Switch On Your HIV Smarts.

Advocates Voices: Solidarity with Sex Workers—On the Agenda or Under the Bus?

, by Anna Forbes and Audacia Ray

The Supreme Court today deemed unconstitutional a policy requirement that had for years put HIV-prevention programs in an untenable position: Accept desperately needed federal funds but adopt an agency policy explicitly opposing prostitution (thus joining in the stigmatization of one of the world’s most vulnerable populations), or refuse to create such a policy, lose the funding, and struggle to keep the lights on and the doors open.

While the ruling is a partial victory for sex workers and their allies—the decision applies to U.S.-based organizations only—it does draw much-needed attention to the marginalization and mistreatment of sex workers, and builds momentum for a wave of advocacy that HIV prevention and sex workers’ rights supporters initiated almost exactly one year ago, in Washington, DC, in July 2012.

On one hand, the 2012 International AIDS Conference (IAC)—with its massive Global Village, plush acres of exhibit hall booths, and plenary panels featuring both community activists and multinational funders—seemed light years away from 1990 IAC hosted by the United States. At its heart, however, it was politically compromised in a way that seemed all too familiar.

In 1990, the U.S. government chose not to issue waivers to allow HIV-positive conference participants to enter the country. Instead, U.S. border guards searched travellers’ luggage and turned away those carrying the HIV drug AZT. Hundreds of U.S.-based organizations boycotted the conference. The halls arranged for poster presentations were pock-marked with blank spaces or messages from authors who, instead of proudly displaying their work, urged viewers to “recognize that vitally needed voices have been silenced because the conference was not relocated.”

At the IAC 2012 opening session last July, IAC President Elly Katabira told participants that “[w]e must resolve together never to go backwards.” Yet, in a way, we had gone backwards, as all conference attendees coming into the country were required to answer these questions on their visa applications:

  1. Are you or have you ever been a drug abuser or drug addict?
  2. Are you coming to the United States to engage in prostitution or unlawful commercialized vice or have you been engaged in prostitution or procuring prostitutes within the past 10 years?

Answering “yes” to either of these questions had multiple implications, none of them good. It might well mean the visa would be denied. Even if the visa were granted, it might mean that the answers became part of the applicant’s permanent record, which could affect future travel and/or have consequences when the applicant went home. The U.S. could not guarantee that the information would not be available to the country of origin, where it could permanently label the applicant as a sex worker or drug user—a label that could trigger severe persecution or death.

Why didn’t sex workers and drug users just lie on their visa applications? Why is this a big deal? It’s a big deal because lying on a visa application is illegal, with a ten-year blacklisting penalty for those who are caught. And how willing would you be as to talk openly about the realities of being a sex worker and/or drug user in conference sessions if you had lied on your visa to get there? But mostly it is a big deal because people shouldn’t have to lie. Sex work is work. Typists rent out their hands. Furniture movers rent out their muscles. Massage therapists deliver pleasure by touching people’s bodies. Actors give pleasure by creating fantasies. Why is engaging in consensual, commercial sex not legitimate work? And if it is, why should people have to lie about it?

By paying a $545 fee and waiting approximately 120 days for temporary waiver processing, individuals denied visas could apply for a “waiver of grounds of inadmissibility,” which, if approved, would allow admission into the U.S. But procuring one required substantial cash and travel to one’s U.S. embassy to petition in person for a special exception. This was not only geographically and economically out of reach for many of the affected people, but also put them at risk of violence should they be asked to reveal why they needed to request a special visa.

Successful scholarship applicants learned of their acceptance in April 2012. Sex worker and drug-using scholarship applicants, therefore, had to start their visa application process  before they even knew if they would receive the funding they needed to attend. If they waited for the notification, they would be left with insufficient time to get through the visa application, rejection, and individual waiver application process in advance of the conference, even if they could afford the time and expense of undertaking it. Consequently, the only people realistically helped by the individual waiver process were those who started their visa application process at least six months in advance and who had the time and resources to pursue its complexities.

A working group assembled by the conference organizers to deal with this problem asked U.S. government officials to issue a blanket waiver for all IAC 2012 conference participants denied visas—as they did in 2008 to enable people living with HIV to attend the UN High-Level Meeting on HIV/AIDS in New York when the HIV travel ban was still in effect. The government declined to do this and insisted that every visa application be considered individually. Neither was the U.S. government willing to pursue other arrangements (as was done for the Mexico City IAC in 2008) to ensure that the questions did not bar people in these key populations from attending the IAC.

