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   Launch of APNSW+ and NSWP+

    on Tuesday 24th July 2012

    at Sex Worker Freedom Festival

    in Kolkata, India.

 

We are a group of HIV+ Sex Workers and people committed to treatment access for sex workers living with HIV. We have decided that we need a special platform to fight for the rights of HIV+ sex workers and to bring the sex worker’s issues and the energy and glamour of the Sex workers movement to the treatment activist movement!

Our new platforms ‘Asia and Pacific Network of Positive Sex Workers’ (APNSW+) and ‘Global Network of Positive Sex Workers’ (NSWP+) make these demands:

  • HIV+ Sex workers demand the right to look fabulous- to do this we need better and affordable HIV drugs now
  • WE DEMAND AS POSITIVE PEOPLE THE RIGHT TO WORK AS SEX WORKERS!!!
  • We demand the right to work in all sectors, including in the sex industry
  • We demand that the drug companies from the West stop trying to kill us through their attacks on developing countries right to manufacture, export and import generic ARVs
  • As HIV+ sex workers we face MULTIPLE stigma and discrimination despite 25 years of treatment activism there is an extra layer of stigma if we have HIV and do sex work. As positive sex workers, we demand that this stigma is fought and our specific needs are met
  • We demand not to be last in line for treatment or refused treatment because we are sex workers
  • Treatment needs to be matched to the patient not the patient matched to the treatment
  • Post Exposure Prophylaxis is not available to most people around the world – we need access and availability of PEP, especially for sex workers

AS HIV+ SEX WORKERS, WE DEMAND THE RIGHT TO LOOK FABULOUS!!!


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Last month APNSW members decided to paint a mural to represent the problems sex workers have with GFATM programmes but also to give ideas for how they can be fixed so that GFATM money is used responsibly and ethically on programmes addressing sex work and HIV.

Left side of the banner is the way programmes run now.
The sex worker (organisation) is a puppet. It shows her collecting all the paper work for GF programmes as her main activity. she is also treated as a target and carries an STI Test book, which records the results of the compulsory STI and HIV tests funded by the Global Fund.

Further to the left, is the Evil Elf, which represents the INGOs and UN organizations who are involved in all of this programming but just end up stealing sex workers power and (mis)appropriating the money for sex worker HIV Programmes

Behind the Elf is a road delivering GF money, but bags of it are falling off to all the wrong places.
There is an intersection with a sign post, but the remaining money goes to token pecs and compulsory testing and no money gets to the projects run by sex workers.

On right hand side is how things can be if sex workers are allowed to run our own programmes rather than being passive recipients and targets.

If GF will,allow us to,cut the puppet strings then the puppet turns into a multi armed angel,winged goddess who can deliver Value For Money- something we as sex workers know about and deliver to our clients daily!

So if,community is empowered and directly funded we can deliver for the people.
Small amounts of money used to nurture the grass roots lead,to huge outcomes growing.
If we work on principles based on the right to health then we can work,together instead of having to fight with all,the agencies and organizations who should be working with us.


In about 10 different languages a few key messages are written by sex workers from those countries.

Sex work is work
My body is mine, not the governments
My body is my business
No compulsory testing
Sex workers have human rights.

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From October 12-16, 2010 in Pattaya, Thailand, the Asia Pacific Network of Sex Workers (APNSW), UNAIDS, and UNFPA collaborated on a consultation on HIV/AIDS and sex work in Asia. The meeting brought together UN and Global Fund for HIV TB and Malaria representatives, non-governmental organisations, and government officials along with sex worker groups and projects from Indonesia, Myanmar, Pakistan, Thailand, Fiji, Papua, New Guinea, Cambodia, and China.

The meeting created space for NGO workers, and policy makers and sex workers to share information about human rights, health, and law.

Throughout the consultation particular issues arose. These are some of them

  • The proportion of funding for effective HIV programming with male female and transgender sex workers, is not adequate or proportionate to the role of commercial sex in HIV epidemics in Asia and the Pacific.
  • Interventions that are initiated and sustained by sex worker communities are crucial.
  • Lack of access to HIV medications and support for positive sex workers remains inadequate in many places.
  • Discrimination and abuse of HIV positive sex workers must be addresses.
  • The criminal law is a major barrier to good HIV programming, but so too are other laws and conventions that commit governments to eliminating trafficking and sexual exploitation.
  • The conflation of trafficking and sex work and the redefinition of sex work as sexual exploitation or entertainment is eroding countries capacity to provide effective HIV Services.
  • Violence is the most important issue overall and violence by police outweighs all other violence as a priority for sex workers throughout the region.
  • Mandatory and coerced HIV testing remains a problem throughout the region. It must be stopped.
  • Condom confiscation by police is a widespread problem.

Sex workers drafted a UN style declaration at the meeting called the Pattaya Draft Declaration that outlines what sex workers want. Like a UN document it will be circulated for discussion before it becomes a final declaration.

