2 May 2007

People Just Like You....

PEOPLE JUST LIKE YOU: DON'T BLAME IT ON THE SEX WORKERS -
By Aditya Bastola

Organised efforts towards minimising the commercial sex industry's impact on the spread of HIV/AIDS often incorporate the assumption that it is the behaviour of the sex workers themselves that should be targeted for change. Based on fieldwork conducted in Pune, the second city of India's Maharashtra state, this article considers such an approach to be inadequate, arguing that more attention needs to be focused on the roles particularly of regular clients and of women sex workers' non-paying sexual partners. The practice of unsafe sex within the sex-trade should not be seen solely as a consequence of sex-workers relative ignorance of the dangers, but also in relation to the need to maximise earnings under conditions of exploitation and poverty. Furthermore, the epidemic needs to be addressed in the context of a society that is relatively conservative in its attitudes towards sex and sex education, a situation that fosters widespread lack of awareness of safer practices extending well beyond women in sex-work. The report presented here is resultant of bi-weekly interactions with women sex-workers between July 2003 and April 2005 in Pune's red light district of Budhwar Peth. Information collection was informal in nature and reliant upon the gradual creation of a rapport between the researcher and the women. Although the evidence gathered was thus largely anecdotal in nature, it is contended that (given the subject matter) this approach yields more accurate results than a more formal survey, as the latter method can readily be anticipated as prompting answers based not on real experiences but rather upon what is believed to be sought by the researcher.

Saheli HIV/AIDS Karyakarta Sangh (SHAKS) in the only collective of women in Pune to be registered under the Bombay Society's Act. Established by a small group of such women in 1998, the efforts of SHAKS are aimed at protecting members and non-members alike, not only through raising sex-workers own awareness, but also by changing the negative attitudes prevalent in so-called 'mainstream' society. This involves drawing attention to the many problems experienced by sex-workers, as well as mobilising them towards the collective achievement of their fundamental human rights as women. The evolution of SHAKS can be traced to the initiations of HIV prevention/awareness activities under Dr. Ishwar Gilada's leadership of the People's Health Organisation (PHO - formerly the Indian Health Organisation). Thus, following India's first reported HIV diagnosis in 1986, the PHO launched an initiative to reach out to the sex-workers of Budhwar Peth, Pune, recognising that the fight against the epidemic necessitates changes in existing high-risk behaviour patterns. The Times of India estimates that Budhwar Peth contains 6000 sex-workers, a figure which includes 200 minors (1). However my own exhaustive efforts at 'sex-mapping' suggest a somewhat lower figure of 3744 women distributed amongst 394 brothels (with each such establishment thus averaging approximately 10 workers), in addition to approximately 500 street-based workers. In addition to the red-light district trade, the sex-work of women operating from apartments in many locations around the city remains far more hidden and harder to documents.

It was the need to promote sex-worker's active participation in HIV/AIDS prevention/control that directed the PHO's work in Budhwar Peth towards the launch of the first 'peer education model' of community-based organisation in India. The essence of peer education is that the agents through which information and practical support are disseminated are themselves drawn from the community of sex-workers. Making the transition from a scheme sponsored by government to one with more organic roots, it was these peer educators that then went on to become the founder members of SHAKS.

Today SHAKS is funded by the Maharashtra State AIDS Control Society (MSACS), and not only intervenes with sex-workers, but also works with their children, non-paying sexual partners, brothel keepers (gharwalis), with those living with HIV/AIDS, as well as with local residents. In addition, SHAKS lobbies the Government for the provision of basic amenities, civic services and legal rights to be directed towards women in sex work, as well as conducting awareness campaign amongst government officials aimed at informing them of sex-worker's human rights. Another central aspect of the union's work has been its contribution to the provision of free nutritious meals to patients of opportunistic infections to which sex-workers are particularly vulnerable due to their typically low economic profile. Together with MSACS, and Pathfinder (an organisation sponsored by the Bill Gates Foundation), SHAKS is presently reaching out not only to the brothels, but also to non-brothel based women sex-workers including those working outside of Budhwar Peth. Alongside the distribution of free condoms to the women's doorsteps, the outreach activities of SHAKS' peer educators also involve other areas of health assistance and monitoring. Thus, early diagnosis is enabled by providing the women with an escort to government hospitals as required, and behavioural change amongst sex-workers is promoted through daily discussions utilising information, education and communication (IEC) tools, for example flipcharts and role play techniques.

