barrier to their accessing programmes."
Kay Thi Win, chair of Asia Pacific Network of Sex Workers (APNSW) and programme manager of the Targeted Outreach Programme in Myanmar, said despite clear policies stating law enforcement officials cannot use condoms as evidence to arrest sex workers, in reality, the reverse is true.
"So sex workers no longer dare to carry condoms around with them even if they wanted to. They think if they have condoms, they will get arrested," she told AlertNet.
Worse, UNAIDS is concerned what little money spent on HIV programmes for sex workers is being reduced further both internationally and nationally despite evidence that targeting sex workers is one of the most cost-effective ways of preventing HIV.
It said in Cambodia, the figure decreased from 5 percent of total AIDS spending in 2007 to 2.2 percent in 2008. In Pakistan it was 10 percent in 2008 but fell to 9 percent in 2009.
Targeted programmes, such as the one in Myanmar, can be very effective in reducing HIV infection rates because they involve the community.
The programme, which is part of Population Services International, started with 10 sex workers as peer educators. Now they have 350 peer educators and 18 centres all over the country, providing outreach, clinical services and HIV care and support.
"When our programme started in 2004, HIV infection rate among sex workers was over 20 percent," Win said. "But the rate is less than 10 percent now."
POLARISED DEBATE
"(The success) is because of community involvement - they know how to persuade amongst themselves and they understand and trust each other. Sex workers know very well what issues they face, they just never had the authority to act," Win said.
"I'd like the non-governmental organisations (both national and international) to help sex workers so they have the authority to act and make their own decisions."
But it is a challenging task to get everyone on board to establish focused programmes.
"It is a very polarised debate and people have different viewpoints where they position themselves on a moral high ground and they won't move," Carol Kidu, Papua New Guinea's first female cabinet minister, told AlertNet.
"So you try different tactics, new pathways that are less controversial... There is lots of work to be done to advance the agenda," she said.
The meeting in Pattaya this week was organised by UNAIDS, the United Nation's Population Fund UNFPA and APNSW.
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http://www.alertnet.org/db/an_art/52132/2010/09/15-130557-1.htm
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ASIA: Laws driving HIV prevention underground
Condom possession can prove problematic in some countries
BANGKOK, 15 October 2010 (IRIN) - In a region where carrying a condom has been construed as evidence of illicit activity, 10 million women sell sex to 75 million men, who then have sex with another 50 million people, according to the multinational Independent Commission on AIDS in Asia.
"The technology is there to prevent infections, but punitive laws get in the way," said Steve Kraus, regional director of UNAIDS Asia Pacific.
Asia's AIDS epidemic is linked primarily to unprotected paid sex, according to the commission, but policies outlawing sex work are undermining HIV/AIDS prevention efforts by fragmenting and stigmatizing the sex workers and turning condom possession into an act that could lead to jail time, NGO officials say.
Until recently, Cambodia was praised by the international community for its implementation of the 100 percent Condom Use Programme, which allowed for selective enforcement of anti-sex work laws and required condom availability and use for sex workers. But a national anti-trafficking law introduced in 2008 broadly criminalized sex work, and sent sex workers into hiding.
Now officials are interpreting the law to implicate even those who distribute condoms, according to a July 2010 Human Rights Watch report .
The closure of most brothels in Cambodia as a result of the law drove thousands of sex workers into underground karaoke bars, massage parlours and parks, making them more vulnerable to police corruption and HIV infection, said Andrew Hunt, founder of the Asia Pacific Network of Sex Workers based in Bangkok.
"The full impact of this new law is still unknown," said Hunter on 15 October, speaking from a conference in Thailand that gathered 140 civil society and government officials and sex workers from Cambodia, China, Fiji, Indonesia, Myanmar, Pakistan, Papua New Guinea and Thailand, to discuss issues of HIV/AIDS and sex work.
"Police actually think they have a duty to arrest sex workers and use condoms as evidence. They need legal training - most countries do not accept condoms as evidence in court - but most sex workers never make it to court," Hunter said.
Fighting stigma
The Cambodian law is but one example of policies driving an indu
stry into hiding and making containing HIV a challenge, according to UNAIDS. A coalition of agencies working on HIV/AIDS reported that all the eight countries at the conference had created obstacles to accessing HIV services for vulnerable sub-populations: Cambodia and Papua New Guinea specifically criminalize HIV transmission or exposure.
New International Labour Organization (ILO) standards adopted in June 2010 include sex workers in all areas of non-discrimination, but experts say that while policies can change, without proper understanding and implementation, the stigma and violence that surround sex work will continue to threaten human rights and HIV prevention.
"Most sex workers say access to justice and process is equally important to law reform - they have no faith that changing the law will make a difference," Hunter said.
Kay Thi Win, programme manager of the Targeted Outreach Programme, a peer-to-peer project in Myanmar primarily run by current or former sex workers, confirmed that sex workers are up against more than policy. "Stigma is the issue," she said. "But if the policies change, we need the police to be trained."
http://www.irinnews.org/Report.aspx?ReportID=90782