The consultation was remarkable for its ambitions. To ask police, sex workers, government and UN officials to discuss approaches to HIV in Asia and the Pacific is a big call. Some countries were more successful at this than others and there were many problems to remind us of the power differentials between us all. Some police and government were very hostile and there were various moments that illustrated the kinds of discrimination against sex workers that were being identified at the meeting as a significant barrier to HIV prevention and care. However overall the opportunity for bridge building with the UN and sex worker activists in the region was invaluable and APNSW is confident it will lead to better policy. We also hope sex workers’ chance to interact with the Global Fund will be the start of a process to make better use of that money by ensuring that more of it goes to sex workers at community level to run rights based effective programs.

The Pattaya Draft Declaration on Sex Work in Asia and the Pacific

http://plri.wordpress.com/2010/10/15/pattaya-draft-declaration-on-sex-work-in-asia-and-the-pacific-2010

IRIN News has a piece about the effect of criminalization and condoms being used as evidence of prostitution on the spread of HIV

http://www.irinnews.org/Report.aspx?ReportID=90782

AlertNet/Reuters has an article on the failure of national and UN agency programmes to effectively reach sex workers

http://www.alertnet.org/db/an_art/52132/2010/09/15-130557-1.htm

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Ricky Swuanpyae  spoke at the opening plenary for the thematic session of The UNAIDS Programme Coordinating Board (PCB)  in Geneva on 22-24 June, 2010 This is his speech….

My name is Ricky and I am a male sex worker from Myanmar. I started to work as a sex worker when I was 18 to help pay for my schooling costs. I was at the time working as a housekeeper in a hotel.  In fact, one night as a sex worker , I earn the same as a month as a housekeeper.

However when I first started as a sex worker I had no knowledge about  STI and HIV and did not know how to insist on condom use. So I developed STIs. I only got to understand HIV and STIs when I was introduced to a Clinic where HIV and STI related health services are available. From such centres I and my friends learned from our peer sex worker about the risks of getting STIs and HIV. It was also there that I made a decision to be also be a peer sex worker to ensure others like me have access to prevention information and services. So increasing accessibility to such centres where one can get information and awareness about HIV and STIs is much needed.
Ladies and Gentlemen.

The reports of the Commission on AIDS in Asia and Commission on AIDS in the Pacific have been fundamental in recognising sex work as a central driver of the HIV epidemic in the region. The Asia report calculates that up to 10 million women in Asia sell sex to an estimated 75 million men, who in turn have intimate relations with a further 50 million people. HIV prevention coverage reaches only one third of all sex workers in the region and programmes to reduce the demand for unprotected paid sex are simply not adequate. Coverage for male sex workers is unknown as they are rarely dissagregated from MSM statistics.

As a result of discriminatory laws and social practices, sex workers experience debilitating stigma and discrimination that undermine their ability to protect their health and well-being. Hence a crucial component of Sexual and Reproductive Health  services must be identifying mechanisms for encouraging respect and acceptance of sex workers.

Sexual and reproductive health information and services must recognise the sex worker as a whole man, woman or transgender person. We have to acknowledge  that female sex workers have sexual reproductive  issues like other women but also understand they have special needs as sex workers as well. For example the need for more frequent pap screening. Further, SRH services for all sex workers must cover sexual and reproductive health issues such as access to a full range of contraceptives, including emergency contraception, and abortion; and screening and treatment for STIs including hepatitis.

Male and transgender sex workers need STI services that are equipped to diagnose and treat anal, oral and genital STIs. While stopping work when an STI is present is ideal, many sex workers may not be able to afford to do this.  Male sex workers can be encouraged and taught to provide services that do not transmit STIs, for example not offering receptive an anal sex while they are being treated for an anal STI. Transgender sex workers may need access to specialist services that can address their HIV and sexual health needs alongside the issues created by use of hormones and sexual reassignment surgery.

All sex workers need access to competent and caring health care workers that are free from judgement, stigma and discrimination.

The basic idea of the 100% Condom Use (CUP) program was to increase use of condoms to 100% of the time, in 100% of risky sexual relations, in 100% of sexual acts taking place within sex entertainment establishments.  Sex workers who do not comply with the requirements of the programme, and are discovered to be infected with HIV or and STI, usually face severe consequences, such as being dismissed from brothels, thus depriving them of income and healthcare.

The 100% condom programming  continues to be used as a justification for the State to police and arrest sex workers and to justify compulsory testing.