Unsafe sex as a means out of poverty and sex-work.

Given that from the gharwalis' perspective sex-workers represent productive assets, it is unsurprising that they are typically keen to allow SHAKS' peer educators to inform the women with regard to the correct use of condoms. SHAKS thus only rarely encounters resistance in this crucial area of their work, and statistic of monthly free condom usage indicate an increase from 50,000 - 1,00,000 pieces as of 1991 to a current figure of 5,00,000 - 8,00,000. Demand is such that sex-workers frequently come to SHAKS in need of more supplies despite of the peer educators' daily distribution of condoms to each brothel. Other than this, there are women who prefer to use branded condoms with their non-paying sexual partners, believing such usage to increase the latter's pleasure. Thus, evidence suggests a considerable positive impact regarding peer educators' work in creating demand for condom usage so as to slow the epidemic.

Nevertheless, with the continuing spread of HIV/AIDS, it would obviously be premature to announce that the problem has been successfully tackled. One reason for this is that the poverty trap within which many women in sex-work exist serves to increase temptations to accept offers of extra payment for unprotected sex. When a woman is purchased from traffickers to work in a brothel, the price paid effectively becomes her own debt, with earnings shared on a 50/50 basis with the gharwalis. She also has to pay the rent for her lodging and cover her living expenses, as well as support any children and remit money home to her family. Thus, with the rates paid by customers in some cases as low as Rs20, a woman may be effectively trapped both in poverty and the sex-trade for her entire working life. Under such circumstances, agreeing to unsafe sex is not simply a factor of a lack of information or of a disregard for personal well-being. Rather, it may be a survival strategy aimed at maximising income.

Another contributing factor to the relative lack of progress in halting the epidemic's spread is the sexual behaviour not so much of the sex-workers, but of a number of their non-paying sexual partner and regular clients. Many of the latter group are in search of not simply sex, but also seemingly of love and affection, whether due to unmarried status, because they are lonely migrant labourers, or as a response to some family conflict. Such regular clients, together with non-paying sexual partners, often constitute the only men with whom women in sex-work are able to form meaningful relationships, and are frequently viewed as offering a potential route out of poverty and the sex-trade. Sometimes this leads to marriage and the wearing mangalsutra (symbol of marriage), even in the women's knowledge that the man already has a wife elsewhere. Yet, although there are cases in which hopes of a new beginning via these men are fulfilled, all too often the men consider such relationships as a ticket to an easy life sponsored by the women's continued sex-work. In need of both secure emotional bonds and a hope of a brighter future, some of the sex-workers spend a significant proportion of their earnings on these exploitative males, who are also not unknown to steal directly from the women. Thus, rather than an offering a way out of their existing situations, such relations often serve to further entrench women sex-workers into the trade.

Furthermore, regular clients and non-paying lovers commonly insist on unprotected sex, which may be accepted by the women - given their desire to please these men to maintain the possibility of a route out of sex-work. Hence, given that these men are often highly promiscuous, sometimes cultivating the same exploitative relationships with more than one woman in sex-work, the dynamics through which they secure unprotected sex by raising the women's (usually) false hopes may be a major contributor to the spread of sexually transmitted infections (STIs). Thus any programme which focuses on changing sex-workers behaviour without also addressing the attitudes and powerful position of regular clients and non-paying lovers would seem to offer only limited potential for success.

Unsafe sex and social attitudes to sex education

A further factor feeding the epidemic, and which is also insufficiently addressed by efforts focused on changing sex-workers' behaviour, is the intense sexual curiosity of male youths promoted by a society within which attitudes towards sex are generally conservative. In such a social climate, where the open and frank discussion of sex frequently remains taboo, one of the few options open to satisfying such young men's desire for sexual experience or observation of the female body is to visit women in sex work. Furthermore, with few school curricula providing information regarding condoms,
knowledge of their correct usage is less than it would otherwise be, contributing to a situation within which almost 6000 new HIV infections occur amongst 15-24 years old each day across the globe (2). Considering this mix of amplified curiosity and relative ignorance, it is of little surprise that experimenting young men are often eager to experience unprotected sex. Whatever a client's age, given the debts within which many sex-workers are trapped, the women may be vulnerable to offers of extra payment for such encounters, regardless of their own personal knowledge of the dangers. This is not to say that sex-workers are necessarily willing to take such risks, or even to accept youngsters as their customers, as the following example (which I myself witnessed) illustrates. Obviously uncomfortable with such scenario, one of the women was seen bundling a rather awkward young lad into an autorickshaw, remarking that there was no way that she was prepared to conduct business with someone younger than her own son. At a general level, the manner in which the women retain their dignity despite their work, and the good humour they express, has left a lasting impression of respect and admiration upon this researcher.