Working Together to Create Solutions

In 2010, the U.S. HIV-specific travel ban was lifted. Most of the U.S.-based “AIDS world” (advocates, activists, HIV service providers, researchers, public health experts, etc.) expressed elation when the International AIDS Society (IAS, organizer of the bi-annual IAC) announced Washington, DC, as the 2012 conference venue. At last, delegates living with HIV could be welcomed into the country. The fact that international sex workers and drug users were not welcome slipped by.

When the 2012 conference location was announced in Vienna at IAC 2010, there was some immediate outcry visible within the conference. Meena Seshu delivered the Jonathan Mann Memorial Lecture at a 2010 IAC plenary. An Indian activist and founder of SANGRAM (a women’s rights organization that partners with VAMP, a collective run by and for sex workers), Seshu expressed appreciation for the reversal of America’s HIV travel ban, and then called on advocates and scientists to refuse to participate in a 2012 conference unless sex workers and drug users could attend without risk—pointing out that it is unethical to debate AIDS policy decisions while excluding the people most impacted by those decisions.

Immediately after the announcement, over 100 groups signed a letter to IAS asking them to change the conference venue. After that request was declined, however, Seshu’s boycott call went essentially unheeded.

When planning for IAC 2012 began in earnest in the fall of 2010, the Global Network of Sex Work Projects and its member organizations demanded a change of venue for the conference. The IAS rejected this demand and countered with a proposal to provide special visas for drug users and sex workers to enter the country for the conference (through the process described above). IAS also funded a “Sex Workers Freedom Festival”—referred to as a conference “hub”—in Kolkata, India, that ran concurrently with the Washington conference and was hosted and organized by the Global Network of Sex Work Projects and two major Indian sex workers’ networks. IAS similarly sponsored a pre-conference consultation in Kiev organized by the Eurasian Harm Reduction Network (EHRN) and the International HIV/AIDS Alliance in Ukraine for “people living with HIV, people who use drugs, and representatives of other key affected populations.” Both events were accredited as official IAC hubs—a strategy viewed by some as a “separate but equal” solution.

At the same time, about 25 sex workers, drug users, and allies from the United States gathered in Washington, DC, at the official IAC event. A handful of international activists, mostly from the North American and Caribbean regions risked being turned away at the U.S. border to attend the conference in Washington. Some were turned away, but those who made it, with their domestic colleagues, participated in panels both in the main conference and the Global Village and ran the Sex Workers Networking Zone inside the Global Village.

The Sex Workers’ Freedom Festival (SWFF) attracted 550 participants from 46 countries and was linked digitally to the Washington, DC, conference center so that, in theory, presentations and sessions could be streamed in both directions. Unfortunately, the 9.5 hour time difference between regions required participants to stay very late or arrive early see each other in real time. Due to chronic technical glitches, the sound transmission was also either frequently garbled or non-existent, ironically making the sex workers in Kolkata literally seen but not heard.

Although attendees did valuable organizing at their respective hubs, they were outraged and disappointed that other activists in the AIDS world had not fought their exclusion harder. This came across in videos from the Kiev and Kolkata meetings that were sent to Living 2012, a pre-conference Positive Leadership Summit hosted in Washington by the IAS, the Global Network of People Living with HIV, the International Community of Women Living with HIV, and other allies. In these videos, representatives from the two hubs speak directly to their colleagues, asking them to convey messages to the Washington conference participants from those unable to attend IAC 2012.

In the SWFF video, Andrew Hunter, President of the Asian Pacific Network of Sex Work Projects, said, “Sex workers are gathering here in Kolkata, India, because we are not allowed into the United States for the AIDS conference. India produces most of the world’s generic ARV medicines…sex workers have formed part of the largely Asian movement that keeps those drugs coming for the rest of the world. What we need is for the [HIV] positive movements globally to show solidarity with sex workers in return for what we are doing to keep the generic drug pipeline open for positive people the world over.”

Unfortunately, the video was not aired in plenaries during the main conference.

