U.S. Continues to Discriminate Against Sex Workers, Deny HIV Prevention Funding

A white sign reads REFORM PEPFAR NOW! in black and pink letters. The sign is held by a single hand and rests against the feet of an otherwise unseen person who sits on the sidewalk.Last Friday, Titania Kumeh wrote an excellent blog post at Mother Jones about the International AIDS Conference in Vienna, and the over 100 sex workers and advocates who protested outside. The protest was about how U.S. funding to fight HIV transmission explicitly and deliberately excludes sex workers, even though they are one of the groups most vulnerable to becoming infected and transmitting the virus to others.

The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) requires that funds do not go to sex workers or those who work with sex workers, and has done so for years. In fact, it recently came up in a post that I wrote about police abuse against sex workers in Cambodia. But while the situation is nothing new, it is discussed far too little, and needs to be highlighted whenever an opportunity presents itself. Because it’s killing people.

Back in 2003, Congress mandated that in order for any group or organization to get US global HIV/AIDS funds, it must have “a policy explicitly opposing prostitution and sex trafficking.” (See: Sex, American Style). The 2008 PEPFAR fact sheet states “prostitution and sex trafficking are abusive and dehumanizing to women, and they fuel the spread of HIV.” It’s not clear whether former-President Bush—who implemented PEPFAR and its anti-prostitution pledge—recognized the difference between sex trafficking and prostitution, spoke to any sex worker-run organizations that combat exploitation, or spoke to groups that seek HIV preventative care and battle sex trafficking. The anti-sex worker, anti-trafficking pledge left sex worker organizations—which incidentally work with one of the most at-risk populations for HIV (PDF)—out in the cold.

“We need HIV treatment but we don’t need the mandate that sex workers are excluded,” says Pisey Ly of Cambodia’s Women’s Network for Unity (WNU), a sex worker advocate organization. When WNU applied for US HIV prevention funds, it was denied and told to drop its sex worker status, Ly says. It refused. “The original idea behind WNU was to be an independent sex worker organization, to provide sex workers with ownership and leadership to speak about the issues that effect their lives,” Ly says. Because of PEPFAR’s anti-prostitution policy, Ly says, many donors and NGOs that once worked with Cambodian sex workers have abandoned them for fear of losing their US funding.

Meanwhile, unprotected intercourse between sex workers and clients is the main cause of new HIV infections in Asia, the Caribbean, and Latin America, according to the US Department of Health and Human Services.

Really, you should go read the whole post. I wholeheartedly mean that — quoting as much of Kumeh’s text as I would like to would genuinely constitute copyright infringement.

What it comes down to though, is this: U.S. policy is not only failing to help sex workers, it’s actively harming them. Through requiring that any group oppose sex work in order to receiving funding, we’re not just failing to provide funding to those who already didn’t have it and leaving them where they started — though when the situation is so dire, that would be unconscionable on its own. No, we’re ensuring that organizations that previously worked with sex workers and trafficking victims, providing them with information, resources, and care that they needed, no longer will. Because they can’t keep working with sex workers and trafficking victims and afford to stay open.

It’s very similar to the Global Gag Rule. It’s probably just as deadly, if not more so. And it deserves every damn bit as much attention from feminists and other people who care about women’s rights and welfare.

The PEPFAR policy is blatantly misogynistic and sex worker-phobic. It makes sense that organizations should be anti-trafficking in order to receive funds — kidnappers and rapists don’t need anymore money than they already have — but it certainly doesn’t make sense to say that organizations can’t even assist trafficking victims as a part of their work, as such victims are usually among those who most need assistance. To further extend anti-trafficking sentiment to anti-sex worker sentiment is to conflate two issues, and obscure them both. And to deny funding and services to sex workers because they are at particular risk for contracting and transmitting HIV is more than counter-intuitive, it’s downright nonsensical. No — it’s malicious.

I would go so far as to say (and do not doubt that I am not the first) that such a denial of funds constitutes a direct act of violence. With a vast majority of sex workers being women, it constitutes an act of misogynistic, gender-based violence. With sex workers also being disproportionately women of color, trans*, and/or non-straight men,  it further constitutes an act of racist, transphobic, and homophobic violence. And when the U.S. has such great financial power over those who are most vulnerable to it, the label of colonialist violence also applies. We know that when sex workers don’t have access to condoms and information about how HIV is transmitted and prevented, they die. And yet, we continue as though we’re not killing them, or as though their deaths do not matter.

I greatly resent the notion that PEPFAR’s anti-sex work rule has anything to do with “protecting” women. The paternalistic notion that sex work is inherently “dehumanizing to women” isn’t based on a concern for women’s health and well-being. If anyone was concerned about that, the rule wouldn’t exist. The rule is about shaming and punishing those women who step outside of society’s bounds, whether through choice or coercion or force, of what a proper woman acts like. The rule is about appeasing the concerns of religious groups and middle-class moralists and generally taking out society’s hateful, misogynistic disgust at sex workers at those who can be harmed the most. It’s about taking power and abusing it in the worst way possible, just because we can.

Just because we can, and because we can simultaneously tell ourselves that by doing so, we’re doing something good.

And until the rules regarding access to U.S. anti-HIV funding are changed, it’s just yet more blood on the nation’s hands.

h/t @audaciaray

0 thoughts on “U.S. Continues to Discriminate Against Sex Workers, Deny HIV Prevention Funding

  1. SunlessNick


    The paternalistic notion that sex work is inherently “dehumanizing to women” isn’t based on a concern for women’s health and well-being.

    Even if you believed that, and were fervently against prostitution, how would it translate into humane policy to leave sex workers to die? (Because that’s absolutely what this policy does). How can this be considered protection?

  2. Kali

    It’s also classist. Prostitution is far more common among people who are struggling to get by than it is among the elites.


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