The Global Working Group on HIV and Sex Work Policy was convened by the Global Network of Sex Work Projects to formulate sex workers’ and civil society groups response to the new UNAIDS Guidance note on Sex Work.

The group is a broad based coalition that believes in evidence informed, rights based programming in relation to HIV.

This website contains the first draft of our reworked Guidance Note. We hope that this reworking is the start of a dialogue between sex worker organisations, HIV organisations, programme implemeters, governments UNAIDS, UNFPA and the other cosponsors.

37 Responses to

  1. Susan Blake says:

    It’s great that you’ve taken on this tough job! Good work on the draft! Prostitutes of New York are proud!

  2. Tracy Quan says:

    The UN should really stick to a rights-based platform on sex work. For future generations of sex workers, too. This is the only way to seriously deal with HIV. Pretending you can “prevent sex work” is ineffective. Not to mention dangerous.

  3. Its not only limited to the UN and HIV. There is a real backlash on the whole issue of sex workers and their rights. The campaign to stop sex workers rights is mailny because of the strength and visible voice of the sex work movement. As long as sex workers were in the background no one cared if they existed, much less the feminists and right wingers who would like them to be victimised till kingdom come!

  4. Anna Forbes says:

    I just watched the video of the Document Lanuch on 17 September. I congratulate you on producing a successful event and a critically important document. As an American woman old enough to remember the 1960’s, I was deeply moved to watch you all singing “We Shall Overcome” at this event. It is, as you know, a song strongly associated with the African American civil rights movement in the US. It was wonderful to be reminded of how well it reflects the determination of any people seeking their civil and human rights — and especially that demonstrated by the Global Network on HIV and Sex Work Policy. It was the perfect symbol of what is at the heart of your and our struggle. Thank you for your hard work, courage and dedication.

    Sincerely,

    Anna Forbes
    Global Campaign for Microbicides

  5. This initiative touches upon an issue we can’t ignore anymore. The sex work movement is doing a very important work to address the point that many others movements are also fighting for: HUMAN RIGHTS are about everybody and everyone. However, it is true that not always sex work groups are invited to participate to debate the “general issues” and policies, unless when it refers specifically to their necessities. Sincerely, I can’t see how to achieve better policies or even guarantee the full rights of people (with or without HIV) if not working together with all movements engaged on the battle against AIDS.

    It is time to really joint efforts. And the points mentioned in the document should be REALLY reinforced by others agendas. We congratulate your effort and achievements.

    In solidarity,

    Alessandra Nilo
    GESTOS – Brazil

  6. Susmita Roy says:

    I find it is important to reiterate the experience gathered and distilled in Female sex worker intervention specifically in Indian context. Since last 12 years a score of Targeted Intervention duly supported by NACO and other agencies, gained a lot of experience in running Targeted Intervention and the nation learned from those intervention as they duly articulated in National Aids control Program Phase III popularly known as National Aids Control Organization III. It is important to recognize the significance of strategies and policies which has been articulated in National Aids Control Program III.

    The National Programme of Government of India recognizes stigma and marginalization of high risk groups amplifies risks and limits their ability to protect themselves from HIV acquisition. Therefore, NACP strategies to empower high risk groups to enable improved negotiation and health seeking practices. Creation of enabling environment and community mobilization are the key programmatic strategies to address such vulnerability of sex workers. NACP III design aims to strengthen the processes of community-led and community-owned TIs (CBOs) (where “community” refers to HRGs).

    There are six components in the said program
    1. Syndromic case management
    2. Condom Programming
    3. Behaviour change communication
    4. Linkages with care, treatment and support
    5. Community organizing and ownership building
    6. Enabling Environment

    Out of the above 6 component four are service provision related, e.g. condom promotion, STD, BCC ,care and support and to deal with structural issues ,two other components which was added in subsequent years are

     Creating enabling environment
     Community organizing and ownership building

    The basic aim is to build self esteem and collectivize them and also to build their capacity so that they can deal with their issues related to life, profession and HIV. Other component like enabling environment looks into social and political milieu, where sex workers negotiate safer sex practices with their clients.

    Building enabling environment seems to be a critical element of the program and it aimed to address all possible structural barriers. It starts from the place where he or she negotiates with local trade controller like Madam, local goons etc. Secondly in the interphase between operation/cruising sites and administration where she negotiates with police and other authorities in addition.

    Stigma and discrimination related to sex work vis a vis service provider’s negative attitude and practices, what essentially force them to live in the margin of society. All these practices puts them in a precarious condition and limits ability to access prevention and care services.

    When we talk about enabling environment one can’t keeps his/her eyes closed to policies and practices too. These are framed either in terms of laws, rules or customary practices. As a result, in the recent past NACO expressed their strong concerns about the attempt to make changes in the ITPA, which can create more obstacles to reach out to sex worker’s community as well as their accessibility and utilization of service components. These structural barriers(laws and policies) are one of the major impediment to HIV program implementation among sex workers, functioning either in Brothel or street settings.

    A country like India with no death of technical expertise took initiative to distill out various experiments to HIV prevention program for sex workers, as well as make clear decision to support important activities with budgetary allocation. NACO also has a set of sensitive indicators to assess the progress of the program in this direction. We feel that this national framework of TI could be one of the best possible frame work evolved in sex work Intervention and one need to comprehend the basis of framework and followed it up with designing appropriate lines into context and canvas.