In 1990, television made it possible for activists to say “the whole world is watching” when political events occurred. By 2012, the whole world was not only watching events but also discussing them publicly and in real time via Twitter, a format that is inevitably more democratic than broadcast television. The unease that some conference participants felt from the outset about the exclusion of sex workers and drug users is documented in their IAC tweets:

  • Russian activist Alexandra Volgina wrote in connection with applying for her visa, “Would it be easier if I lied?”
  • An unidentified source tweeting under the International Planned Parenthood Federation handle wrote: “Sex workers: excluded from #AIDS2012. How unprogressive is that?!”
  • Jon Cohen, deputy director of the Open Society Public Health Program, wrote: “Sometimes we live in denial pretending that #sexworkers do not exist. This is wrong.”

Growing Awareness

In March 2012, a Johns Hopkins study of nearly 10,000 sex workers in 50 low- and middle-income countries showed that the HIV risk and disease burden among them was disproportionately high—14 times higher than among the general female population in those countries. A Lancet commentary on this study attributed this to “structural conditions that increase risk of HIV and prevent engagement in interventions among female sex workers, including criminalised legal and policy environments, violence, stigma, and restrictive funding policies.”

On the heels of this breakthrough meta-analysis, the United Nations Global Commission on HIV and the Law issued a report, HIV and the Law: Risks, Rights & Health, in which 116 countries are reported to have laws that effectively deny sex workers any legal protection from assault, theft, compulsory medical examinations and other abuses. This makes HIV prevention and care services harder for sex workers to access. Thus, the report concludes, “[c]riminalization, in collusion with social stigma, makes sex workers’ lives more unstable, less safe, and far riskier in terms of HIV.”

Both the Hopkins study and the Global Commission’s report were presented several times throughout the conference, drawing attention to the absence of foreign sex workers and drug users. Awareness escalated slowly, however, because most of those dedicated to raising it were among the excluded. At the 2008 IAC in Mexico City, the collective impact of about 3,000 out, loud, and proud sex workers’ rights advocates was unmissable. Their visibility was even higher at the 2010 IAC in Vienna, where the Sex Workers Networking Zone was a gorgeously decorated hub of frenetic advocacy activity, learning, and networking.

But in Washington, only about two dozen sex worker advocates struggled day and night in close collaboration with the harm reductionists to achieve visibility in a crowd of almost 24,000 conference participants. They worked with determination and creativity, interrupting numerous sessions—starting with the opening press conference—with loud protests and masses of red umbrellas, the signature of sex workers’ rights movement. White stickers appeared on surfaces throughout the conference that read, “Where are all the sex workers? Not at IAC 2012.” And conference participants could be seen wearing green Statue of Liberty-style crowns that read, “Drug User? Visa Denied!” or “Sex Worker? Visa Denied!”

On Sunday, the opening night of the conference, Zimbabwean activist Annah Sango called on President Obama during her plenary speech to lift the travel ban on sex workers and drug users. She received a little scattered applause.

On Monday, none of the plenary speakers who followed Ms. Sango lead by speaking out against the “other” travel ban. U.S. Secretary of State Hillary Clinton made no mention of the exclusion of sex workers and drug users but said that, “[w]e can’t afford to avoid sensitive conversations and we can’t fail to reach those who are at highest risk” if we are to achieve the goal of an “AIDS-free generation.”

Tuesday featured the massive Human Rights March, about which one reporter wrote, “[a] thousand people—sex workers, drug users and AIDS activists—marched towards the White House carrying red umbrellas to protest the stigma associated with drug use and prostitution, a stigma that makes these two groups (sex workers and intravenous drug users) the two highest HIV risk groups in the world.”

On Wednesday, sex worker and harm reduction advocates interrupted a session on “The United States Congress and the Global AIDS Epidemic” with chants of “Repeal the Pledge, reform PEPFAR” and “Sex workers rights are human rights.” When things quieted down, Congresswoman Barbara Lee of California, a member of the panel, spoke about the Ending the HIV/AIDS Epidemic Act of 2012, legislation she introduced in Congress that, had it passed, would have repealed the PEPFAR Anti-Prostitution Pledge and made a host of other progressive changes in the U.S. AIDS response. The protest generated added media coverage for the session that, in turn, expanded the visibility of Lee’s remarks.

