By Festus Mogae and Stephen Lewis
In South Africa and across Africa, HIV continues to prey on women, sex workers and men who have sex with men. It is clear that to end the HIV epidemic, we must protect and support these groups.
Yet, our country and others enforce bad laws and customs that disempower these groups and make them more likely to be infected with HIV. We cannot hope for an HIV-free generation when we have laws that marginalize and punish those most vulnerable to the disease. A global commission of legal, human rights and HIV leaders recently released a report that shows punitive laws are standing in the way of effective AIDS responses.
Archaic laws and customs make women and girls more vulnerable to HIV. Legally condoned violence and oppression—including genital mutilation, sexual violence, denial of property rights and early marriage— undermine the ability of women to protect themselves. Laws urgently need to protect women, who are often the ones left to care for the sick, tend to the family and till the fields.
In addition, many countries have punitive laws that criminalize sex workers. However, these laws drive sex work underground and make sex workers more at risk for HIV. Police violence and the threat of arrest disempower sex workers, making them more vulnerable to abuse and HIV transmission. Many are unable to access prevention and care because of the stigma they face, even from health care workers. In contrast, sex workers who are not harassed by the police and who have access to services have lower HIV rates and more economic power.
Laws across the continent also criminalize homosexuality. Yet, punishing men who have sex with men force them into secrecy. They are unable to access counseling and testing, making it almost impossible for HIV prevention and treatment interventions to reach them. In 2008, when the Senegalese government jailed nine gay HIV outreach workers under a law prohibiting “acts against nature,” health workers went into hiding, advocacy groups disbanded and HIV treatment sites were shut down.
The time has come for African leaders to take action against bad laws that stifle our HIV response. We must challenge societal values rooted in fear and prejudice and implement laws based on human rights and sound public health.
This starts with recognizing the rights of women and decriminalizing homosexuality and voluntary sex work, which is vital to protecting the health and dignity of these groups. Voluntary sex work should not be confused with human trafficking, which remains an abhorrent human rights violation. Laws protecting women and children from trafficking must be vigorously enforced and strengthened.
Change will not come easy. It will require us to challenge tradition and deeply held personal values. It will mean confronting religious beliefs and antiquated practices that endanger our citizens. Leaders will face shock, anger and opposition. But change is essential if we hope to slow the spread of HIV. Many leaders have refused to confront this reality. Instead, they opt to hide behind religion and the veneer of morality.
But other leaders have demonstrated the courage needed to use laws as a powerful response to HIV. In May, Malawi President Joyce Banda announced she would make efforts to repeal Malawi’s laws that criminalize homosexual acts. "As leaders, especially in this part of the world (Africa), which is the epi-centre of the epidemic, we need to harness our efforts in confronting antiquated beliefs based on fear and misinformation that are codified in our laws and engraved in our cultures," said President Banda.
In 2010, Rwanda Secretary of Health Agnès Binagwaho called for human rights-based policies that empower sex workers to negotiate safe sex and protect their health. Botswana enacted a law in 2008 to protect survivors of domestic violence and another in 2004 to establish equality of spouses. In recent years, 8,000 communities across the world, including in 15 African countries, banned genital mutilation.
Leaders in South Africa and across Africa must embrace change and follow these examples. We have a tremendous opportunity to accelerate the end of HIV. We must reverse laws and practices that stand in the way of effective HIV responses and replicate those that protect the human rights and health of our citizens. Evidence-based, humane HIV responses will not only help shield us from HIV, they will also help build a more prosperous African continent. Africa’s leadership must boldly rise to the challenge. Together, we can turn the tide against HIV.
[[This event announcement was sourced from Link2Media: AIDS response must be guided by human rights and justice]
His Excellency Mr. Festus Gontebanye Mogae and Stephen Lewis are members of the Global Commission on HIV and the Law. Mogae is the former president of Botswana. Lewis is the co-director and co-founder of AIDS-Free World and was formerly the United Nations special envoy for HIV/AIDS in Africa.
By Mickey Meji
The Constitution, enforced and guarded by the Constitutional Court and various Chapter Nine institutions, is world leading, and over time the reality on the ground seems to be improving.
Yet there is one area where South Africa’s human rights record leads Africa for all the wrong reasons. One group of people is excluded from all these protections because of action and inaction by the government and Parliament.
The relentless police brutality and health services stigma meted out to South Africa’s 200 000-plus sex workers – most of whom are black women on low incomes – is exacerbated by political indifference, and leads the African continent in its scale and impact.
The results are measured in high HIV rates, in low take-up of health services and in poor relationships with the police.
