Sandhya Srinivasan interviews Meena Seshu, campaigner for the rights of sex workers

An interview with PLRI member Meena Seshu on the PANOS website by Sandhya Srinivasan.

An interview with PLRI member Meena Seshu on the PANOS website by Sandhya Srinivasan.

“Some sections don’t believe that people can be in sex work because they want to be there,’’ says Meena Seshu, General Secretary of Sampada Grameen Mahila Sanstha, in Sangli, India, which has worked for the empowerment of people in sex work since 1991. Meena will deliver the Jonathan Mann Memorial Lecture at the Vienna AIDS Conference in July. 

 Q: What is a “rights-based approach” to prostitution?

A: The rights-based approach to prostitution focuses on dealing with the vulnerabilities within prostitution – violence, sexual exploitation, police harassment, and risk of HIV infection.

Sex work needs to be seen as work, like any other work that adult men, women and transgenders enter for various reasons, and that they are engaged in with the limitations of any occupation. You can’t be judgmental about sex work. You need a policy to protect sex workers against the vulnerabilities within sex work.

Criminalisation of sex work leads to many human rights abuses: sex workers will work in unsafe conditions, they can’t obtain healthcare services, they have no protection against violence, they are stigmatised. Because of criminalisation, sex workers are subjected to raids, rape, beating and extortion – by the authorities.

(Remember, we’re talking about adult consensual sex; we oppose the entry of minors into sex work. Nor should sex work be equated with trafficking, which we oppose. Finally, we support decriminalisation, not legalisation; legalisation will increase state interference in the lives of sex workers.)

Sometimes public health agencies believe their job should be focusing on getting sex workers out of the business as a way to reduce HIV transmission. Though this “demand reduction” approach does not advocate criminalisation, it, too, threatens the rights of sex workers. Trying to reduce demand, by, for example, punishing clients, actually forces sex workers into dangerous situations in order to obtain work, as clients want to protect themselves from the law. It has also been well established that demand reduction stigmatises sex work, and the consequences of stigmatisation include violence and denial of services such as healthcare.

The International Guidelines on HIV/AIDS and Human Rights clearly state that “criminal law should be reviewed with the aim of decriminalising, then legally regulating occupational health and safety conditions to protect sex workers and their clients, including support for safe sex during sex work.”

But many international organisations working in HIV/AIDS are ambivalent about sex work and how to deal with it.

The problem is that some sections don’t believe that people can be in sex work because they want to be there.

Q: What has the approach of governments been?

A: Many governments are outraged at the very idea of talking about the subject. A good example was visible at the 14th session of the UN Human Rights Council in June. Anand Grover, the Special Rapporteur on health, reported on the impact of criminalisation of same-sex conduct and sexual orientation, sex work, and HIV transmission. He pointed out that as a result of criminalisation, these groups are denied access to HIV prevention, treatment and care, putting them and the larger public at risk. His comments were received with indignation.

I quote from some of the responses reported on the HRC website: “The … African Group rejected the link between the criminalisation of sexual orientation, sexual work and HIV/AIDS transmission and the right to health.” “…the Special Rapporteur had transgressed beyond his mandate and should avoid highly controversial issues in the future….The Organization of the Islamic Conference would therefore continue to closely monitor the Special Rapporteur’s future work.” Bangladesh “regretted the Special Rapporteur had chosen an issue that was not universally recognised as a human rights issue. The Special Rapporteur had intended to identify a group as vulnerable that did not fall in the category of vulnerable groups. Bangladesh urged the Special Rapporteur to be more careful in future to avoid controversial areas in selecting his focus of work.” Egypt stated that “The Special Rapporteur on the right to health … had [not only ] stepped over his mandate, but he had gone as far as prescribing to sovereign Member States how to devise and enact their national laws and legislation.”. The United States “could not endorse the call in the report for all States to repeal laws criminalising sex work and to establish appropriate regulatory frameworks to ensure safe working conditions.”