By Thursday (the last full day of the conference), awareness and public acknowledgement of the exclusion had increased substantially. In Thursday’s plenary, Cheryl Overs, founder of the Global Network of Sex Work Projects, pointed out the irony of the conference theme—“Turning the Tide Together”—and noted that the exclusion of her community “contravenes everything that is being said here about human rights.” Overs challenged organizations and funders responding to HIV/AIDS to engage authentically with sex workers by hiring them in meaningful (not token) capacities and channelling significant resources directly to sex worker organizations.

Debbie McMillan, the first openly transgender woman to be a plenary speaker at an IAC, described her lived experience of homelessness, drug use, and sex work as having “virtually guaranteed” that she would contract HIV. She pointed out that “[w]hen people like me are included in the design of policy and programming, these programs are much more successful. They are much less so when we are not consulted.”

Finally, at the closing ceremony on Friday, open outrage was expressed by a few plenary speakers. Ian McKnight of the Caribbean Vulnerable Communities Coalition referred to the exclusion of sex workers and drug users as “an abomination,” adding that “organizing hubs is a nice gesture, but we needed their voices and their issues here with us at this conference. These half-baked attempts at including people who use drugs and sex workers is tokenistic and it must stop now.”

Lauringo Garcia from B-Change in the Philippines started his remarks by noting that “[a]rchaic travel restrictions have prevented international advocates for sex workers and people who use drugs from sharing the stage with me now.” President Bill Clinton even chimed in, condemning stigma, “against men who have sex with men, against sex workers, against people who are drug users, where this is not treated enough as a public health problem.”

It felt as though we had finally—after five long days—reached the point of collectively acknowledging the fundamental human rights violation that had excluded the essential participation of sex workers in IAC 2012. Unfortunately, the events toward the end of the conference were nowhere near as well-attended and covered by media as those events at the beginning of the week, so awareness of this transition was diminished or lost altogether for many participants.

Moving Forward: The Work Ahead

In the future, how will we stand together with all heavily impacted populations and insist on universal application of the “nothing about us without us” principle?

Darby Hickey, a sex worker and transgender rights activist, wrote after the conference that, “[w]hile we critique the US for its flawed immigration laws or the IAS and conference partners for deciding to hold the conference in DC despite the barriers to sex workers and drug users, we are not off the hook…we must interrogate the common practice within the AIDS world of hiring or paying people from key communities (transgender, formerly incarcerated, youth, and so on) to give input only on ‘their issues.’ Sex workers have insight into policy issues beyond criminalization of sexual exchange. Transgender people can write grants and run programs. People who use drugs can develop evaluation models and plan campaigns—including those not directly related to drug use, believe it or not.”

So how do we take this message home? Perhaps we start by heeding Debbie McMillan’s observation that policies and programming are most successful when designed by and with those to whom they will apply and Darby Hickey’s reminder that hiring and paying people for their work is a basic hallmark of respect and solidarity.

The “AIDS world”—and particularly the direct service and advocacy organizations—can also reach out and work collaboratively with sex workers’ rights organizations. But well-meaning ally organizations must also be respectful of the capacity of sex worker–led organizations, many of which operate on a much smaller scale than more mainstream AIDS service organizations. The small and sometimes informal nature of sex worker organizations makes them nimble and able to react quickly; however, it also means that they often have few (if any) paid employees. It is important that larger organizations interested in working with them as allies conscientiously make space for sex workers to be heard and be leaders, and support sex workers in gaining leadership skills so they can be at the table in the fullest capacity possible.

Harm reduction communities have modelled that this type of collaboration is possible. In the 1990s, the formation of the U.S. of Ryan White Planning Councils and CDC Prevention Planning Groups got AIDS service organizations led by and serving primarily gay white men working side by side with organizations serving drug users and those focused on women and children. It took serious adjustment but, eventually, some powerful joint advocacy was generated at these interfaces. By 2010, strong consensus in the AIDS world about the value of harm reduction gave rise to the “Vienna Declaration,” through which tens of thousands of endorsers have called collectively on their governments to support syringe exchange, implement opioid substitution therapy, and enact “drug policy reform to remove barriers to effective HIV prevention, treatment and care.”