All this is known – it has been researched and highlighted through lobbying, and repeatedly pushed aside. Our democracy has comprehensively failed this most marginalised of groups at every turn. Just take a look at three key areas – Parliament, the law reform process and HIV services.
Assuming that Parliament would be interested in such abuse on its doorstep, two prominent organisations serving and representing sex workers in SA – Sweat, working on rights and providing health and advocacy services, and Sisonke, representing sex workers themselves – wrote to all 462 members of Parliament (National Assembly and National Council of Provinces) on December 9, 2011, giving detailed examples of police and health service abuse of sex workers’ rights, and even providing an easy response sheet. By the end of February 2012, just 10 responses had been received.
Back in May 1996, the SA law reform commission started a project examining the law relating to sexual offences, including “adult prostitution”. The parliamentary justice portfolio committee wanted it to come back with proposals for change.
An unbelievable 16 years and many thousands of human rights breaches later, the commission has still not reported.
And nearly three years after it conducted a public consultation which attracted many submissions, those who responded are still waiting for clarity on where the process is going next, and the commission has refused to release copies of the submissions it received.
About one in five new HIV infections in SA is related to sex workers, their clients and families; and HIV rates among sex workers are about four times the national adult average.
Back in 2007, the government agreed a national strategic plan on HIV/Aids, which included commitments to set up specialist health services for sex workers, and to move on the decriminalisation of sex work. Five years later, no progress has been made.
So what’s the relevance of all this to the average South African?
First, the neglect of the issue creates extreme moral discomfort. We live in a country defined by people’s rights, moulded by conflicts around those rights. When the law labels as criminals a group of adults who do no more than choose to enter into private, temporary, generally financial, arrangements with other adults, and are treated by the police as subhuman, all of us should surely be disturbed at the hypocrisy and inhumanity involved.
If we aren’t, maybe we should examine why we aren’t. However immoral one may regard sex work, surely long and painful lessons have been learnt in this country about doomed attempts to write the moral view of some into legislation applying to all.
Secondly, the current situation encourages police corruption, and soaks up scarce resources better used elsewhere. The mix of police discretion over what action they take against sex workers and their clients and of an activity which operates in the shadows of our society is a toxic one.
The outcome is a wide and deep range of abusive police behaviour towards sex workers, including verbal abuse, demanding and taking bribes, and much worse.
In a 2009 survey, 12 percent of Cape Town sex workers reported being raped by police. Decriminalisation transforms the police-sex worker relationship from being fraught and police-dominated to being necessarily complex and diverse, with a number of agencies being involved – as they are with the rest of the population.
Thirdly, criminalisation undermines our urgent national mission to combat HIV.
By feeding stigmatised behaviour by health workers, and by forcing sex work into the shadows, criminalisation makes it virtually impossible for sex workers to access condoms and health services without fear of stigma.
Just when sex workers should be the safer-sex ambassadors in an HIV-aware world – more willing than the general population to exercise safer sex – they are instead rendered highly vulnerable to the virus.
Fourthly, the concern for everyone is the way in which our democratic institutions have turned a collective cold shoulder on this significant issue. There are proven, win-win options available, notably decriminalisation of sex work, as in New Zealand and in the Australian state of New South Wales.
Instead, our elected leaders seem to be hung up on religious opposition and political conservatism (interests which opposed every other progressive reform throughout the past 18 years), on looking at the detail without realising that it is the legal status of sex work which is at the heart of the matter, and on tossing the issue into a confusing cocktail of agencies and processes.
[This news article was originally sourced from IOL News: Democracy has failed this groups]
By Chanda Katongo, Women's eNews correspondent
These days, Comfort Mwansa, 26, has a full, busy life.
While attending school, she also makes and sells doormats to meet expenses. She is looking forward to having a family and giving her children a better life than her own.
"I want to work hard and make sure that the children I will have in the future will have everything they need," she says.
Mwansa is one of many women who say their lives have been turned around by the Tasintha Programme, a grassroots nongovernmental organization that aims to eliminate commercial sex work and HIV/AIDS in Zambia.
Lucy Bwalya, Tasintha's program officer, says it has recruited and provided skills training to 7,000 female sex workers in Lusaka since 1992. Of them, about 60 percent have left sex work; 120 have died from AIDS and other diseases.
Kunda Matipa, Tasintha's operations officer, says that recruiting sex workers on the street to stop sex work and join Tasintha isn't easy.
"At times during the process of recruitment, we have to pretend to be a sex worker," he says of the female staff members. "Or if you are a man, you have to pretend to be buying sex."
