Risk, Morality, and Blame: Donor Approaches to HIV Prevention Among Sex Workers

[Guest guest]

New paper from the Center for Health and Gender Equity entitled Risk,

Morality, and Blame: A Critical Analysis of Government and U.S. Donor

Approaches to HIV Prevention Among Sex Workers in India. The paper

can be downloaded from www.genderhealth.org.

(If you experience difficulty in accessing the document please contact the

moderator of the FORUM for a pdf vesion of the document)

This paper is the second in a series on gender and HIV in India.

India is one among several priority countries currently receiving a

large amount of U.S international assistance for HIV prevention.

Forthcoming papers will examine the efficacy of government of India

and U.S. bilateral approaches to married women and adolescent girls

in the general population.

Since 1995, the United States has contributed $67 million to India's

AIDS control program, focusing its efforts on the states of Tamil

Nadu and Maharashtra. In this paper, we examine the scope and

effectiveness of strategies being used by the Government of India—

with bilateral development assistance from the United States. The

paper examines whether targeted interventions, the main component of

India's National AIDS Control Program, have effectively addressed the

HIV prevention needs of women sex workers in Tamil Nadu and

Maharashtra. Additionally, the paper poses the following questions:

Are the targeted interventions in use in India and supported by U.S.

bilateral assistance adequate for and effective in reaching sex

workers?

--Do they address the complex set of factors that make sex workers

vulnerable to HIV?

--And, by extension, how effective are they in addressing the

epidemic in India?

We conclude that gender inequities play a critical role in fueling

the epidemic and need to be addressed in programs and strategies

focused on women, including female sex workers. An increasing body

of program experience with sex workers reviewed for this analysis

highlights the limitations of models that fail to address the broader

needs and rights of sex workers as human beings. These limited

models therefore fail to slow the spread of HIV to the general

population. Our analysis of effectiveness is based on the premise

that gender and human rights concerns are critical to the success of

HIV/AIDS programs and policies. Gender and human rights must be

integral at all levels of program design and implementation.

Such analyses are profoundly relevant to current debates on U.S.

global AIDS strategies. The U.S. Leadership Against HIV/AIDS,

Tuberculosis, and Malaria Act of 2003, passed last May, prohibits the

U.S. Government from providing international AIDS initiative funding

to any organization that does not have a policy " explicitly opposing "

prostitution and sex trafficking. As with the Global Gag Rule, which

prohibits grants of U.S. international family planning funding to

organizations seeking to reduce the toll of unsafe abortion (i.e. by

conducting research on or advocating change in abortion access), the

new law may require organizations to sign a vague statement averring

that they do not promote prostitution. The plan for implementing

this legislation is still under review by the U.S. State Department,

so the operational definition " promotion " of prostitution is

unclear. Yet numerous organizations previously cited for " best

practices " in working with women in prostitution have already been

denied U.S. funding, and other groups are expressing great dismay in

the ill-defined nature of this policy.

As part of our ongoing work in this area, CHANGE will soon be

releasing several papers on U.S. global AIDS policies. These papers

will include a legislative and policy analysis of the restrictions on

working with women in prostitution, and recommendations on ways to

mitigate the impact of new restrictions imposed by the Bush

Administration on women's human rights.

We hope you find this and other papers, which are accessible at our

website www.genderhealth.org, useful in your work, and we also hope

you will contact us with any questions or comments.

With best wishes, Jodi son

Center for Health and Gender Equity (CHANGE)

6930 Carroll Avenue Suite 910

Takoma Park, land 20912 USA

Phone: (301) 270-1182

Fax: (301) 270-2052

www.genderhealth.org

E-mail: jjacobson@...