  7. A.R. Bestham says:

    There are strong reasons not to lose focus on sex workers collectives and empowerment as the centrepiece of HIV prevention with sex workers. As Bharati Dey of the Sonagachi Project said, “Over the years, critical thinking around targeted intervention program has expanded from the issues of individual risk to those of social vulnerabilities. The changing discourse around social dynamics of HIV/AIDS has led to a revision in the dominant construct of prevention strategy and reinforced the importance of ‘collective empowerment’ and ‘community mobilization’ as effective prevention strategies”. It is very good to see Indian government supporting this strategy and global network.

  8. Cheryl Overs says:

    Well done all ! I love the video. I am pleased to see sex workers who speak different languages from different backgrounds working together on global policy. As a former co-ordinator of the NSWP I know how difficult it is to make spaces for this to happen. I haven’t read the document thoroughly but it looks very professional and constructive. I am sure it will help take the dialogue with the UN forward rapidly. Congratulations again.

  9. Jende Ping says:

    It is very important for United Nations to consult with sex workers. It is good to hear that management of UNAIDS stopped a policy formed without sex workers contribution to be passed.

  10. Kerry Porth says:

    It is incredibly important effort by those most affected by these policies are consulted and we at PACE (Prostitution, Alternatives, Counselling & Education) Society are very much in support of the draft re-working of the UNAIDS guidance note on HIV and sex work.

    Thank you for working to protect the human rights of sex workers everywhere.

    Kerry Porth
    PACE Society
    Vancouver, British Columbia, Canada

  11. Sasa says:

    The best educators for HIV prevention is can be Sex Workers, also SW is can be good in many alls thinks, and if we like to happening good think in this world-special when we speak for HIV-prevention is good to consulate SW.

  12. My personal position is below:
    1. A strong statement about holistic approach should be done. Here in Kyrgyzstan AIDS became an only one perspective to look at sex workers and their lives. A discriminative link between sex work(ers) and AIDS should be destabilized and (ideally) destroyed. Unfortunately, human rights perspective is also not enough to reach something in countries (like Kyrgyzstan) where ‘human rights’ term means nothing and not popular – at least in a foreseen future…
    2. This document could be promoted actively on a country level not on international level only. It could be very useful and exciting agenda for local SW groups, organizations and networks – even in case if it is not approved by UN. Discussions around main topics of this document could be a good initiative training for new SW leaders in articulation of their position.
    3. Great work!

  13. Asian-not-want-blackban-by-unfpa says:

    We did hear all about the UNFPA consoltations on sex work and everyone very exciting about it. Now I’m not understand why UNFPA & UNAIDS spend so much money to hold meetings of sex workers about policy and then totally ignore what we say??? For what??No wonder people talks about waste of UN money and be a need for UN reform. And why do Jenny and Steve say they agree with what all sex workers say and then only listen to mad anti-prostitution people like Melissa Farley and make policy like U.S and Sweden policy??? I thought idea is to stop HIV not try to stop prostitution. And to listen to sex workers not totally F*** us over.

    Great to see our networks do not give up the fights for us.

  14. Notre communauté est la mieux placée pour lutter contre le sida. Nous, les travailleuSEs et professionelLEs du sexe sommes la communauté la + responsable face à cette épidémie avec les usagers de drogues. C’est grâce à nous que la population hétérosexuelle dans les pays occidentaux a été en partie épargnée par cette maladie.
    Nous continuerons à éduquer notre clientèle et la population. Nous encourageons donc tout programme visant à promouvoir la lutte contre le sida avec les travailleuSEs du sexe.

    Vous avez tout notre soutien ici en France.
    Thierry Schaffauser
    activiste pute

  15. UNAIDS needs to hear the following message loud and clear : this guidance note on sex work is threatening to become the tipping point where UNAIDS becomes more a part of the problem than part of the solution. And if UNAIDS were to let itself be taken across that point, it would find itself with dangerously few genuine allies.

    If UNAIDS lets anti-prostitute ideology come in the way of issuing evidence-based recommendations as to how to effectively prevent HIV transmission in commercial sex settings, then UNAIDS will have betrayed its mandate. UNAIDS is not supposed to be a political organisation ; its role is not to make political decisions as to what AIDS fight policies are going to be *implemented*. Its role is only to make technical decisions as to what AIDS fight policies are showed by evidence to achieve success. The political decision to implement these recommendations is left to national governments. Most are very happy to ignore evidence or recommendations that ruffle their political feathers – such as clean needles and heroin substitutions, for instance. Keeping the recommendations independent from what the politicians want to hear thus remains absolutely necessary, and entirely feasible.

    Peter Piot has said it many times : what drives the continued expansion of the pandemic is not the absence of effective preventive technologies, but discrimination, exploitation and repression of certain social groups. Only reforms and services to end or mitigate the discriminatio, exploitation and repression perpetrated on sex workers can successfully reduce HIV transmission in commercial sex settings. Only by issuing a guidance that dares to say so will UNAIDS bring what positive impact it can on the commercial sex compartment of the epidemic. If UNAIDS cannot deliver this, then let’s the politicians write up the “science” directly — without aid of a costly UN whitewash machine.

  16. Jenn Clamen says:

    The video is a fantastic example of how sex workers can organize and inform policy that affects them.

    Sex workers are in the best position to define their needs and to inform HIV policy. It is shocking and appalling that sex workers had not been consulted in the first Draft of the UNAIDS policy on sex work: its results were detrimental to the livelihoods of sex workers worldwide. There needs to be measures put in place to ensure sex workers’ participation in these processes. This will allow for a policy that does not focus on the elimination of sex workers and sex work, but rather on the elimination of policies and working conditions that contribute to HIV risk, violence, and other sources of imposed danger on sex workers and their lives.

