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PEOPLE JUST LIKE YOU: DON'TBLAME IT ON THE SEXWORKERS -By Aditya Bastola

Organised efforts towards minimisingthe commercial sex industry's impact onthe spread of HIV/AIDS oftenincorporate the assumption that it is thebehaviour of the sex workers themselvesthat should be targeted for change.Based on fieldwork conducted in Pune,the second city of India's Maharashtrastate, this article considers such anapproach to be inadequate, arguing thatmore attention needs to be focused onthe roles particularly of regular clientsand of women sex workers' non-payingsexual partners. The practice of unsafesex within the sex-trade should not beseen solely as a consequence of sex-workers relative ignorance of thedangers, but also in relation to the needto maximise earnings under conditionsof exploitation and poverty.Furthermore, the epidemic needs to beaddressed in the context of a society thatis relatively conservative in its attitudestowards sex and sex education, asituation that fosters widespread lack of awareness of safer practices extendingwell beyond women in sex-work. Thereport presented here is resultant of bi-weekly interactions with women sex-workers between July 2003 and April2005 in Pune's red light district of Budhwar Peth. Information collectionwas informal in nature and reliant uponthe gradual creation of a rapport betweenthe researcher and the women. Althoughthe evidence gathered was thus largelyanecdotal in nature, it is contended that(given the subject matter) this approachyields more accurate results than a moreformal survey, as the latter method canreadily be anticipated as promptinganswers based not on real experiencesbut rather upon what is believed to besought by the researcher.Saheli HIV/AIDS Karyakarta Sangh(SHAKS) in the only collective of women in Pune to be registered underthe Bombay Society's Act. Establishedby a small group of such women in1998, the efforts of SHAKS are aimed atprotecting members and non-membersalike, not only through raising sex-workers own awareness, but also bychanging the negative attitudes prevalentin so-called 'mainstream' society. Thisinvolves drawing attention to the manyproblems experienced by sex-workers,as well as mobilising them towards thecollective achievement of theirfundamental human rights as women.The evolution of SHAKS can be tracedto the initiations of HIVprevention/awareness activities underDr. Ishwar Gilada's leadership of thePeople's Health Organisation (PHO -formerly the Indian HealthOrganisation). Thus, following India'sfirst reported HIV diagnosis in 1986, thePHO launched an initiative to reach outto the sex-workers of Budhwar Peth,Pune, recognising that the fight againstthe epidemic necessitates changes inexisting high-risk behaviour patterns.The Times of India estimates thatBudhwar Peth contains 6000 sex-workers, a figure which includes 200minors

(1)

. However my own exhaustiveefforts at 'sex-mapping' suggest asomewhat lower figure of 3744 womendistributed amongst 394 brothels (witheach such establishment thus averagingapproximately 10 workers), in additionto approximately 500 street-basedworkers. In addition to the red-lightdistrict trade, the sex-work of women

operating from apartments in manylocations around the city remains farmore hidden and harder to documents.It was the need to promote sex-worker'sactive participation in HIV/AIDSprevention/control that directed thePHO's work in Budhwar Peth towardsthe launch of the first 'peer educationmodel' of community-based organisationin India. The essence of peer educationis that the agents through whichinformation and practical support aredisseminated are themselves drawn fromthe community of sex-workers. Makingthe transition from a scheme sponsoredby government to one with more organicroots, it was these peer educators thatthen went on to become the foundermembers of SHAKS.Today SHAKS is funded by theMaharashtra State AIDS Control Society(MSACS), and not only intervenes withsex-workers, but also works with theirchildren, non-paying sexual partners,brothel keepers (