Nearly 70 percent of the population lives below the national poverty line in Zambia, according to the World Bank. HIV prevalence is 13.5 percent among adults ages 15 to 49, according to the Joint United Nations Program on HIV/AIDS. Women are more likely to be living with HIV than men. Varying Categories
There are different categories of sex workers in Zambia, according to Tasintha. "White-collar sex workers" are educated and have jobs, yet also secretly engage in sex work. "Hard-core sex workers" work in hotels, lodges, clubs and bars. They are usually targeted by foreigners and tourists and frequently use drugs. Those in the third are children who start sex work as early as 12 years old.
President Michael Sata, who took office in September 2011, has pledged to create more employment opportunities for young people and for women as part of his poverty-alleviation strategies.
But for now, sex work remains a huge lure for women such as Clara, 28, who declined to give her full name for privacy reasons. She has been a sex worker for the past 10 years.
"I do this for my little girl," Clara says. "I provide for her through this."
She says she can make $80 in a day.
Clara says she does her best to protect herself from HIV/AIDS by using condoms, but that clients don't always comply.
"For me, I know about HIV, and I always do my best to avoid getting this disease," she says. "And, you know, it is not easy because at times we get clients who don't want to use a condom and, actually, there are times when our clients even rape us."
She says that some sex workers don't realize that condoms can protect against HIV and other sexually transmitted diseases. Some think condoms are only to prevent pregnancy.
[This news article was sourced from Women's eNews http://www.womensenews.org/story/hivaids/120115/zambian-sex-workers-offered-transformation]
By Anso Thorn, Health-e News
Moriscia Cloete (37) bucks the trend. Many sex workers share stories of broken, unhappy, abusive homes and childhoods, but the tall woman with the easy smile recalls growing up “with a good family” and receiving a solid education.
Cloete was a highly qualified paramedic with dreams of becoming a doctor when she responded to an advertisement for a masseuse.
“It was my first paying job and I realised very quickly that this was not only about being a masseuse,” she giggles, her long, curly black hair falling over her shoulders. Some grey around her temples is the only hint that she is not a youngster anymore.
“Very soon, I was working as a stripper and pole dancer,” explains Cloete, who only works from escort agencies where she feels safer, protected from abusive clients.
“I only have sex with a condom, but it’s not easy as about 80% of my clients, men and women, want to have sex without condoms. But even if they offered me R500 extra, I wouldn’t agree,” says Cloete, adding she has regular HIV tests.
“So, it not easy to always find customers who will have sex with a condom, but I am telling you the female condom has become our best friend. The men often complain that the condom robs them of their manhood or they lose sensation, but I manage to convince them to give the female condom a try, and more often that not they love it. The female condom has a ring which rubs against the penis, so that is already a big plus and I feel much tighter to the man, so that is another bonus. It’s well lubricated and he can feel my body heat. I should really be a saleslady for the female condom,” Cloete laughs.
Cloete frowns when quizzed on the treatment of sex workers at healthcare facilities. “Look, I have been in the game for 17 years, they know me by now. I am honest because if I am not I run the risk of not receiving proper treatment. But there is no doubt they treat us differently. You get shoved to the back of the queue and they take so long to help you. Instead of respecting the fact that I am concerned for my health and that of my clients, they don’t treat me in a dignified manner,” says Cloete.
A couple of years ago, Cloete broke both her ankles in an accident and she now walks with a limp. The injury has also hampered her ability to work regularly.
“I never received any physiotherapy after the accident, despite me asking several times, and I am still convinced it was because they viewed my case as less important,” claims Cloete.
Cloete adds that condoms often break, but rather than trying to find help at the clinic or hospital, sex workers have devised their own remedies.
“We douche with a mixture of water, a pinch of salt and lemon immediately after the incident. If these ingredients are not available we use beer,” she says. Quizzed about whether it is not risky to rely on an unproven remedy she laughs: “It’s not very comfortable, but it does the job.”
“I have no doubt that a dedicated service would go a long way towards addressing the challenges of HIV, surely by not assisting us many people are being placed at risk,” she says.
[This news article was originally sourced from Health-e News, http://www.health-e.org.za/news/article.php?uid=20033359]
An official of the Botswana Network on Ethics, Law and AIDS (BONELA) has called on government to legalise prostitution and allow foreigners free access to anti-retroviral drugs (ARVs) if it is serious about winning the battle against HIV and AIDS.
Speaking at an event held ahead of the World AIDS Day commemoration in Moshupa last Wednesday, Felistus Motimedi, who also called for free distribution of condoms to prison inmates, said some men rape sex workers but the victims cannot report the abuse to the police because prostitution is illegal in the country.