Inspired by this precedent, sex workers’ rights advocates in the U.S. wrote the Call to Change U.S. Policy on Sex Work and HIV to urge 2012 IAC attendees and other supporters to express solidarity with sex workers and speak out for their human rights and HIV prevention needs (which are currently addressed with less than 1% of HIV prevention funding globally). The Call demands that the U.S. government:

  • Eliminate restrictions placed on domestic and global AIDS funds (such as the PEPFAR’s Anti-Prostitution Loyalty Oath) and invest, instead, in evidence-based HIV prevention, treatment, and care targeted to sex workers.
  • Stop law enforcement from interfering with HIV prevention efforts via immigration restrictions, criminalizing HIV transmission, and allowing police to confiscate condoms and use possession of them as evidence of intent to do sex work.
  • Stop arresting sex workers, detaining them, forcibly testing them for HIV, and subjecting them to mandatory “rehabilitation” programs. Instead, train law enforcement officials to adhere to legal and human rights standards.
  • Reorient anti-trafficking campaigns to conform to the standards set by the UN and engage sex workers themselves in the work of ending exploitation in the sex work sector.

Fix Federal Funding

The real obstacles that necessitate these demands were illustrated throughout the 2012 IAC. At a July 25 session, Miriam Edwards from Guyana described her organization, One Love, which used peer education, community mobilization, and economic empowerment activities to reduce HIV transmission among sex workers. In Guyana, the overall HIV prevalence rate among adults is 1% according to UNAIDS data, but the rate among sex workers is 16%. One Love was dissolved in 2011, Edwards said, when U.S. government officials told the leaders that they had to either sign the PEPFAR anti-prostitution oath or repay the money they had received from PEPFAR.

On April 22, 2013, the Supreme Court heard arguments on both sides in United States Agency for International Development v. Alliance for Open Society International et al.—a case challenging the constitutionality of the Anti-Prostitution Loyalty Oath. The plaintiffs’ challenge contended that the oath violates PEPFAR grantees’ freedom of speech and imposes a level of control exceeding what can reasonably be associated with program oversight. The American Civil Liberties Union, in its amicus brief (a document supporting the plaintiffs’ case), added that the oath effectively acts as a screening device, disqualifying organizations that are fully capable of doing the funded work.

In a landmark decision on June 20, 2013, the Supreme Court ruled the oath unconstitutional. “The Policy Requirement [the Anti-Prostitution Loyalty Oath] violates the First Amendment by com­pelling as a condition of federal funding the affirmation of a belief that by its nature cannot be confined within the scope of the Gov­ernment program,” states the court’s decision. Taking the oath was not something grantees could do passively. To be eligible for PEPFAR funding, they were required to write and adopt their own agency policy explicitly condemning  prostitution, and thus go on record as stigmatizing sex workers. The Supreme Court decision ruled this as tantamount to requiring funding recipients “to pledge al­legiance to the Government’s policy of eradicating prostitution. That condition on funding violates the First Amendment.”

The Supreme Court’s decision removes an unjust barrier that, as Congresswoman Barbara Lee said in a press release, “is counterproductive to the effective work that many HIV and public health organizations are performing.” What are the on-the-ground implications of this major change to PEPFAR? U.S.-based organizations will no longer be required to adopt the oath in order to receive federal money, but it remains to be see whether this change will also apply to international organizations that accept PEPFAR funds. Advocates still have a role to play in eliminating the oath as a condition for funding organizations based overseas.

Ditch Condoms as Evidence

Just three months prior to the 2012 IAC, the PROS Network, a New York–based coalition of sex workers, organizers, and service providers, in collaboration with the Sex Workers Project at the Urban Justice Center, released a report titled Public Health Crisis: The Impact of Using Condoms as Evidence of Prostitution in New York City. This study documents the experiences of people in the sex trade and those profiled as sex workers (a common experience for transgender women) with police within the New York Police Department (NYPD), which uses possession of multiple condoms as “evidence” of an individual’s intention to sell sex. The PROS survey revealed that fear of police harassment and arrest discourages some people from carrying as many condoms as they need, thus undermining HIV prevention efforts.

Significantly more attention was drawn to this issue when Human Rights Watch released a report titled “Sex Workers at Risk: Condoms as Evidence of Prostitution in Four US Cities” in July 2012. With data from hundreds of current and former sex workers and transgender women in New York, Los Angeles, San Francisco and Washington, DC, it also documented police harassment, threats, and arrests in which condom possession was used as evidence of criminal activity. These were corroborated by the outreach workers, police, and prosecutors also interviewed. Such practices have also been documented in a July 2012 report by the Open Society Institute, which described incidences of condoms being used as evidence of prostitution and police confiscating and destroying condoms carried by sex workers in several African counties, Russia, and other areas of high HIV incidence.

