29/01/2015

Taking sex workers off the streets won't help fight HIV

The Contrarian / By Dianne Massawe

It’s not sex work that causes high HIV rates and violence, it’s the criminalisation of it that is the problem, argues Dianne Massawe of the Sex Workers Education and Advocacy Taskforce in South Africa.

The South African National Aids Council (SANAC) shocked media and public when it announced, mid-January, that sixty percent of sex workers in the country are HIV-positive (1). The Council based its statements on research carried out by the sex worker rights organisation SWEAT (Sex Workers Education and  Advocacy Taskforce). It also called -perhaps surprisingly in a country that traditionally rejects ‘prostitution’-, for decriminalisation of the industry. “Indeed it’s not sex work that is the problem, but the fact that it is still criminalised”, argues Dianne Massawe of SWEAT.

If sixty percent of sex workers are infected with HIV/Aids, wouldn’t that be a reason to immediately remove all sex workers from the streets of South Africa and get them into different jobs as well as treatment?

It’s not just sex workers that carry this high rate. You find similar HIV rates in other marginalised groups. South Africa has one of the highest infection rates in the world. Rather than calling for a removal of sex workers, which won’t work anyway, one should ask how we bring the rates down.

But how about offering women other options through social programmes and support? Your study says that many customers refuse to use condoms. So as long as one stays in sex work, the risk of infection will remain.

Of course sex work is not a first choice for some women, or men. But in South Africa, with its high unemployment rates, there is not much one can do with only a primary school education.  I doubt that this country can offer alternative employment or social support to over 150 000 sex workers. And even then, many would hesitate. The choice for sex work is often also made because you are more independent and you earn up to four times as much as in the job you’d otherwise get.

But then you get HIV. Or otherwise abusive customers. Or you get harassed by the police. Your study talks of the stigma that causes sex workers to hide what they do even from their own families. It is a high price to pay.

These risks don’t come with sex work per se. They are caused by the fact that it is criminalised and stigmatised. For example, HIV is treatable. But police arrest sex workers and keep them in cells over the weekend, so they miss out on their medication. When they ask for help to get their medicines, the police refuse. Then when they get back to the clinic after having missed out, the nurse will shout at them for being irresponsible. This stigmatising attitude in our clinics is one of the things SANAC wants to address. Their new programme aims at better access to health care for sex workers.

Even with improved health care access, sex workers will still be dealing with customers who refuse to use condoms.

Many sex workers we know, especially the more experienced ones, want to avoid unsafe sex. They tell their clients not just to use condoms with them, but also with others and with their wives.  Again it is the criminalisation that stands in the way. You can get into trouble as a woman if you carry condoms.  Police arrest women on the streets and search their handbags. If they find more than three, they conclude you are a prostitute and arrest you. So you sometimes end up hoping that your customer will carry a condom.

And if he doesn’t, then that’s that?

I’d say that decriminalisation would help to improve the behaviour of the customer as well. As long as the sex worker is the target of the police, the customer is free to be irresponsible and abusive. But if the sex worker could call the police on a client who forcibly wants to have sex without a condom, not only would she be protected, but she would protect her colleagues as well. Now you have to accept abuse in order to keep that customer who would otherwise go to Jenny or Mary. But if you could call the police on him, you would also protect them -your colleagues. In New Zealand, demanding sex without a condom is a crime. We’d love to see that here.

How long you think that will take?

Law reform proposals have been on the cards for the past eleven years already. But now that SANAC has started its sex worker programme, we hope that in the next two to three years we’ll see government moving. Even the Deputy President has now expressed interest in what SANAC proposes. It is a great step forward.

(1)The exact number of sixty percent has been disputed by Africa Check, because surveys were only conducted within limited groups and some of the data is years old. However, Africa Check concurs that, though it is difficult to reach reliable statistics from surveys conducted among such a marginalised and criminalised group, “as limited as they are, the findings of the studies that have been published to date (…) give a frightening indication of the extent of HIV infections in the cities and communities surveyed.”

This interview was conducted by Evelyn Groenink, ZAM Chronicle’s investigations editor.