COLLECTIVISATION: COMBATING VIOLENCE AGAINST WOMEN IN PROSTITUTION
Meena Saraswathi Seshu

Context

Sex workers have traditionally had to bear the spectre of being labelled wanton [liberated sexual beings], worthless [making money from sex] and weak [morally]. In the age of HIV, society has further stigmatised those in sex work as `carriers and vectors of HIV', instead of recognizing them as mere links in the broad networks of heterosexual transmission of HIV.

The myth that sex workers are core transmitters of HIV serves the needs of `prostitution bashers' who often view AIDS as an impure disease that afflicts the immoral and the evil. If sex workers are core transmitters of HIV and HIV is evil, then sex workers are clearly the ultimate evil, according to this worldview. This ideology of morality has very real consequences for sex workers in the age of HIV, because it ultimately results in:

•  Increasing public and police violence against sex workers

•  Increasing the number of customers who demand and force unsafe sex

•  Reducing sex workers' ability and capacity to assert themselves

•  Increasing the rate of HIV among sex workers, clients and the families of clients.

SANGRAM - a sustainable response to HIV

It was in this context that SANGRAM began its work in 1992 in Maharashtra, a state in western India. The organization aimed to create a sustainable response to the HIV pandemic by turning conventional wisdom on its head. Health interventions till then had regarded women in prostitution as victims with little capacity to change anything, let alone their health status. HIV programmes based on this approach naturally treated women in prostitution as 'vectors' to be targeted.

SANGRAM - which means 'armed struggle' - saw the women a little differently: as human beings. Below the gaudy glitter and the struggle for survival was a human being - an individual who could be empowered to change her circumstances and to become an agent of change for herself and her community. Based on this philosophy, SANGRAM embarked on a peer-based condom intervention with sex workers in Sangli, a sugarcane-rich district with the highest incidence of HIV in Maharashtra. Today, more than 10 years later, 120 sex workers distribute 350,000 condoms to 5,000 women in sex work in six districts in two states - one of the largest peer education condom interventions in India.

The concept of sex that SANGRAM promotes is one of 'responsible sex', rather than safe sex. This concept springs from the overall notion of taking responsibility for oneself and one's actions. Responsible sex is a gamut of things that together constitute a way of life. "It is responsibility to yourself that makes you ensure you use a condom every time you have penetrative sex", the women say. Responsible sex is not a moral concept, but a concept that encompasses more human dimensions than safe sex.

Over the years, the peer-based HIV intervention has resulted in the formation of two registered collectives of sex workers, called Veshya AIDS Muquabla Parishad or VAMP.

These collectives grew out of the need to fight against the stigmatisation of prostitution per se - and to support women in their struggle to realize their rights. While the VAMP collectives rely on self-organization to empower sex workers, these collectives need training and capacity building to strengthen themselves to face the hostile atmosphere of the mainstream. SANGRAM strengthens these collectives through continuous systematic discourse, training workshops and information dissemination on a range of subjects including the correct approach, human rights perspectives and practical strategies to combat violence.

While condoms are still not used in all sexual encounters - e.g. police, lovers, pimps, and persons with power in the community do not use condoms - there has been a gradual shift in behaviour. But the condom distribution program and the collectivisation of women have had a broader impact in terms of HIV prevention. Enforcing condom use with a client means explaining why he must wear the condom. This creates a chain of information, a chain that is vital to prevent the spread of HIV. In this sense, women in prostitution have become a group that is not just creating theoretical awareness about AIDS, but is enforcing preventive measures in practice. The peers are changing sexual behaviour right there and then.

Absence of rights - a major obstacle to improving the health of sex workers

Stigmatisation, which has its roots in the standards set by patriarchal morality, is experienced as the major factor that keeps women from accessing their rights - and this impacts the lives of women in more ways than one. Although women in sex work and prostitution are women and citizens, they do not enjoy the same rights as other women or citizens of India. Some of the rights denied to women - due to discrimination - are the right to education and information, health, medical care, social security and social services, housing, freedom from physical and mental abuse among others.

The absence of rights has particularly severe consequences in the context of HIV. Women in sex work are denied adequate medical care, sex workers face police violence while distributing condoms, and HIV-positive women in sex work are sometimes not even given the right to die in dignity.

No right to health and medical care

Accessing health care is a major concern for all women in prostitution and sex work. While the `immoral whore' image makes it difficult to get good medical treatment the illiteracy, ignorance and fear of the medical establishment makes the women vulnerable to exploitation and extortion. Reproduced here are some of the women's responses regarding health care:

  1. The medical and paramedical personnel at public hospitals have a callous, indifferent and often humiliating attitude to them.
  2. Medical personnel often ask sex workers about sexual positions, the client's enjoyment and other irrelevant questions that are embarrassing.
  3. Doctors and social workers force the women to have free sex with them.
  4. Doctors often refuse to treat and admit sex workers, saying they are AIDS carriers.
  5. In many hospitals, doctors depute subordinates and attendants to do the physical examination - and then treat the women.

In this context, sex workers typically shy away from medical treatment - which results in further declines in the health status, including HIV status.

No right to freedom from violence

Sex workers have always faced violence from the police, but police violence has intensified in the context of HIV. Human Rights Watch has documented how police in India have beaten peer educators, claimed without basis that HIV/AIDS outreach work promotes prostitution, and brought trumped-up criminal charges against HIV/AIDS workers. Police extort money and sex from these workers, placing them at risk of contracting HIV. The very possession of condoms - a key tool in the work of peer educators - is enough to trigger police harassment.

Against All Odds

SANGRAM's peer-based HIV intervention has been severely affected by public and police violence. In February 2002, local politicians tried to stop SANGRAM's HIV/AIDS meetings in the village of Nippani. The women refused to stop the meetings. They were then threatened and subjected to violence. One woman, Shabana, complained to the police and asked for protection. The police inspector refused to file her complaint, verbally abused her, and even threatened to rape her.

Since then, sex workers have launched an ongoing struggle to secure justice - holding meetings with politicians, marching on the streets, protesting outside police stations. But a year and a half later, the policeman who threatened to rape a sex worker is still in power, while 30 women in sex work have been forced to flee from their houses. How can an HIV intervention flourish in a context where a woman in sex work has no right to justice - like any other woman?

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