In April 2013, Human Rights Watch announced these practices were being modified or eliminated in the four target cities as a result of advocacy pressure. The Washington, DC, Police Department has issued a “Know Your Rights” card assuring all citizens that they will not be stopped for condom possession. The District Attorney for Nassau County, New York, has announced that county prosecutors will no longer use condoms as evidence, as did the San Francisco Police Department. Los Angeles Police Department is considering similar action, and a bill (AB 336) prohibiting the practice statewide has been introduced in the California state legislature.  The actual impact and enforcement of these positive developments remains to be seen.

Decriminalize Sex Work—and Distinguish it from Human Trafficking

At a July 24 symposium on the Global Commission on HIV and the Law report cited above, J.V.R. Prasada Rao, the UN’s Special Envoy for AIDS in the Asia-Pacific Region, discussed the Commission’s critical emphasis on “ending police violence and ensuring access to supportive harm reduction services.” The GCHL report also calls for the decriminalization of sex work and states explicitly that, “[s]ex work and sex trafficking are not the same. The difference is that the former is consensual whereas the latter is coercive.” This distinction, rooted in human and labor rights, maintains that trafficking is criminal and voluntary sex work is work.

Noi Apisuk, a Thai leader on sex workers’ rights, noted in another conference session that, where sex work is criminalized, “our boss is automatically considered a crime boss and our workplace is not a workplace, it is a crime scene. Problems at workplace end up at criminal court, not labor court.” Moving sex work (as distinct from trafficking) into a labor context, as some countries have done, allows for a rights-based framework in which employees can negotiate working conditions with their employers or be self-employed without state harassment.

The most powerful moment in this session was triggered by a question from a Thai sex worker at the Kolkata hub where the local time was 10 PM. Fortunately, the streaming video link was functional at that moment. Alice Ouédraogo of the International Labour Organization (ILO, the UN agency that drafts and oversees international labor standards), had just reported that a standard adopted by the ILO’s 185 member countries applies to all women and men “under all forms or arrangements, and at all workplaces,” including sex workers. The questioner on the screen asked if she had heard Alice correctly. “Did you say sex work is work? We’re not clear if we heard you correctly. We are proud of the work we do.” Ouédraogo replied, “I did say sex work is an economic activity—it is work. ILO is there to support efforts of sex workers and their organizations.” And cheering broke out in Kolkata.

What Can Advocates Do?

The Call to Change U.S. Policy on Sex Work and HIV is still open to individual and organizational endorsements. Its central premise is that evidence-based best practices and human rights principles must inform the global response to AIDS—not bigotry and the politics of coercive “morality.” It has been endorsed to date by most of the large national HIV/AIDS-focused organizations, as well as some of the leading researchers, activists, and human rights strategists in the AIDS World internationally. But many more endorsers are needed if we are to make our government understand that our fight is not to stop the spread of HIV and uphold human rights for some of us, but for all of us.

Allies of the sex workers’ rights movement can also take action by demanding that sex workers be included in discussions addressing sex work issues. How many Ryan White Planning Councils or CDC Prevention Planning Groups have self-identified sex workers at the table? Yet discussions of sex workers’ HIV risk and roles in confronting the epidemic is part of the agenda (or certainly should be, if it isn’t). Would it be acceptable to discuss HIV among gay men, or women, or people of color with no gay men, or women, or people of color at the table? Obviously not. So how is it OK for sex workers to be absent?

Raising this question—and refusing to let it go when people don’t immediately see its validity—is essential for allies for two reasons. The first is that it is often safer for allies to raise this. There may well be people at your policy and planning tables who have life experience as sex workers but who do not feel comfortable acknowledging that in such settings. The “nothing about us without us” principle must be defended by allies of the affected group, as well as by group members themselves. And those who are not stigmatized have a particular obligation to use their privilege to confront and dismantle exclusion where it exists.