Sex-work, neo-liberalism, migration and trafficking

The sex industry's customer base is cross-class in character, with a high demand arguably facilitated by men's tendency to control household expenditure within all social strata (3). Thus there is a need to avoid stereotyping clients as either migrant labourers or experimenting youths, not least as there also seems to be a burgeoning demand for high-end 'escort' services generated by the growing incomes of the more economically privileged, which in turn can be understood as partly consequent of the widening disparities in wealth distribution produced by the era of neo-liberalism.

In addition to economic reform stimulating demand for paid sex, withdrawal of state interventions has also bolstered the supply of sex-workers. This is resultant of growing rural hardship as well as of a decline in public-sector employment, both of which have contributed to falling livelihood opportunities amongst low-income groups. That migration ultimately leads many women into sex-work may also be related to illusions of a 'good-life' in the city which are planted by the media and other sources, but which all too often turn out to be false notions masking a lack of real opportunity. These 'push' and 'pull' factors not only spur increases in the unforced migration of women, but also fuel a situation within which the rural poor in certain areas have become particularly vulnerable of the false promises, not to mention the outright abductions, perpetrated by the human traffickers. Whatever the processes through which migrant women come to be involved Pune's sex industry, that there than typically follows an 'internal migration' to Budhwar Peth is a response, either by themselves or by their brothel keepers, to locate in an environment which provides a degree of protection both from prosecution and from police harassment (4).

In summary, it is both erroneous and insensitive to blame women in sex work for the proliferation of HIV/AIDS. The epidemic must be seen in terms of the wider implications of the society for which they all too often serve as scapegoats. Traditional patriarchal values, combined with more recent neo-liberal initiatives, keep such women vulnerable to exploitation related to their subordinate socio-economic status. Whilst the sex-workers are stigmatised and often seen as the epicentre of the epidemic, their male clients somehow seem to manage to escape similar criticism, even though it is their desires (together with women's poverty) which fuel the sex industry. Combined with archaic attitudes to sex and sex-education, society is ill equipped either to understand the compulsions that drive the business or to change the dynamics, which lead the women to be so grossly exploited. There is a saying amongst women in sex-work that neatly illustrates the necessary change in social attitudes without which efforts to halt the epidemic seem destined to fail - "we are the whores of the society. For which we are stigmatised, marginalised, ostracised, despised, disenfranchised, dehumanised, discredited, disinherited, disowned, studied, blamed, raped, imprisoned, rendered invisible - but we won't go away. And now you must deal with us as artist. For we are also creative, artistic, poetic, sensual, erotic, multi - talented, diverse, interesting, thespians, comedic, playful, fantasy, weavers, sagacious, loving, giving, nurturing, empathetic, compassionate, patient, tender and strong. We are people, just like you…" (5).

NOTES AND REFERENCES:
1. Times of India, 22nd October 2003.
2. Young People Speaking Out - Meeting out rights to HIV prevention and Care: Access for all, UNICEF, 2004.
3. Johnson, R. Men in the Informal Sector: Studies of Rickshaw Driving and Lottery Vending. Unpublished dissertation, Institute of Development Studies, University of Mysore, 2005. (Johnson argues that this control is reflected not only in high demand for sexual services, but also for other male oriented recreation including the lottery industry).
4. Tejaswi Sevekari, Times of India, 5th March 2004.
5. Action Aid Communication on SHAKS' notice board (Action Aid formerly operated in Budhwar Peth).

(Any further details please contact: adityabastola@hotmail.com)

2 comments:

Noushin said...

hey aditya,

i emailed you a couple of weeks ago about the possible articles you might want, but i think it might have gone to your junk - oops. let me know

ps: say hi to everyone at saheli for me!

Elia said...

Well said.