Recognizing and protecting the civil rights, working conditions and opportunities of vulnerable and marginalized groups is an essential element of tackling the HIV/AIDS epidemic. Minority sub-groups of society are generally the most affected by the spread of the HIV virus such as Lesbian Gay Bisexual Transgender and Intersex (LGBTI) people, drug users and sex workers. They also tend to be the most disenfranchised and stigmatized segment of the population. This discrimination stems from a particularly religious and morally based development of U.S. policymaking in the last twenty years. Religion and the institutional power of the Church have played a pivotal role in pervading morals and values that influence how these marginalized groups are perceived. As a result, sex work has long been considered blasphemous and unsuited as a profession.
The result is that U.S. policy and foreign aid programs express a moral justification in restricting funding to sex worker related NGOs and unions: “You have a fundamentalist religious ideology that’s governing the way we spend money on prevention and access to prevention information and technologies like condoms and training for negotiation of safer sex and such” stated Jodi Jacobsen, Former Executive Director for the Center for Health and Gender Equity at Pepfwarwatch.org.
In January 2003, President George W. Bush announced the implementation of his Emergency Plan for AIDS Relief (PEPFAR), and the appropriation of $15 billion dollars for programs to combat the global HIV/AIDS epidemic. Included in this Plan was the “Anti-Prostitution Loyalty Oath” (APLO) policy that required all its foreign and U.S.-based NGOs and grantees to oppose prostitution and sex trafficking in order to receive AIDS funding. As a result, Brazil turned down 40 million U.S. dollars in aid. This funding mechanism undermines access to HIV/AIDS information, prevention and treatment for sex workers. Evidently, any sex worker-affiliated NGO or organization is seeing its support system slowly weaken. With stunted grants or funds, drop-in centers and condom distribution numbers decrease, especially for this sub-group.
The Open Society Institute (OSI) believes that the anti-prostitution pledge raises a question of constitutionality. Indeed, is it constitutionally verifiable for a private organization (locally or internationally-based) to be forced to comply with the American government’s legal position on a cross-national issue like HIV/AIDS? The Center for Health and Gender Equity (CHANGE) expressed that “such funding restrictions follow other similar- and increasing- efforts to force organizations working in public health to comply with ideological litmus tests that often run counter to both public health practice and human rights standards” .
The international significance of such discriminatory policies was exemplified at the 2012 International AIDS Conference in Washington, D.C. that took place July 22 -25. While President Obama lifted the travel ban on HIV-infected people in 2009, current U.S. immigration policy, in accordance with U.S. “moral turpitude” laws, denies visa acquirement to anyone with a history of drug use or sex work in the last ten years. Therefore, faced with these conditions, many sex workers were not able to attend the conference. In reaction to this policy, approximately 1,000 demonstrators marched to the White House during the conference, in support of sex workers and LGBTI rights, and U.S. HIV policy reform.
The International AIDS Conference is meant to be a safe space for all people with HIV/AIDS, regardless of race, gender, sexual orientation or occupation. Michael Sidibe, the Executive Director of UNAIDS, was shocked that sex worker organizations could not have a real presence at the IAC. During the Human Rights and HIV/AIDS: Now More Than Ever campaign, he shared his disappointment in a blog post: “it is outrageous that in 2012, when we have everything to beat this epidemic, we still have to fight prejudice, stigma, discrimination, exclusion, and criminalization.” It is tragically ironic that the people who usually fall victim to HIV/AIDS are prevented from attending the conference.
U.S. policy on “prostitution” reflects a problematic conflation of terms: “sex trafficking” and “sex work” are increasingly confused in political rhetoric and legal discourse. A chosen professional occupation is very different from sexual exploitation. Subsequently, sex workers are not only at increased risk of HIV infection, but also of persisting police violence and social exclusion.
According to the United Nations Population Fund, every 12 seconds another person contracts HIV and every 16 seconds another person dies from AIDS. How do U.S. policymakers and health experts allow for these numbers? And how do they explain the fact that close to 40 million people are living with HIV but only 8 million people are being treated? We can reasonably deduce that antiretroviral treatment being widely inaccessible in developing countries and unaffordable to Americans that don’t have health insurance, are conceivable reasons for this enormous gap in treatment. But also significant in this equation, is the stigmatization of vulnerable groups in AIDS funding and in U.S. policy and legislation.
Sex workers deserve to be publicly accepted and to live in a non-judgmental environment. The spread of HIV/AIDS will be slowed hugely if morally backed and institutional discrimination of sex workers is put to an end, and if sex work is finally considered as a regular, viable profession.