    Jenn Clamen
    Mobilisation and Communications Coordinator, Stella

  17. Juhu Thukral says:

    This is an excellent document on policy relating to sex workers and HIV. It has a focus on the rights to health, liberty, and security, which highlights the importance of protecting the human rights of sex workers in all aspects of the fight against HIV.

    I also found it very helpful that this policy emphasizes the need to expand economic and social opportunities for sex workers, as this is a key tool for empowerment. This approach also takes into consideration the harms to health that happen as a result of criminalization and stigma, and makes clear the benefits of collective action. Thank you for writing such a useful Guidance.

  18. The UNAIDS Guidance Note on HIV and Sex Work fails to reflect the central importance of respecting, protecting and fulfilling the rights of sex workers in programs and policies related to sex work and HIV. In particular, it fails to consider seriously the precarious human rights situation of sex workers, or to discuss the human rights of sex workers as workers, including their right to work, their right to a livelihood of their choosing, and their right to workplace safety.

    Sex workers’ human rights are the basis of the draft reworking of the Guidance Note by the Global Working Group on HIV and Sex Work Policy. The draft reworking focuses on empowering sex workers to take control of their work conditions by advocating for the recognition of sex workers as rights holders who are entitled to equal protection from violence under the law, choice of work, workplace health and safety, access to comprehensive HIV treatment and freedom from discrimination and persecution. The draft reworking also underscores the need to actively engage sex workers in prevention efforts and to meaningfully involve sex workers in decision-making related to sex work and HIV/AIDS programs and policy.

    The real experiences of sex worker organizations demonstrate that protecting, promoting and respecting the human rights of sex workers is the most important strategy for ensuring HIV prevention, care, treatment and support. The centrality of sex workers’ human rights to the draft reworking of the Guidance Note thus provides sex workers, HIV/AIDS organizations, governments, UNAIDS and its cosponsors with an excellent foundation for a more effective, better informed and more inclusive dialogue about sex work and HIV.

  19. Jenn Clamen says:

    # Jenn Clamen Says:
    October 29th, 2007 at 9:22 pm

    Stella is a sex workers’ organization based in Montreal, Quebec (Canada.) We provide information, support and rights-defense to women working in the sex industry. Our goal is to help sex-workers improve our work- and living- conditions, and as such we concentrate much of our efforts on denouncing and preventing violence against sex workers. We also make it a priority to combat the societal prejudices and stigmatization of those living with HIV/AIDS.

    We appreciate the work that this global committee has done to bring the rights of sex workers to the attention of policy makers. We were extremely concerned about the original UNAIDS Guidance Note that focused on the elimination of the sex industry, rather than improving the life and working conditions for sex workers.

    The old Guidance Note was an example of the ignorance and miseducation around HIV and AIDS. This new Guidance note created by the Global Working Group underscores the importance of sex workers’ contribution to the fight against HIV/AIDS and the need to focus on working conditions and HIV prevention, rather than the elimination of sex work. We applaud you all and thank you for this contribution to a policy that affects us all.

    Jenn Clamen, Mobilization and Communications Coordinator
    for Stella, l’amie de Maimie (Montreal, Canada)

  20. Rosie Campbell says:

    The re worked guidance note on Sex Work & HIV is a very important document which stresses the need for a holisitc and rights based approach to HIV prevention, which was alarmingly absent in the original UNAIDS guidance. We celebrate the acheivement of all those who have contributed to the reworked guidance and who organised and attended the inspirational gathering in Delhi.

    We urgue the United Nations to listen carefully and taken on board the voices of sex workers from around the globe. It is critical that UN guidance and policy is evidenced based and evidence points us to the need for a rights based approach to HIV prevention in the context of sex work. As an organisation that advocates for policies that enhance the safety and rights of sex workers the UKNSWP supports the reworked guidance!

    Rosie Campbell
    Chair
    UK Network of Sex Work Projects

  21. We applaud the efforts of the Global Network and sex workers who reworked the draft guidelines on Sex Work and HIV.

    The New Zealand Prostitutes Collective is deeply concerned with gains made in respect to sex workers rights, including occupational safety and health and human rights; and that they not be eroded in any form. It is vital that a response to HIV prevention be focussed on the rights of sex workers to safe work and working conditions.

    Catherine Healy
    National Co-ordinator
    New Zealand Prostitutes Collective

  22. What should be entitled the “three pillories model” and not the “three pillars model” the UNAIDS Guidance Note on HIV and Sex Work threatens to undermine the rights of sex workers! This campaign, led by sex workers, to stop the draft document from being implemented should alert policy makers that sex workers will not sit passively by while they determine our futures.

    The right to be heard
    “We assert our right to participate in public forums and policy debates where our working and living conditions are being discussed and determined.

    We demand our voices are heard, listened to and respected. Our experiences are diverse, but all are valid, and we condemn those who steal our voice and say that we do not have the capacity to make decisions or articulate our needs.” (Sex Workers in Europe Manifesto 2005)

    The International Committee on the Rights of Sex Workers in Europe (ICRSE) says thank you to our colleagues for the important work they have done to revise the UNAIDS Guidance Note to prioritise the experiences, needs and voices of sex workers. We join our colleagues around the globe in urging UNAIDS to work with us and other affected communities so that we can achieve the lives we want for ourselves. We urge all of our allies around the world to support sex worker self-determination and to add their comments to this campaign!

