To what extent is the HIV epidemic in southern india driven by commercial sex?-response

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To the editor

Re:

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I am interested to know how the question of public health ethics is

addressed in this kind of research.

Here, the research subjects viz, sex workers are the most stigmatized

and marginalized groups. An ethicist in public health may have

concern in the way by which the research question is formulated. Who

are the beneficiaries of this research? The discussion substantiates

the notion that sex workers are the vectors of HIV/AIDS. In fact, they

are a group more susceptible to HIV infection. It is the occupational

hazard to them. Doctors and nurses also have chance of susceptibility

to many illnesses. It does not become a major problem because they

take all precautions, which is possible due the status, power,

knowledge etc. Sex workers do not have these and they are not

acknowledged as an occupational group. So, they are always considered

as “transmitters” of disease rather than “susceptible” to disease.

Being the most affected group, sex workers should be considered as the

beneficiaries the programs. Considering this, the HIV funders and

supporters brought the idea of partnership. How far the concept of

partnership is translated to action is a different question. In

research how can we have a meaningful partnership? It can be in

formulating the research questions and interpreting the results rather

than in the methodological part.

How partnership could have helped to formulate the research question

in this study in a different way? If we take a community centered

approach, the question will be how far sex workers as an occupational

group have the risk of transmission of HIV in their life? When we

count them as people who drive transmission to others, they are

treated as less human being. As human beings, they are primarily the

affected ones. The question of transmission is secondary, where the

privileged groups should take responsibility for their own protection.

Then, the question will be how many of the people protect themselves

from sexually transmitted diseases?

Regards

Dr. Jayasree. A.K

Associate Professor

Community Medicine

Academy of Medical Sciences

Pariyaram. kannur. Kerala

e-mail akjayasree@...