Nothing illustrates the continued tensions between science and morality than the opening of the XIX International AIDS Conference and the US announcing it would embark on a “significant expansion of the war on drugs” in Africa.
Secretary of State Hillary Clinton addressed the Conference promising “a generation that is free of AIDS.” She wasn’t making a pie in the sky promise — until a vaccine or cure, HIV transmission will remain a global problem — but she did promise access to treatment that would prevent infections from progressing into AIDS.
But on the same day that 20,000 scientists, public health officials, activists, and journalists gathered at the AIDS conference, the New York Times reported that “The growing American involvement in Africa follows an earlier escalation of antidrug efforts in Central America.”
America’s dual policies of harsh enforcement and public health measures called harm reduction were seen in other ways.
Sex workers were barred from the conference by US immigration policy. They held an alternative meeting in India — The Sex Worker Freedom Festival — in Kolkata (formerly Calcutta), the home of the largest sex worker union in the world. The 65,000 sex workers in the Durbar Mahila Samanwaya Committee have received funds from the Bill and Melinda Gates Foundation, which also funded efforts to replicate the model in six other Indian states. Collectivization is regarded as an important public health tool; HIV rates among sex workers in Kolkata are drastically lower than in Bombay, where collectivization has not occurred.
Michele Sidibe, the executive director of UNAIDS, said he was “extremely inspired” by the “Freedom Festival” as “it is a wonderful example of people who face stigma and discrimination speaking out and taking control of their own destinies."
With a growing clarity UN health officials are saying that legal discrimination harms AIDS prevention by preventing drug users, sex workers, and men who have sex with men from receiving accurate and empowering advice. Criminalization means reduced use of condoms and higher infection rates. This evidence is moving the international AIDS movement in a radical direction.
The Global Commission on HIV and the Law, which was supported by the United Nations Development Program, issued unambiguous recommendations to the AIDS conference. They rejected the claim that prostitutes are victims of sex traffickers. After warning that “nations have squandered the potential of the legal system,” they conclude that “punitive laws, discriminatory and brutal policing and denial of access to justice are fueling the epidemic. These legal practices create and punish vulnerability.” The commission called for an end to criminal sanctions against sex work and the end of mandatory testing for HIV and sexually transmitted infections.
Drug users are also at risk. The global commission was dismissive of zero tolerance goals, recommending that law makers “decriminalise the possession of drugs for personal use, in recognition that the net impact of such sanctions is often harmful for society.”
Other policing practices in high-income nations must be reformed as well. “Anti-human-trafficking laws must be used to prohibit sexual exploitation and they must not be used against adults involved in consensual sex work.” The commission called for enforcement of laws against child abuse while “clearly differentiating such crimes from consensual adult sex work.” The report methodically dismantles the justification for policing practices put forward in cities like New York, Washington, D.C., and New Orleans. The commission calls for change so that, “Existing civil and administrative offences such as ‘loitering without purpose,’ ‘public nuisance,’ and ‘public morality’ are not used to penalise sex workers and administrative laws such as ‘move on’ powers are not used to harass sex workers.”
New Yorkers would do well to consider the commission’s recommendation, as community groups like the LGBTQ youth organization Streetwise and Safe have documented the intersection of stop-and-frisk with the profiling of transgender women as sex workers and the confiscation of condoms as evidence in prostitution prosecutions.
Globally, the commission’s recommendations are a significant defeat for coalitions who call all prostitution sex trafficking and assume public revulsion will lead to behavioral changes that will abolish prostitution. Advocates from many nations expressed growing fear of the anti-trafficking movement and its “raid and rescue” missions to save benighted sex workers. In Uganda, already under fire for considering the death penalty against homosexuals, an anti-prostitution drive is humiliating sex workers and trumping up charges to arrest them and their advocates. Kyomya Macklean, a human rights defender and former Ugandan sex worker, says the anti-trafficking movement and US restrictions on its foreign aid foster this anti-prostitution campaign and “rescue missions” focused on prostitutes are becoming a new burden.
The model for the anti-trafficking coalition is Sweden, which made prostitution legal and johns buying sex a finable offense. The anti-prostitute nature of the law is apparent, says Pye Jakobsson of the Rose Alliance. Jakobsson is a sex worker and staunch critic of the 1999 law. It’s sham legalization; the premise is that all prostitution is men perpetrating violence against women. This model is adopted by the health care system. The cult of the rescue of the victims leads to the denial of services to sex workers who won’t stop because they are “suffering from false consciousness or need psychological help because of their failure to realize that sex work is self-harm.” In this way, the helping professions are made to serve conformity and overcome the free choices of adults.
The perspective offered by the global commission shows the gap between conventional morality and the scientific evidence that overcoming stigmatization and gaining hope and a sense of empowerment are needed for real behavioral change. And this can only occur when a person voluntarily undertakes the task.
And the two faces of US policy were a major subtext at the UN conference.