  23. Carol Leigh says:

    “Draft Reworking of the UNAIDS Guidance Note on HIV and Sex Work April 2007 ” is excellent. Of course it is essential that sex workers participate.

    I am very disturbed that the Guidance that was supposed to be published put forth that there was a consensus when there was not.

    As sex workers internationally are organizing to respond and correct this, it is quite clear that revisions should be made in accordance to the Draft submitted from NSWPP, ICRSE and APNSW.

    The authoritarian approaches in the original Guidance Note are clearly counter-productive. Sex Workers must be regarded as people with rights, and especially the right to representation. The notion behind authoritarian approaches, that sex workers should not be given a voice and should basically disappear from the earth, represents a deep prejudice and discrimination against this class of people.

    Of course broader issues of gender disparities in economic and other areas are meaningful, but very often these issues are used a smokescreen to avoid looking at the immediate needs of sex workers in the context of this (and other) health crises and to avoid the elephant in the room, which is the abuse of sex workers by factors connected to prohibitions.

    It is a moral belief that assumes that the purchase of sexual services by males is a moral transgression and inherently oppressive. In fact there is little research as to the cultural and anthropological relationships between the genders in regard to various sexual arrangements including commercial sex.

    The notion that approaches such as ‘masculinity workshops to reduce demand’ would in any way benefit women, men and sex workers is not science, but is based on a ideology which is based on moral assumptions which are obviously counter productive to improvement of conditions for sex workers (and for society).

    UNESCO, having refused to sign on underscores the obvious flaws in this guidance note. The process must include sex workers who should be treated as human beings with rights as others and certainly the right to leadership in health programs that address their communities.

    Carol Leigh, Director
    Bay Area Sex Worker Advocacy Network
    http://www.bayswan.org

  24. As an organization which has its specific focus on lesbian, gay, bisexual and transgender people’s rights, we would like to propose looking into sex workers which belong to these groups with particular attention. From our work we came to a conclusion that it is most important to take into account specific needs and voices of our communities. We hope that the UNAIDS Guidance Note will include LGBT and put more effort into getting these group to speak of our needs and context. We support Gulnara Kurmanova’s efforts with the Guidance Note and using simple language to frame the concepts outlined in the Guidance Note in Russian.

  25. Shahnaz Islamova says:

    We discussed this document “Reworking Draft of the UNAIDS Guidance on HIV and Sex work” in Kyrgyzstan with sex workers. The working group which developed “Reworking Draft of the UNAIDS Guidance” took into consideration requests of sex workers: police raids, problems with lodging issues, mandatory medical examinations, access to education for adult sex workers and their children, sex workers’ rights, stigma and discrimination.

    We hope that UNAIDS will incorporate these proposals and will put in their document what sex workers request not the state and its institutions would like to make sex workers do. Otherwise what’s for this work is undertaken if our voices are not be heard and accepted

    Shahnaz Islamova
    Tais Plus NGO
    Kyrgyzstan

  26. HIV/AIDS is a bad perspective to look at people. The attempt to stop prostitution is a bad way to prevent HIV; it is a good way to make services inaccessible that should be addressed to sex workers’ needs. Prostitution is not a factor but unprotected sex and vulnerability of women contribute to spread epidemic.

    According to our experience we know where sex work is under less pressure the prevalence of HIV is remaining at low level for 10 years (1-1, 5% in Kyrgyzstan). It is our great success. It became possible because sex workers were developing prevention programmes according to their own preferences and understanding. Let see on the settings where sex work is under strict pressure of law like in Ukraine, what about the prevalence? Or sex work is under close control of police like in Kazakhstan, what about the prevalence?

    Sex workers are able to protect themselves if we support them. We should not participate in any kind persecuting programmes. We should base on the evidence not on the policy driven agenda.

  27. TAMPEP (European Network for HIV/STI Prevention and Health Promotion among Migrant Sex Workers) was founded in 1993 in response to the needs of migrant sex workers in Europe. It operates a community development and participation model that is rooted within the human rights framework, and seeks to lay a foundation for equitable access to support and services for sex workers. TAMPEP is an international networking and intervention project focused on assessing the situation and needs of female and transgender (migrant) sex workers in Europe and on developing appropriate responses to reduce sex workers’ vulnerability to HIV and sexually transmitted infections.
    TAMPEP is a network of sex work projects that covers 25 countries in Europe.

    The disproportionate levels of violence experienced by both indoor and outdoor based sex workers and the failure of the law to protect sex workers from violence has been identified across Europe as a major factor in increasing sex workers vulnerability, particularly those who have no legal status or are directly criminalised. Social vulnerabilities of sex workers is one of the structural determinants of the risks to health and well-being and in particular to HIV and sexually transmitted infections (STIs).The often unsafe and violent environment of the work place and the poor living conditions of sex workers increases their vulnerability.
    Most importantly, what needs to be taken into consideration is the protection of the individual human rights of sex worker, which are in frequent occasions violated. It is vital to consider the role and impact of community base organisations and sex work projects there efforts for advocacy in the human rights framework
    The presence of migrant sex workers in Europe and in other regions of the world requires a rethinking of the issue of women’s labour migration and complex system of factors that provoke different forms and levels of vulnerability.

    Repressive policies on both prostitution and migration deeply undermine prostitutes’ ability to implement strategies of self-protection and self-determination. These policies are also responsible for trafficking mechanisms.