"Some HIV positive people among us are fired at work merely because of their HIV status. They are not promoted at work just because they are positive. They are also not granted scholarships, despite their potential to perform better, just because they are positive. As parents we still have difficulty in explaining issues to HIV positive children," said Motimedi.
She said HIV positive women are often accused of frequently falling pregnant inspite of their full knowledge of their HIV status.
What surprises her is the fact that nothing is ever mentioned about the women's partners as no pregnancy can occur without the involvement of a woman and a man.
"There are people in our society - men and women-- who are sex workers. They live in our midst though they operate illegally. These people are at high risk of HIV infection because their access to counselling and treatment is limited. Sometimes their potential clients take them to far away places and then dump them there - leaving them stranded.
"Some are raped and the services given a rape victim start with the police. After being taken for medical examination victims are provided with treatment, which should be done within three days from the time of the rape. Since they are not legally recognised, sex-workers are afraid of reporting their abusers. This puts them and their partners at risk. They should be recognised so that they can be helped," she said.
She also highlighted the challenges faced by prison inmates in the country: "We have relatives who have been imprisoned. Our prisons are overcrowded. Sexual urges affect prisoners who have left their partners at home. Sexual intercourse therefore occurs between inmates. Without condoms their risk of contracting diseases, including AIDS, is high.
"Foreign prisoners are denied access to ARV treatment even though they share prisons with Batswana. We say they should also access treatment."
"Batswana have sexual relations with foreigners. If a Motswana woman is in a relationship with a foreigner and she is positive and falls pregnant, she can enter the Prevention of Mother to Child Transmission (PMTCT) programme.
"But this is not the case with a foreign woman who falls pregnant while in a relationship with a Motswana man. This is unfair and should not be allowed.
"I do not know whether this is the case here in Moshupa. But in the rest of the country, co-habitation is common.
In situations where the other partner depends on the other for support, the chances are the dependent one is likely to be dictated to on where, how and when to have sex. So they are at a higher risk of being infected, as they do not make decisions," she said.
Motimedi told her audience that Botswana has gays and lesbians. She said they are human beings like everyone else and should be recognised. For their part, some people accused BONELA of influencing children to be wayward by advocating for their rights.
One elderly man asked where a parent would report to when a child, claiming to be exercising his/her rights, refuses to be sent on errands. Another man advised the youth to change their behaviour by avoiding risky sexual relations with older people. Another elderly woman said she supported BONELA that foreigners should not be discriminated against when it comes to HIV treatment.
On gays and lesbians she said: "Had I known that this dialogue would include the gays and lesbians topic I could have brought my Bible with me. The Bible says it is a sin to be gay or lesbian." BONELA director Uyapo Ndadi said that human rights do not encourage waywardness. Instead people are empowered in order to improve their relationships with others. He reminded his audience that 'Your rights begin where mine end'.
"BONELA does not encourage homosexuality or prostitution. We only urge you to accept these people as fellow human beings and find means of helping them. I am surprised by many Batswana who when you talk of homosexuality they will tell you how Christian they are.
"When people commit adultery in the church they keep quiet. Even if the pastor is very promiscuous, the church members just remain silent. Even if the congregation becomes so promiscuous that so and so bears children with so and so in the church they remain silent. But let one young man say 'my choice is to be in an affair with another man', they will read the Bible to you, showing you how sinful that is."
[This news article was sourced from The Monitor http://www.mmegi.bw/index.php?sid=1&aid=447&dir=2011/December/Monday5]
Mickey Meji, leader of the SANAC sex work sector, said today:
“I have attended five SANAC meetings in the last 3 months to advise on how to improve the HIV response to sex work. My consistent advice was that while sex workers, their clients and partners remain criminals, no intervention would be effective. Decriminalisation was the key action needed. Government ministers, officials, other sectors and NGOs at the meeting endorsed this as a key evidence-based. Now, in one week, all that has dissolved.
It’s really very simple. South Africa has the world’s largest HIV epidemic. One in five new HIV infections is sex work-related. Something must be done. Yet the Government has changed the final draft of the National Strategic Plan to remove any trace of a commitment to end the criminalisation of sex workers and their clients.
Our constitution is a contract between government and the people. Sex workers and NGOs are delivering their side of the bargain, combatting the epidemic and educating sex workers and clients. Yet government has no plan, and the police target our outreach teams and seize our condoms as evidence of sex work taking place – effectively punishing poor, mostly women, who are trying to survive and put food on the table. The government has failed us”.
