Sex Workers Rights, HIV Infection, and Prevention: Parting Thoughts from the IAC

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Sex Workers Rights, HIV Infection, and Prevention: Parting Thoughts from the

International AIDS Conference

ShareBy Garita, July 25, 2010

This article is published in partnership with the International Women's Health

Coalition.

The 2010 International AIDS Conference has come to a close. Throughout the week,

I attended several sessions and workshops and met with both old and new

partners, but three particular sessions made me think a lot.

Serodiscordant, Zero Difference

On Wednesday, July 21 at the IAC, I attended a session led by a personal friend

and fellow activist. She has been living with HIV for 16 years, and her husband

is HIV negative (referred to as " serodiscordant " ). By telling their story, Ana

and Bill were able to demonstrate to over 40 serodiscordant couples in the room

that internalized stigma, guilt, and fear are very common–yet

surmountable–barriers to a strong relationship.

Ana described the nervousness she felt about having unprotected sex with Bill,

even just once. The possibility of her infecting him was very minimal since she

has been on highly active anti-retroviral treatment for over seven years, but

transmission is always a possibility when partners are serodiscordant. She also

has human papillomavirus (HPV), some strains of which can lead to cervical

cancer. Ana and Bill talked about how protecting their health was their

priority, as was having constant communication about their fears, dreams, and

challenges

Ana said: " Before I married Bill, I was HIV positive. It was my life, my body,

my choice. Today, it is OUR lives. We are serodiscordant, but there is zero

difference- in a relationship, in care, in support " .

Vertical Transmission- Is it about women, women and children, or infants?

Only in the last two years has the prevention of vertical transmission of HIV

(commonly known as prevention of mother to child transmission, or PMTCT) been a

priority. In Thursday's plenary session, Elaine Abrams from Columbia University

outlined what was needed to save the lives of women and children.

Although I completely agree that avoiding vertical transmission is vital to the

health and wellbeing of women and their newborns, programming for vertical

transmission in the name of " women " is a misnomer.

The four-pronged approach to comprehensive PMTCT programs include " preventing

HIV infection in women " and " preventing unintended pregnancies, " yet these

programs often focus on the biomedical-focused third prong: providing single

doses of the drug nevirapine to women during pregnancy to prevent transmission

of the virus to the fetus.

If we truly want to invest in women's health within the HIV/AIDS response, the

first prong of PMTCT must be tackled head-on, including by providing women with

the comprehensive package of sexual and reproductive health services-

contraception, maternity care, safe abortion, STI/HIV testing and treatment.

Programs must also respect, protect, and fulfill women's human rights, including

their sexual and reproductive rights.

Unfortunately, this was not a focus of Abram's presentation. If it had been,

perhaps we would have more success in the push towards " combination prevention. "

SANGRAM's Bill of Rights

Meena Seshu, of IWHC's partner organization SANGRAM and one of my gurus,

delivered the Mann Human Rights Lecture Thursday. Through a series of

short videos, anecdotes, personal histories, and people's stories and voices,

Meena spoke truth to power. She made a call to action so that everyone in that

room will think of SANGRAM's Bill of Rights when designing and implementing HIV

and AIDS programs.

Check out a video of Meena and more from her speech and the SANGRAM Bill of

Rights in our Akimbo post No Excuses: A Living Experience of the Struggle for

Rights.

http://www.rhrealitycheck.org/node/13948