    We call UNAIDS to promote holistic policy and strategy underpinned by principles of respect and inclusion of (migrant) sex workers, which should be based on 9 basic principles:
    1. To have a non-repressive approach to sex work and to sex workers.
    2. To include sex workers in the development, implementation, evaluation and decisions regarding activities and policies concerning sex work.
    3. To facilitate the access to appropriate social and health care services for both national and migrant sex workers based on voluntary and anonymous offers, to reduce social and health inequalities.
    4.To have a multi-disciplinary approach to HIV and STI prevention, which address the needs identified by both national and migrant sex workers.
    5. To create a legal and a social framework for dealing with sex work based on the protection of sex workers’ human, labour and civil rights.
    6. To guarantee migrant sex workers human, labour and civil rights.
    7. To recognise the universal right to migrate.
    8. To create anti-trafficking policies which are based on the protection of women’s human rights and integrate a human rights impact assessment in all anti-trafficking and migration policies and programmes in order to protect and promote the rights of migrant sex workers and trafficked persons.
    9. To facilitate the cooperation and the networking of sex work projects on local, national and international level
    10. To recognise sex workers contribution as a prerequisite of the development of effective policies and intervention in reducing vulnerabilities to HIV/AIDS

  28. Posted on behalf of the campaign Women Won’t Wait: End HIV and Violence Against Women and Girls. Now.

    “The challenge is to bring all rights holders into the decision-making process, even those who are sometimes marginalized, like women, LGBT, children, “minorities”, etc. For marginalized rights-holders to participate more equally in decision-making, they must be able to understand their own situation, determine their own vision for development, and then negotiate for its fulfillment with duty bearers. They create and negotiate their vision – and realize their rights – by communicating, first within their own group and then with other social groups around them” UNICEF ESARO Guidelines for rights-based programming

    The Women Won’t Wait: End HIV and violence against women and girls. Now. campaign is writing to offer our support to The Global Working Group on HIV and Sex Work Policy’s Draft Reworking of the UNAIDS Guidance Note on HIV and Sex Work, April 2007. We have carefully read the April 2007 Guidance note with alarm, particularly from the perspective of whether or not the guidance note will foster or hinder efforts to address violence against women and girls in the context of HIV. Sex workers are part of the solution to reversing the HIV epidemic. Addressing violence against sex workers can result in crucial steps toward solving the AIDS crisis.

    1. Human rights based approaches
    First and foremost, it is critical to anchor this guidance note in rights-based principles and programming and a commitment to ending human rights abuses that occur in the context of the global AIDS response. Sex workers face many barriers to accessing the support and services they need to maintain healthy lives free of violence and HIV. Basic human rights principles are core elements of effective strategies to address the intersection of violence and HIV among sex workers – especially in situations where the AIDS epidemic is concentrated in sex worker communities. These activities can only take place with the cooperation of sex workers themselves and fully take into account the diversity of forms of sex work as well as the diversity of sex workers.

    Rights-based programming principles stress the universality, inalienability, interdependence and indivisibility of rights. They specify accountability and obligations as core principles. Commonly, rights-based approaches are understood to be based on practices of:

    o Universality/Inalienable/Non-Discrimination
    o Participation/Inclusion/Empowerment
    o Transparency
    o Accountability/Obligation
    o Interconnectivity (i.e. assuring the conditions for enjoyment of rights)

    For programming to be meaningful, it must be available, accessible, acceptable, and of high quality (3AQ). However, as currently drafted, the guidelines fail to anchor the “pillars” in such human rights principles. The statement of the pillars makes no reference to human rights approaches or human rights violations. Moreover, some have argued that the process by which the guidelines were prepared was not sufficiently participatory, and in designing an approach that appears to regard sex workers as “victims” rather than as independent actors making decisions (albeit constrained) about their labor. In order to facilitate sex workers’ ability to exercise more control over their labor circumstances, the guidance note should recommend sufficient levels of targeted outreach to male and trans sex workers about the use of the female condom in addition to massively scaled up distribution and outreach to female sex workers.

    2. The conflation of sex worker with trafficking
    Increasing evidence, and global norms, confirm the clear distinction between trafficking and sex work and lay out the distinctive and specific characteristics of trafficking. While trafficking may force some individuals into engaging in sex work, it also includes a range of forms and endpoints of forced, coerced and/or bonded labour (i.e. into factories, begging, fishing, agriculture, etc). As Mike Dotteridge explains about the Palermo Protocol, “the official commentary on the significance of terms used in the UN Trafficking Protocol … explains that, ‘the Protocol addresses the exploitation of prostitution of others and other forms of sexual exploitation only in the context of trafficking in persons. The terms ‘exploitation of the prostitution of others’ or ‘other forms of sexual exploitation’ are not defined in the [Trafficking] Protocol, which is therefore without prejudice to how States Parties address prostitution in their respective domestic laws.’” However, the guidance note fails to clarify this distinction and, rather, blurs the lines between trafficking and sex work. This conflation of sex work with trafficking is not unique to this document. However, it fails to pass the test of being evidence-informed, and can rather be seen as ideologically driven. The document begins with a discussion of trafficking thus suggesting that the context of trafficking (i.e. force, deception, and coercion) is the appropriate framework for understanding the challenges of HIV for sex workers. Indeed, the fourth paragraph of the document states this explicitly, “The increasing feminization of migration and the involvement of families, kin networks and local communities in the movement of women and girls, blurs the difference between trafficking and sex work.” Not only is this a debatable portrayal of contemporary sex work (and, indeed of the distinct features of trafficking), but it also seems to equate sex workers and trafficked persons as women and girls.