How the NSP drafters have gone back on their wordExtract from Draft 3 of the NSP 2012-2016 (pg 58)
In addition, there is a large body of evidence showing the negative impact of the criminalisation of adult sex work on sex workers and their clients, their other sexual partners and public health more broadly. Much of this was already known in 2007, resulting in the previous NSP’s recommendation that sex work be decriminalised. The DOJ&CD, working together with the South African Law Review Commission (SALRC), must take urgent steps to finalise the legislative reform process that began with SALRC Project 107 (Adult Prostitution). This must result in (a) the completion of the SALRC report on Project 107 by no later than 30 September 2012, and (b) the tabling of a bill to decriminalise adult sex work by no later than 15 December 2012. Thereafter, SANAC must closely monitor the law reform process in Parliament.
Extract from Final draft of the NSP 2012-2016 (pg 53)
In an attempt to address any barriers and shortcomings – legal, social or economic – that may exist and therefore could undermine the rights of individuals, reviews and assessments will be conducted over the five year lifespan of the NSP. In addition, audits of interventions related to HIV, STIs and TB by all stakeholders should be undertaken, using tools adopted by SANAC, to ensure that they comply with human rights. The results of such reviews and audits will inform the course of action to be recommended to all stakeholders as well as Cabinet for consideration.
... Decriminalization of sex work is a matter that has been a subject of debate and society should continue to deliberate on the matter until final resolution.
Contacts for media comments
Mickey Meji is available on 073 992 0478.
Sally Shackleton, Executive Director of SWEAT, is available on 082 330 4113
[Please find below a downloadable PDF version of the NSP on HIV, STIs, and TB 2012-2016, sourced from the SANAC website http://www.sanac.org.za/files/uploaded/NSPabf.pdf]
By Ester Lewis, IOL News
Harassment by police and humiliation at clinics mean just 5 percent of sex workers are getting health care.
This is according to research by the Sex Worker Education Advocacy Taskforce (Sweat), which says up to 60 percent of sex workers nationwide were HIV-positive and nearly 20 percent of all new infections were related to the industry through clients, partners, abuse and rape, according to its research.
Micky Meji, national co-ordinator of the Africa Sex Worker Alliance, said that adding to the infection rate was harassment by police, who often confiscated condoms from sex workers.
But City of Cape Town director of safety and security Richard Bosman said law enforcement officials didn’t confiscate condoms from sex workers.
Meji, a former sex worker, also claimed some police officers would force sex workers to have sex with them without the use of condoms, or face arrest.
She said a small number of sex workers accepted increased rates for unprotected sex with clients. Meji explained that if they had no clients, the need to feed their children often drove them to unprotected sex.
While the infection rate was high, Meji said the low number of sex workers seeking treatment was due to humiliation at clinics.
This was echoed in a submission by the Sonke Gender Justice Network to the African Regional Dialogue 2011.
The submission included several stories by sex workers about the abuses they faced when arrested, including being denied access to their medication and also ill-treatment at clinics.
A sex worker told the group that in May she went to a Khayelitsha clinic to be tested for a sexually transmitted infection (STI).
“The nurses treated me badly and embarrassed me (by) disclosing my result to everyone. According to my understanding, it is confidential,” said the woman.
This deterred her from seeking help at the clinic again.
Meji alleged that some women who visited clinics for STIs multiple times were refused treatment.
[This news article and accompanying photo were sourced from IOL.co.za http://www.iol.co.za/news/crime-courts/sex-workers-trapped-in-hiv-nightmare-1.1175758?showComments=true]
“When faced with questions about sexual history, it’s difficult for them. Some nurses refuse treatment until they bring in their sexual partners,” said Meji.
Department of Health spokeswoman Faiza Steyn said while people were urged to bring their partners to the clinic to be tested and treated, they could not be refused treatment. If there was any refusal of treatment, patients could report them to the Western Cape Health Independent Complaints Commission and the Human Rights Commission.
Sweat has partnered the NGO TB and HIV Care to provide screening programmes in Cape Town and Durban.
Sex workers in Rwanda say the criminalization of their activities, combined with their general isolation from society, means they are often excluded from HIV prevention, treatment and care opportunities.
Article 225 of the Penal Code states that "Any person who practices the profession of prostitution shall be liable for a term of imprisonment ranging from six months to three years or a fine ranging from 50,000 [US$81.5] to 500,000 [$815] Rwanda Francs."
Sex workers fall into the category of "most at-risk populations" in terms of HIV infection and transmission, and according to the 2010 Rwanda Behavioural and Biological Surveillance Survey the overall prevalence of HIV among female commercial sex workers was 51 percent - 17 times the national average of 3 percent.