The second reason is that allies, acting in solidarity with sex workers, have the power to bring the process to a halt by refusing to participate until there is meaningful sex worker representation. Imagine what would happen if a whole PLHIV Caucus or Consumer Caucus of a Ryan White Planning Council refused to continue with the process until a minimum number of self-identified sex worker representatives were invited to join the council and adequately supported to participate? Work would stop and the demand would have to be recognized. Sure, it’s a daring move. So was demanding the adequate inclusion of PLHIV in the early 1990s. The Councils themselves were set up in 1990 but the federal requirement that 25% of Planning Council members be living with HIV was not added until 1994. Noisy and demanding Planning Council members (HIV-positive people and their allies) made that expansion happen.

Obviously, you can only work with people if you first know how to get in touch with them. You can find a listing of sex workers’ rights organizations at the global Network of Sex Work Projects website. Click on your region and you will see a number of organizations listed on the right side of the page. (They are not sorted by city so you will have to click through them to find the ones nearest you. But it’s a highly educational tour!)

If you do not see an organization in your city or state, ask your local harm reduction organizations to find out who is doing local organizing for sex workers rights. In many cities, it is just starting up and you will meet some remarkable activists whose critical work needs respectful support. The sex workers’ rights movement is growing—with national and international conferences and advocacy actions. They are working to assert their basic rights against profound stigma. Those involved can tell you how best you can help.

Standing in solidarity with sex workers’ rights organizations and building bridges of engagement at local and national levels is essential if we want to walk the walk of ending AIDS for all of us. This means reaching out and starting the conversations needed to identify, strategize around, and engage in joint advocacy to advance the demands we have in common. Endorsing the Call is just a first step. After you take it, become an ally in deed as well as in word by figuring out how to collaborate with your local sex workers’ rights advocates.

The North Carolina Harm Reduction Coalition wrote that they endorsed the Call because, “people in the sex trade have the right to earn a living just like everyone else and to live their lives free from persecution and disease. When HIV/AIDS affects our communities’ most vulnerable people, it affects us all.”

Anna Forbes, a Washington, DC–based writer, organizer, and women’s health activist, has worked in HIV/AIDS continuously since 1985. Now an independent consultant with an international client base, her work centers around women, HIV, health, and rights, with particular focus on the importance of including sex workers’ expertise in HIV prevention efforts.

Audacia Ray is the founder and director of the Red Umbrella Project, a New York–based, peer-led organization that amplifies the voices of people in the sex trades through media, storytelling, and advocacy programs.

Selected Sources

AID v. Alliance for Open Society International 570 U. S. ____ (2013).

Baral, S. and others. Burden of HIV among female sex workers in low-income and middle-income countries: a systematic review and meta-analysis. Lancet Infectious Diseases 12(7):538–49. July 2012.

Cohen, J. 2012 AIDS Conference: criminalized groups need not apply. Human Rights and HIV/AIDS Now More than Ever Blog. July 9, 2012.

HRSA. Training Guide: A Resource for Orienting & Training Planning Council & Consortium Members. March 4, 1997.

International AIDS Society. XIX International AIDS Conference (AIDS 2012) Secretariat announces two off-site conference hubs for sex workers and people who use drugs. Press release. May 10, 2012.

Shannon, K. and J. Montaner. The politics and policies of HIV prevention in sex work. Lancet Infectious Diseases 12(7):500–502. July 2012.

United Nations Development Programme. HIV and the Law: Risks, Rights & Health. July 9, 2012.


3 Responses to Advocates Voices: Solidarity with Sex Workers—On the Agenda or Under the Bus?

  1. Pingback: Expert Q&A: Ernest Hopkins on The Supreme Court’s Anti-Prostitution Pledge Ruling

  2. “There may well be people at your policy and planning tables who have life experience as sex workers but who do not feel comfortable acknowledging that in such settings. The “nothing about us without us” principle must be defended by allies of the affected group, as well as by group members themselves. And those who are not stigmatized have a particular obligation to use their privilege to confront and dismantle exclusion where it exists.”

    First of all, there are many of us prostitutes here in the US of A who are out and actively advocating for ourselves. Why aren’t we ever invited to the ‘table’ in the first place?

    Two, for those who have life experience as sw and want to participate, the way to do that is to guarantee privacy. That mean employ a new standard of respect. That means we must have advocates that stand with us now and demand enactment of anti discrimination laws now to address negative stigma now in housing, education, employment, child custody and financial institutions. This is a priority!

  3. Pingback: HIV/AIDS Policy and Prevention Cannot Succeed if Sex Workers Are Stigmatized | Our Bodies Our Blog