    This elision of trafficking and sex work runs an additional risk – that of failing to accurately portray and address the reality of violence in the lives of sex workers. Such approaches should be evidence based and stemming from ethical research. The document’s strong suggestion that addressing the danger of HIV in the lives of sex workers will be served by eliminating demand suggests another ideological view that is not informed by the evidence provided.

    Many women, men and transgenders choose sex work voluntarily. Others may be manipulated or forcibly placed into the sex work, including through trafficking. While both violence and trafficking need to be examined in the context of migration, those who have been trafficked more than often experience physical and sexual violence that places them at high risk for HIV transmission. In addition, rescue raids within the sex industry have exacerbated violence against sex workers who are often rounded up, beaten, raped by police officials, and placed into institutions for further sexual exploitation and abuse. The threat of these raids pushes sex workers underground and onto the streets, thereby increasing their susceptibility to violence and HIV transmission.

    3. The threat and reality of violence
    Ending violence against women and girls as well as all forms of gender-based violence must be foundational to any rights-based programming. In many countries sex workers are subjected to police violence, neglect and discrimination from health care services, and denial of other basic human rights. Indeed, the lives of sex workers are often inflected with the reality or threat of violence – especially from the police. Such conditions force individuals underground and limit HIV outreach efforts; access to treatment, care and support; sexual health and HIV/STI prevention information, services and products; and advocacy.

    Many countries criminalize sex work, and sex workers are subjected to police violence, neglect and discrimination from health care services, and denial of other basic human rights. The stigma and discrimination that sex workers face is compounded with the risk for HIV transmission in societies that do not acknowledge sex workers as frequent victims of sexual violence, so that, in some cases, a rape of a sex worker is not even considered to be a rape. Moreover, since it is law enforcement agents who often perpetrate or excuse rape, sex workers are inhibited in their reporting of crime, and states (and those acting with the authority of the state) are treated with impunity.

    A recent report by the Central and Eastern European Harm Reduction Network sums it up:
    [Sex workers] face violence on a daily basis and have limited or nonexistent legal protection. As in most other countries of the world, state policies addressing issues of sex work in the region are rarely driven by pragmatism, scientific evidence, and human rights concerns; instead, they are often restrictive and based on moral prejudice. Even when sex work is not technically illegal, it is frowned upon and its practitioners discriminated against and shunned by much of society.
    These attitudes greatly impede sex workers’ access to public health services, including treatment for drug dependence as well as HIV prevention and treatment information and services. They also place sex workers in a position where their basic human rights can easily be violated and protection of these rights becomes difficult if not impossible.

    Moreover, criminalization and police abuse can hamper HIV outreach efforts: for example, HIV outreach workers have been arrested as sex workers, using evidence of carrying condoms as an indication of prostitution. The underground nature of sex work in many regions means that workers have little recourse in the case of violence or abuse. A study of sex workers in Cambodia found that brothels managers often colluded with police, giving preference to clients and forcing sex workers into unprotected sex. Indeed, police and law enforcement agents themselves may contribute to the transmission problem. According to first hand accounts, sex workers in India have been forced to have sex or pay bribes in return for their release. Based on this information, the guidance should call for quick action by governments to repeal laws that criminalize sex work and prohibit the use of condoms as “evidence” of a crime or infraction. Given the pervasive reality of violence, the guidance note should also call for massive scale-up in education about and availability of pre- as well as post-exposure prophylaxis, as well as emergency contraception and other emergency services for sex workers on demand.

    4. Coercive programming and/or ill-conceived programming and policy
    The direct targeting of sex workers for violence is exacerbated by ill-conceived HIV policies that hamper sex workers’ access to prevention, treatment, care and support. There is a tendency to stigmatize sex workers as “vectors of disease”, irrespective of the source of infection. Sex workers often are required to have regular “health checks” with no support for prevention activities to encourage or require their clients to wear condoms and with little or no access to health-care services.

    Examples of the negative impact of ill-conceived policies include the denial of key prevention tools to sex workers, mandatory health checks, coercive condom policies or the prohibition of clean needle exchange. Other policies which have been documented as potentially leading to or exacerbating violence include: situations of violations of confidentiality which may hinder sex workers from seeking services because they fear exposure. Criminalization of sex work, for example, puts individuals and groups who may be engaging in risky behavior at further risk because they are unable to access information and prevention tools, or–when they are HIV positive–treatment, care and support. Discrimination and hostile legal and political environments, such as those leading to HIV outreach workers being arrested as sex workers further circumscribe efforts to address the health and rights of marginalized communities. Such policies may promote stigma and discrimination, or put sex workers at greater risk of violence, while promoting impunity for perpetrators and reducing the possibility for victims to seek services and redress.