The survey also found that condom use by sex workers was inconsistent with their paying sexual partners as well as with their chosen partners, and 36 percent of sex workers reported having had at least one sexually transmitted infection symptom in the 12 months preceding the survey.
Sex workers say the illegal nature of their profession has a direct impact on HIV prevention and treatment. For instance, when HIV-positive sex workers are jailed, they are unable to adhere to treatment. They also face stigma and discrimination by their communities and even health workers.
"I had this unrelenting cough and I was losing a lot of weight. My skin was deteriorating. The doctor - without my knowledge and consent - just conducted an HIV test," said Nelly*, a sex worker in Nyarugenge, a suburb in the capital, Kigali.
"He gave me some treatment for opportunistic infections, but didn't reveal to me that I was HIV-positive. When I went back to the health centre some time later, the reception was very cruel... No one wanted to attend to me; the nurses and all the other staff were avoiding me, just pointing fingers,” she said.
"After a long and frustrating wait I managed to see the doctor, who gave me a few tiny tablets and impolitely told me I was suffering from some incurable disease. I was confused but I came to discover, much later, I was HIV positive," she added. "I resorted to going to a far-off health centre, where they don't know about my [sex] work - at least they would treat fairly there."
But news of her HIV status had already reached her home and when she visited her family, her parents and siblings forced her to use separate cutlery, crockery and other household items.
In 2010, more than 100 civil society organizations submitted a position paper on human rights, HIV/AIDS and sex workers to the Rwandan senate, stating that the continued criminalization of the profession forced sex workers to operate covertly, and denied them access to vital healthcare.
The country's National Strategic Plan on HIV/AIDS (2009-2012) aims to reach 60 percent of sex workers with HIV prevention programmes, but criminalization makes it difficult to reach them, said Willy Mwanafunzi, the executive director of Faith Victory Association. The NGO has embarked on a three-year campaign to fight HIV/AIDS among sex workers.
"The campaign with sex workers seeks to find alternative economic activities away from [sex work]. We have so far trained over 4,000 sex worker peer educators around the country in HIV prevention, advocacy for condom use and human rights, among others, and these peer educators are also supposed to identify and recruit these sex workers into the project, but the main challenge we have had is identifying the sex workers," he told IRIN/PlusNews.
"Sex work is illegal here, so they tend to shy away and hide from the peer educators because they do not trust their motives. They think they [peer educators] are working with the law enforcers, and this has kept them [sex workers] away. However, we have taken it upon ourselves to sensitize the authorities and our target beneficiaries that our activities are for the good of this most at-risk population," Mwanafunzi said.
Officials at the Ministry of Health told IRIN/PlusNews that sex workers were free to access the country's widely available HIV services.
"We have carried out sensitization programmes across the board… directed towards behavioural change and HIV/AIDS education to all audiences through the media and other fora,” said Dr Sabin Nsanzimana, head of the HIV/AIDS division of the Institute of HIV/AIDS Disease Prevention and Control at the Ministry of Health's Bio-Medical Centre.
“We also have in place other HIV/AIDS services, like voluntary counselling and testing, condom distribution and availability, ARV access to all...We do not offer these services in isolation of the high-risk groups.," he pointed out.
A paper authored by, among others, Rwanda's current health minister, Agnes Binagwaho, noted that "protecting the health of Rwanda's sex workers (and with them, the broader population) does not demand intensified repression.”
On the contrary, the paper on developing rights-based strategies to improve health among female sex workers in Rwanda urged “a comprehensive agenda of medical and social support to improve these women's access to health care, reduce their social isolation, and expand their economic options."
However, the paper also noted that some Rwandan lawmakers continue to advocate a hard-line approach to tackling sex work.[This news article was sourced from PlusNews Global: http://www.plusnews.org/report.aspx?Reportid=94231]
The HIV and AIDS, STI and TB (HAST) National Strategic Plan (NSP) 2012-2016 is the culmination of extensive review of documentation, consultation and deliberation with a wide range of stakeholders. These processes were key to determine the strategic priorities in dealing with the dual epidemics of HIV and TB in South Africa.
The South African National AIDS Council (SANAC), and more specifically its Programme Implementation Committee (PIC), has led this process. The PIC and the Plenary Committee of SANAC has provided the overall guidance and framework for the NSP. One of the key decisions included the development of a single integrated strategy for HIV, STIs and TB for 2012-2016. This is primarily due to the high co-infection rate between HIV and TB, as well as HIV and STIs.
Under the leadership of the PIC, a small team was constituted to develop Draft Zero of the NSP 2012-2016. This draft will be used during August/September 2011 to consult with provinces, SANAC sectors, government departments and society in general to guide the development of the final NSP to be released on World AIDS Day 1 December 2011.