It’s not just about the law. For example, though Bangladesh and Myanmar among many countries don’t have a ban on sex work, sex workers in these countries are harassed by the police anyway. And laws against trafficking are used by the police against sex workers. In Cambodia, for instance, the US-backed “Law on the Suppression of Human Trafficking and Sexual Exploitation” has led to an increase in police raids on brothels, sex workers being beaten up, raped, arrested and those on medication being denied it,

Most countries are not willing to give rights to vulnerable communities. There are many moral and religious barriers that vulnerable communities have to fight over and above fighting the virus.

Q: What’s the biggest threat to the sex workers’ movements in current times?

A: There are two streams of thinking that threaten the human rights approach and both of these are major concerns:

One is religious fundamentalism: the ideology that HIV is a matter of morality, that monogamy alone reduces the risk of HIV infection, that sex work is immoral. It was expressed in the Bush administration’s US Global AIDS, Tuberculosis and Malaria Act of 2003 (President's Emergency Plan for AIDS Relief or PEPFAR), which banned US government funding to any group or organization that does not have a policy explicitly opposing prostitution and sex trafficking, and required all organisations with USAID funding to sign an “Anti-Prostitution Pledge”. This had a major impact on funding of work on vulnerable groups who are at risk of HIV.

With Bush, money was being poured into faith-based organisations whose agenda was abstinence. As for sex work, their agenda was “raid, rescue and rehabilitation”.

This moral tone was also expressed in the UNAIDS Guidance Note on Sex Work which  read like it was written by abolitionists – the reduction of sex work seemed more important than the reduction of risk to HIV.  It did not address working conditions or empowering sex workers – both key to HIV prevention and treatment programmes.

We can hope for better things with the Obama administration, but the law is not going to change for now; what looks to change is its enforcement.

The other parallel concern is the medicalisation of HIV, the idea that HIV can be eliminated through a medical approach alone – which inevitably results in human rights abuses.  So, for example, you get provider-initiated testing, which really amounts to mandatory testing; in a country like India, people do not have the “option” to refuse to be tested. Also, the notion of “100 percent condom” programmes which are nonsense without the creation of conditions enabling their use. In countries such as Thailand, China, Cambodia, the 100 percent condom use programme is run by a different GIPA – “Greater Involvement of Police and Army”.

All the community strengthening that we have been doing will disappear if we allow these trends to continue.

This medicalisation trend was there in UNAIDS, but it has changed. The current Executive Director of UNAIDS, Michel Sidibé, has made it a UNAIDS priority to support countries to “remove punitive laws, policies, practices, stigma and discrimination that block effective AIDS responses.”

Q: What has the response been to these threats?

A: Confronted by the double threat of medicalisation and fundamentalism, sex workers are organising and fighting back. We’ve seen global networking on sex workers’ policies. For example, when UNAIDS released its Guidance Note on Sex Work which talked about a reduction in demand in order to reduce HIV transmission, there was a swift response from sex workers’ organisations across the world. Letters of protest went out. The Asia-Pacific Network of Sex Workers pushed for a review of the guidance, joined by other organisations. The Global Working Group on HIV/AIDS and Sex Work Policy, formed by the International Network of Sex Workers’ Projects, produced a reworked guidance note and members of the National Network of Sex Workers, India, presented it to UNAIDS and the United Nations Population Fund in Delhi.

There was a huge push at the Mexico conference to bring human rights back into the centre of HIV/AIDS prevention which is why the human rights theme runs through the programme of the Vienna conference.

Q: What are the challenges of the future?

A: The challenge is to get policy to focus on vulnerabilities – and to get the money here as well. We need a review of policies relating to human rights, sex work and HIV. The focus should be on lowering the risk of unsafe sex. One has to work with governments on their policies, on getting the money in. HIV/AIDS money needs to be spent on condoms, services for sexually transmitted infections, good information and community empowerment. Right now, less than one percent of money in HIV prevention is spent on HIV and sex work.