    To summarize, we believe that a human rights-based approach must be the foundation for this guidance note on HIV and sex work, especially because of the pervasive threat of human rights violations that sex workers face in their lives, but more generally because rights-based approaches to addressing HIV work. In this spirit, we offer the following recommendations:

    a. We strongly urge the drafters (as proposed by The Global Working Group on HIV and Sex Work Policy) to reintegrate human rights as the foundational principle for the guidance note. As we have noted above, activities to address the impact of HIV among sex workers (female, male and transgender) will be most effective if they are designed, developed, implemented and evaluated with the cooperation of sex workers themselves, taking into account the diversity of forms of sex work as well as the diversity of sex workers.
    b. Empowerment and facilitating sex workers’ more effective agency is critical to any comprehensive AIDS response. To this end, the guidance note should call for national governments, international agencies, donors and local implementing partners to expand and intensify targeted outreach to male and trans sex workers about the use of the female condom in addition to massively scaled up distribution and outreach to female sex workers.
    c. The conflation of trafficking and sex work is a dangerous return to ideologically-driven policymaking, and departs from international norms and standards. It is crucial that the guidance note consider the recommendation from The Global Working Group on HIV and Sex Work Policy, and specify the significance of this distinction for users of the guidance note. Sex workers should not be subjected to the violence and related human rights violations that all-too-frequently accompany “raids and rescues,” whether these are directed by state agents or non-state actors.
    d. It is increasingly evident that criminalization of marginalized communities seriously hampers HIV efforts. In this light, the guidance should encourage governments to repeal laws that criminalize sex work and, in particular, to prohibit the use of condoms as “evidence” of a crime or infraction. Given the pervasive reality of violence, the guidance note should also call for massive scale-up in education about and availability of pre- as well as post-exposure prophylaxis, as well as emergency contraception and other emergency services for sex workers on demand.

  29. Roseline says:

    Hello there,
    My name is Roseline Carter and I coordinate a program called Shift in Calgary, Alberta. We are looking for some more information on this group and am wondering if you can email me some info. Are you looking for more people to be involved? We would love to help out any way we can.

    Thank you,
    Roseline Carter
    email: shift@aidscalgary.org

  30. Harry Walsh Technical Adviser HIV Prevention International HIV/AIDS Alliance says:

    Harry Walsh Technical Adviser HIV Prevention International HIV/AIDS Alliance.
    This is a great initiate as is the resulting first document. Both should prove a much needed resource for all of us aiming to respond more inclusively to the vulnerability of sex workers to HIV transmission. It highlights the urgent need of sex workers globally (and locally) for equitable access to supportive HIV prevention information and resources as well as access to welcoming and sensitised sexual health education, care and treatment. I am encouraged by Peter Piot’s UNAIDS endorsement and see your group as a long-awaited and empowered pivotal reference group in ongoing advocacy, policy and inclusive programme responses to the HIV-related needs of sex workers.

  31. The UNAIDS version of the Guidance Note abandons Jonathan Mann’s legacy of rights-based programming. The Global Working Group has corrected this by including the inputs offered by sex workers from around the world at the consultations held by UNAIDS, but which were neglected in their original draft Guidance Note. The methods included in the GWG inputs are all evidence-based and rights-based. The GWG has done what UNAIDS should have done in the first place.

  32. Anon says:

    In recent negotiations with UNFPA over sex worker funding, I was told by a UNFPA officer that all staff saw the first draft of the Guidance note, and it was a wonderful reflection of what sex workers had expressed that they needed, but later the big nation states who are large funding contributers to the UN (No guessing who that might be), put pressure on UNFPA to re-write the guidance note with an anti-sex work bent.

    This UNFPA staffers said that everyone at UNFPA knew the Guidance note was a joke, its only a Guidance, and for sex worker projects to be successful, “lets just ignore that the Guidance note exists.”

    The Guidance note is playing politics with sex workers lives. It is morally and ethically bankrupt, and is about certain political persuasions getting the upper hand in a policy debate. Can’t we put the point scoring aside for the sake of sex worker rights, safety, dignity and health? A little unity would go a long way these days..

  33. Chris Kalema says:

    That’s not health. They should be more interested in prevention other than fighting Sex Worker Industry.

    Chris Kalema
    OGLM – Uganda
    http://www.oglm.org
    Chris.Kalema@oglm.org

  34. Pia Covre says:

    We all have a long historical experience about how the laws and the political choose impact the life of sex workers.
    From the studies about 18 century policies over prostitution, oriented to the health safety for the society, we argue how the stigma and criminalization of sex worker born from those kinds of models of statements and policies.
    Is not time for joking over the life of Sex Workers, the Guidance must be review.

  35. SWOP fully supports the reworked guidance note on the UN’s Sex Work and HIV policy produced by the NSWP’s Global Working Group.

    The original guidance failed to acknowlede the evidence base for effective HIV prevention by failing to address human rights issues for sex workers.

    If HIV prevention is to be effective, it is essential to take a holistic approach and empower rather than criminalise sex workers. Whilst we recognise the importance for sex workers to have opportunities for economic alternatives and access to education, if “exiting strategies”/ abolition of sex work are the sole focus, it will only serve to increase stigma for sex workers and diminish their human rights, thereby diminishing the efficacy of HIV prevention.

    We would urge the UN to fully acknowledge the value of the participation of sex workers in any policy development that affects them and to accept the reworked Guidance Notes of the Global Working Group on HIV and Sex Work Policy.