Draft Zero was developed using inputs from various SANAC sectors, solicited via a short template for contributions addressing: (a) the programmatic pillars of the NSP, (b) the five-year objectives, and (c) proposed indicators and five-year targets. Inputs were received from SANAC sectors and technical task teams, government departments, and development partners.
The full draft is available below, and downloadable.
Sex work is a crime in South Africa, as is brothel keeping, living off the earnings, as well as many other activities of the sex work industry.
The arguments to keep the sex work industry criminal are a fear of moral and social collapse, a fear of the spread of STI’s and the fear of a link to organised crime. An additional reason given for criminalising the industry is the harm inherent in sex work, i.e. that the women and men who sell sex are psychologically and physically damaged by the work they do.
The ultimate aim of the criminalisation of sex work is the eradication of sex work in its totality. Thus far criminalisation has failed to stop persons engaging in sex work and, after 17 years of criminalising the industry, the impact these laws have had on the eradication of sex work is minimal if non-existent.
If our current system is not effective in achieving the aims it has set, then it must be time to think beyond the standard reaction of criminalising what we do not like and hoping it will go away. We need to start considering other options if it is indeed our aim to prevent the exploitation of women and men in the industry, to contain the spread of STI’s and to address concerns around “moral and social collapse”.
Other countries have already started to look at a variety of options, such as criminalising the client, establishing red light districts and creating laws to specifically deal with the sex work industry .
In South Africa we currently have the opportunity to look at the history of dealing with the sex work industry, look at what has worked or not worked in other countries and then to tailor a response in line with our Constitution and the rights contained within it.
The South African Law Reform Commission (“SALRC”) is in the process of producing a Discussion Paper on possible changes to the legislation dealing with adult sex work, following on from the Issue Paper produced in 2002. Once this Discussion Paper is produced the public will have the opportunity to make submissions. It is important that those submissions are well informed and all factors taken into account. This article therefore analyses the motives behind the support for the criminalisation of the industry and the flaws in this argument.
Involvement in organised crime
Not all sex work is linked to organised crime. No doubt there is some overlap between the two. This is not surprising, as it is the illegal status of sex work that makes it an appropriate partner to organised crime. Persons selling sex are involved in an illegal activity. They are restrained by the inability to find accommodation where their work is tolerated. Accommodation is however always available and on offer from drug dealers. The fact that this may include selling drugs overshadows by far the need for a roof over your head. Drugs are freely available and their use is encouraged. The sex worker’s dependence on the drugs is of benefit to the dealers. In addition the fact that very little assistance is forthcoming from the police or at the very least there is a perception that this is the case, then protection must be obtained elsewhere. Sex workers are reluctant to approach the police when they are being arrested on a continuous basis for assistance if been beaten or raped. Protection is therefore sought in the form of pimps, boyfriends or other sex workers.
“As for criminals, hookers tend to be surrounded by felonious confederates because what they do is illegal. The enterprise attracts violent people because violence is often useful in a business that can’t expect protection from the cops. The retail liquor trade used to be that way too, during Prohibition. Since repeal, it has been about as violent as the dairy industry.”
Decriminalising the sex work industry would obviate the need for protection outside of the police services. It would also enable sex workers to access services, which are taken for granted by persons able to prove an income, such as opening a bank account, securing accommodation and access to loans. Decriminalisation would make them less reliant on services provided by persons involved in organised crime.
The spread of infectious diseases
Sex workers are often seen as ‘vectors of disease’. This makes them a threat to public health. Criminalisation has not deterred persons from entering the industry but its effects have serious implications in relation to addressing public health issues.
Organisations involved in outreach work to sex workers, such as SWEAT and the Reproductive Health and Research Unit (“RHRU”) are involved in the education of sex workers regarding the prevention of the spread of STI’s, including HIV. This outreach is made more difficult by the criminalisation of sex workers and it presents huge challenges to such organisations to access sex workers. Our HIV/AIDS prevention campaigns are focused on education and this becomes increasingly difficult to implement if the target audience has to continuously hide and move in order to avoid the authorities. Some police officers have taken the amount of condoms a woman carries as evidence that she is a sex worker. Sex workers therefore tend to be fearful of carrying condoms.
As long as the sex work industry remains illegal and operates as a largely underground activity, large sections are not being accessed nor have access to non-judgmental health services. It is therefore the criminalisation of sex work itself that is a threat to public health.
Social and moral collapse
If we view the existence of sex work as leading to the social and moral collapse of our society our aim should be to encourage sex workers to exit the industry, as well as to prevent them from entering the industry.