gharwalis

), with thoseliving with HIV/AIDS, as well as withlocal residents. In addition, SHAKSlobbies the Government for theprovision of basic amenities, civicservices and legal rights to be directedtowards women in sex work, as well asconducting awareness campaignamongst government officials aimed atinforming them of sex-worker's humanrights. Another central aspect of theunion's work has been its contribution tothe provision of free nutritious meals topatients of opportunistic infections towhich sex-workers are particularlyvulnerable due to their typically loweconomic profile. Together withMSACS, and Pathfinder (an organisationsponsored by the Bill Gates Foundation),SHAKS is presently reaching out notonly to the brothels, but also to non-brothel based women sex-workersincluding those working outside of Budhwar Peth. Alongside thedistribution of free condoms to thewomen's doorsteps, the outreachactivities of SHAKS' peer educators alsoinvolve other areas of health assistanceand monitoring. Thus, early diagnosis isenabled by providing the women with anescort to government hospitals asrequired, and behavioural changeamongst sex-workers is promotedthrough daily discussions utilisinginformation, education andcommunication (IEC) tools, for exampleflipcharts and role play techniques.

Unsafe sex as a means out of povertyand sex-work

.Given that from the

gharwalis'

perspective sex-workers representproductive assets, it is unsurprising thatthey are typically keen to allow SHAKS'peer educators to inform the women withregard to the correct use of condoms.SHAKS thus only rarely encountersresistance in this crucial area of theirwork, and statistic of monthly freecondom usage indicate an increase from50,000 - 1,00,000 pieces as of 1991 to acurrent figure of 5,00,000 - 8,00,000.Demand is such that sex-workersfrequently come to SHAKS in need of more supplies despite of the peereducators' daily distribution of condomsto each brothel. Other than this, there arewomen who prefer to use brandedcondoms with their non-paying sexualpartners, believing such usage toincrease the latter's pleasure. Thus,evidence suggests a considerablepositive impact regarding peer educators'work in creating demand for condomusage so as to slow the epidemic.

Nevertheless, with the continuing spreadof HIV/AIDS, it would obviously bepremature to announce that the problemhas been successfully tackled. Onereason for this is that the poverty trapwithin which many women in sex-work exist serves to increase temptations toaccept offers of extra payment forunprotected sex. When a woman ispurchased from traffickers to work in abrothel, the price paid effectivelybecomes her own debt, with earningsshared on a 50/50 basis with the

gharwalis.

She also has to pay the rentfor her lodging and cover her livingexpenses, as well as support any childrenand remit money home to her family.Thus, with the rates paid by customers insome cases as low as Rs20, a womanmay be effectively trapped both inpoverty and the sex-trade for her entireworking life. Under such circumstances,agreeing to unsafe sex is not simply afactor of a lack of information or of adisregard for personal well-being.Rather, it may be a survival strategyaimed at maximising income.Another contributing factor to therelative lack of progress in halting theepidemic's spread is the sexualbehaviour

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 tounmarried status, because they are lonelymigrant labourers, or as a response tosome family conflict. Such regularclients, together with non-paying sexualpartners, often constitute the only menwith whom women in sex-work are ableto form meaningful relationships, andare frequently viewed as offering apotential route out of poverty and thesex-trade. Sometimes this leads tomarriage and the wearing

mangalsutra

(symbol of marriage), even in thewomen's knowledge that the manalready has a wife elsewhere. Yet,although there are cases in which hopesof a new beginning via these men arefulfilled, all too often the men considersuch relationships as a ticket to an easylife sponsored by the women's continuedsex-work. In need of both secureemotional bonds and a hope of a brighterfuture, some of the sex-workers spend asignificant proportion of their earningson these exploitative males, who are alsonot unknown to steal directly from thewomen. Thus, rather than an offering away out of their existing situations, suchrelations often serve to further entrenchwomen sex-workers into the trade.Furthermore, regular clients and non-paying lovers commonly insist onunprotected sex, which may be acceptedby the women - given their desire toplease these men to maintain thepossibility of a route out of sex-work.Hence, given that these men are oftenhighly promiscuous, sometimescultivating the same exploitativerelationships with more than one womanin sex-work, the dynamics throughwhich they secure unprotected sex byraising the women's (usually) false hopesmay be a major contributor to the spreadof sexually transmitted infections (STIs).Thus any programme which focuses onchanging sex-workers behaviour withoutalso addressing the attitudes andpowerful position of regular clients andnon-paying lovers would seem to offeronly limited potential for success.

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