    Melanie Potter
    Sex Workers’ Outreach Project Coordinator
    Brighton Oasis Project

  36. Statement of principles

    The efforts of EHRN and its allies with and on behalf of sex workers are based on the following definitions, principles, and goals:

    • Sex work is defined as the unforced sale of sexual services for money or goods between consenting adults. Sex work includes street prostitution, escort service, telephone sex service, pornography, erotic dancing, and others.
    • Sex workers should have the same rights and responsibilities as all other workers, and as every other citizen and resident.
    • Protection of sex workers’ rights is crucial for effective harm reduction, HIV/AIDS prevention, and treatment efforts at all levels—individual, community, and national. To ensure protection of these rights, sex workers should be able to work legally.
    • Barriers preventing access to health, social, and drug treatment services need to be removed to improve the health and social well-being of sex workers.
    • Activities related to sex work between consenting adults should be decriminalized. All national criminal laws relating to adult prostitution should be repealed. All regional and local regulations targeting sex workers to prosecute the practice of their trade should be repealed.
    • Sex workers and other community members should have an active role in designing commercial regulations of the sex trade.
    • Targeted, pragmatic, and comprehensive social programs must be developed in consultation with sex workers and implemented to improve relations between the police and sex workers as well as between sex workers and the community at large..
    • Targeted, pragmatic, and comprehensive public health programs must be developed and implemented with the involvement of sex workers to raise awareness about safer sex; safer drug use; and HIV/AIDS prevention, treatment, and support.
    • Governments throughout Central and Eastern Europe and Central Asia should review and revise accordingly existing laws and policies in the realms of illicit drug use and sex work with the goal of adopting policies in which their human rights commitments are upheld. These commitments include agreements such as the UN Declaration of Commitment on HIV/AIDS, the UN Millennium Declarations, the Convention on the Elimination of All Forms of Discrimination against Women, the Convention on Economic, Social and Cultural Rights, and other instruments of international human rights law.
    • There is no reason to delay reform that helps protect the health and rights of sex workers. The time to act is now!

    Recommendations for policymakers

    • Government officials from across the spectrum should summon greater levels of political will and commitment to address social marginalization, economic exclusion, and violence within broader governance.

    • Mechanisms should be initiated, preferably in cooperation with human rights groups and civil society, to enhance the independent monitoring of human rights agreements; protect the rights of vulnerable populations; and punish violators.

    • Repressive national legislation regarding drug use and the provision of effective interventions, such as harm reduction services, should be revised to reflect pragmatic, compassionate policies. Most importantly, harsh penalties for drug use should be eliminated because they restrict the ability and willingness of those at risk to obtain information and services to protect their own health and the health of those around them.

    • Sex work should be decriminalized, and other national policies that negatively affect sex workers’ human rights and access to health services should be revised or eliminated.

    • Sex workers’ involvement in all government-organized HIV/AIDS and human rights initiatives should be made a priority and guaranteed.

    Recommendations for health authorities

    • HIV testing must be voluntary and confidential for all individuals, including sex workers, IDUs, and others at high risk for contracting the virus.

    • Harm reduction services, including needle/syringe exchange, should be available at all public health facilities.

    • Migrants should have improved access to public health services.

    • Policies and procedures in health care delivery that discriminate against IDUs and sex workers should be identified and removed.

    Recommendations for law-enforcement authorities

    • Policies should be implemented to help stem harassment and abuse of sex workers by the police.

    • All members of the police and other law-enforcement entities should receive regular training on issues related to HIV, drug use, and the legal and human rights of all individuals, especially sex workers and other vulnerable groups. Police should also be expected to refer—but never in a coercive or threatening manner—sex workers and IDUs to programs, projects, and shelters where they can receive appropriate assistance.

    Recommendations for service providers

    • Programs targeting sex workers in general and specific groups within sex worker populations need to be expanded and diversified.

    • Service providers should seek to establish better links with human rights organizations/activists and other stakeholders in the region as part of an enhanced effort to monitor violations.

    • Better program monitoring and evaluation would be a useful step toward improving planning and service delivery in general.

    Recommendations for external donors

    • Donors, especially foreign development agencies, need to base their response and funding on the real situation on the ground and on scientific evidence—and not on domestic ideological considerations in their own countries.

    • Staff at multilateral and bilateral aid entities—as well as public health system employees at all levels—should be encouraged to speak up in response to perceived mismanagement, misallocation of priorities, and discrimination. They should be able to note their objections confidentially and without risk of reprisals such as dismissal.

    • The policies and programs of various donors should be better organized and coordinated to ensure continuity of service, especially in countries where service provision depends mostly on donor assistance.

    Recommendations for researchers

    • Researchers, scientists, national governments, and multilateral organizations should collaborate on the establishment of professional, sustainable research teams that publish more specific and accurate data on the HIV/AIDS epidemic and vulnerable populations, including sex workers, in CEE/CA.

    • The effects of decriminalization of sex work should be carefully analyzed, and the results made widely available. Special attention should be paid to experiences in other countries of the region (notably Hungary and Latvia).

  37. Purwa Bansod says:

    Hi,

    I came across your blog and thought it was a great read. I am writing to tell you about a release event for a special report by the Independent Commission on AIDS in Asia that we are organizing on Wednesday, March 26th from 6:30 to 8:30pm EST at the Asia Society (725 Park Avenue at 70th Street, NYC). The report is entitled “Redefining AIDS in Asia: Crafting an Effective Response,” and this will be the first public unveiling of the Commission’s findings following the presentation of the report to the Secretary-General earlier in the day at United Nations headquarters. More details are provided below.

    I am hoping you can help us spread the word about this important program to your readers. Seven of the nine members of the Commission will be present to answer questions, and copies of the report will be available. To attend the program, online registration is available at: https://tickets.asiasociety.org/public/. The event is free, but because seating is limited, registering in advance is suggested. The event will be broadcasted live via audio webcast starting at 6:30pm EST. The webcast can be accessed at the events page on the Asia Society’s website and a link will be made available to listen in just prior to the start time (http://www.asiasociety.org/events/). Listeners also can send in questions by email (moderator@asiasociety.org).

    Thanks in advance for helping us get the word out about this program.

    Sincerely,
    Purwa Bansod
    Asian Social Issues Program, Asia Society

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