Women and men enter the industry for a variety of reasons. Many enter the industry out of economic need. If we are serious about wanting to make sex work a less attractive choice and thereby reducing the industry we should look to poverty alleviation and educational opportunities for women rather than criminalising people making such choices.
South Africa currently has a very high rate of unemployment, with the trade union movement COSATU quoting percentages as high as 40%. This makes it difficult enough to find a job and any form of employment is hotly contested. A criminal record makes it even more difficult to find employment. So, although many groups claim to encourage sex workers to leave the industry, their method of doing so, criminalising the industry, in fact adds to the factors keeping women and men in sex work.
Criminalising sex work, because we believe it to be inherently harmful to the women in the industry or morally reprehensive, is treating the symptom and not the cause.
If sex work were to be decriminalised then those working therein would access labour rights and protections and be in a far better position to have control over their work environment, their health and their safety. Such a work climate allows persons to make decisions and choices regarding their future, including further education and skills training, and opens up opportunities to change work, if they should wish to do so.
It is interesting to note that a moral argument was made when the selling of sex was criminalised in 1988, as opposed to the criminalisation of the rest of the industry, which occurred much earlier. One argument made was that prostitution (together with homosexuality) was characterised as ‘the first signs of a disintegrating community’. If we have abandoned criminalising homosexuality because it cannot be justified in terms of our Bill of Rights, then we need to analyse the validity of claiming morality as a reason to keep the sex work industry criminalised.
In any event, it has been shown that criminalising the industry has done nothing to decrease sex work and has therefore not in any way lessened the ‘moral decline’ of society.
Exploitation or the perpetuation of women as objects
Many feminist groups have claimed that sex work is exploitative and perpetuates women as objects. This argument has led some groups to claim that criminalising the industry is the best option. Again, this is an argument for the eradication of sex work in its entirety. As we have argued above, criminalisation does not prevent persons from entering the industry. It seems a stark contradiction to argue for the protection of women in the industry, and claim them as victims, and at the same time argue for the criminalisation of these very ‘victims’.
In response, many groups have argued that it is not the sex worker who should be criminalised, as she has much less bargaining power in the relationship, but instead we should criminalise the client. In theory this addresses the imbalances between sex workers and clients. In practice this approach harms the sex worker far more than it does the client and does not lead to a lessening of the industry as a whole. Sweden has criminalised the client and decriminalised the sex worker. If it was difficult to prove that a sex worker has broken the law it is even more difficult to prosecute clients for such a breach.
Very few prosecutions of clients have occurred in Sweden. In addition sex workers from Sweden and the Netherlands report that life has become more difficult since the clients have been criminalised. As in any other business the supply will follow the demand. If the demand has to hide from the police so will the supply. This means less access to sex workers.
Sex workers rely on their instincts when accepting a client. Some reports have said that the fact that the clients are criminalised makes them more nervous and not prepared to spend time talking to the sex worker. She has to get into the car immediately. The discussion, during which sex workers evaluate their clients, has been cut short and the possibility of going with a dangerous client is increased.
Criminalising the client also influences our ability to assist victims of trafficking. Where women are held against their will and controlled to such an extent that they have little or no contact with the outside world, their only hope is the client. A client who makes himself vulnerable to prosecution and is labeled a criminal is less likely to report that women are being held against their will. Criminalising the client, or the industry as a whole, is not an option if the motive is to assist the women in the industry, to protect them from harm or to help them exit the industry.
Our personal opinions about sex work and the “inherent harm” in it should not cloud our perception in such a way that our course of action becomes detrimental to the sex workers themselves. It is arrogant to assume that we know better than persons in the industry and to decide accordingly. If we do we are perpetuating the image of persons in the industry as victims unable to make decisions. Treating women in the industry as children makes us complicit in the perpetuation of the stereotype that women cannot think for themselves.
Persons entering the industry do so despite the risks. Lifting these risks by decriminalising the industry simply makes some aspects of the work less dangerous. Criminalising the industry creates an environment where sex workers are more exposed to criminal acts, such as rape and assault, and advocating for its continuation makes us an accomplice to those crime perpetrated against sex workers.
“Legalizing prostitution would not be a moral endorsement of paid sex, any more than the 1st Amendment is a moral endorsement of supermarket tabloids. It would just be a recognition of the right of adults to make their own choices – and of the eternal futility of trying to stop them.” “… confusing the effects of prostitution with the effects of laws against prostitution.”
Government and civil society now have the opportunity to critically examine criminalisation and its effects and to engage with the real possibility of alternatives that can address the very concerns that strong supporters of criminalisation seek to address.