In Myanmar, the  100% CUP is being implemented in 51 townships  supported
by UNFPA and WHO and National AIDS Program providing STIs treatment, VCT services and free condom distribution . In 2009, National AIDS Program reached only about 5000 sex workers all over the nation and distributed 14 million condoms. Sex workers are afraid to use Government facilities as  the police  continue to harass sex workers and arrest based on claiming that  condom as evidence of sex work. On the other hand, NGOs with by sex workers as peer educators are reaching much larger number of sex workers. In view of their impact the Government and UN have finally renamed the programme  “Targeted Condom Program”.
Law that does not allow selling or buying of sexual services, operating sex businesses and many anti-trafficking measures prevent female, male and transgender sex workers from accessing safe places to work, health and social services and benefiting from legal and civil protections..
I urge Member States to support calls for the removal of punitive laws, policies and practices that block effective responses to HIV and progress towards the Millennium Development Goal. We need protective law enforcement practices and UNAIDS can help facilitate regular dialogue between sex worker groups and Ministries of Health, Justice and Interior, Parliaments, Judiciaries and police, and AIDS Authorities. There will be a decision point related to this at the PCB meeting under Non Discrimination of AIDS Responses and I urge Member States to support it.

Approaches to condom programming needs to address the power differentials which often exists between sex workers and police, government officials, health authorities and brother owners. The power given to police and brothel owners in the 100% CUP design reinforces already exploitative power dynamics, leaving sex workers open to further abuse and corruption. Condom programming must pay attention to clients and sex worker’s intimate partners, as well as male and transgender sex workers.

Here in Asia Pacific  region, there is a need for comprehensive condom programming. Access to good quality condoms and water-based lubricants is essential. While there has been 100% condom use programme in place, there remains the problem of supply, lack of access and a failure to include sex worker organisations and sex workers in the design, implementation and evaluation of these programmes.

Finally I would like to conclude that, we, the sex workers community would ask for those present here help us demand that UNAIDS and co sponsors include sex workers in the design, implementation and evaluation of all programmes with sex workers and that we shift from a 100% CONDOM USE programme to a 100% CONDOM ACCESS programme at country level.

Ricky Swuanpyae
APNSW Myanmar
22nd June Geneva, PCB

Redefining AIDS in Asia; Crafting an Effective Response (2008):  HYPERLINK “http://data.unaids.org/pub/Report/2008/20080326_report_commission_aids_en.pdf” http://data.unaids.org/pub/Report/2008/20080326_report_commission_aids_en.pdf.
Turning the Tide; An OPEN Strategy for a Response to AIDS in the Pacific (2009):  HYPERLINK “http://data.unaids.org/pub/Report/2009/20091202_pacificcommission_en.pdf” http://data.unaids.org/pub/Report/2009/20091202_pacificcommission_en.pdf

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Here is the first of our reports from the UNAIDS Program Coordinating Board meeting in Geneva, where Rathi Ramanathan is representing APNSW as one of the new NGO representatives for Asia Pacific.

We raised the issue of whether Pepfar restrictions on sex work would be reviewed under the administration.

Goosby: Prostitution clause – in middle of law suit 0 confident that we have internal agreement to minimize impact at global level. Will not require written statement to accept funds. Afraid to try to change language so as not to disrupt law suit. Getting sued is the correct approach. Confident we will be able to have it not impact the way it was intended to impact.

Goosby, the head of Pepfar and head of US delegation at the PC responded was that while language around Pepfar would not be reopened because too many detractors however two US based NGOs are now challenging the restrictions and should they be successful, that could open some opportunity for policy to be revised and he said the Obama administration was more open to the idea of relaxation the prostitution pledge. However, Michelle Moloney-Kitts, assistant coordinator of Pepfar who while insisted that funding around sex workers and access to prevention and other services (food, microcredit, eduaction, condoms availabiility) was still possible under Pepfar but insisted that monies could not be used for legalisation of sex work. When asked after the briefing Goosby’sposition on sex work, he said he was sympathetic but difficult to rally public support for Pepfar to fund legalisationof sex work in view that most americans do not view the legalisation of sex work favourable but he indicated, he would not object to international language drafted around legalisation of sex work . Michellle, part of the remaining Bush camp still holds a lot of weight especially around issues around gender and gender based violence and clearly anti-trafficking at the international fora. The current health attache of the US mission in Geneva is also an abolitionist.

Discussion with Michelle Sidibe and cosponsors

Met up with Steve Krause of UNFPA and he says, there is money for core funding for sex work related activities for 2010 but advised that proposals are sent in by end of Jan. For Asia Pacific proposals be sent to Bangkok office and him. Asked whether advocacy around MDG summit would be accepted, he said he would take a look. Rathi is talking to Vince about a collaborative proposals between Seven sisters and APNSW to build capacity and advocacy around MDG Summit and follow up for Universal Access review in 2011. We understand from Michelle Sidebe that he intends to lobby China, South Africa and another State (yet to be determined) to hold a HIV dialogue to review universal access after 2010 (UNGASS+). So it is important to start strategising around this Summit and securing funding for sex workers networks to attend.

Sidebe is expected to announce a high level task force on prevention which we view as positive especially in view that with of potential cutbacks by donors as a result of the financial crisis. This task force could garner political will to increase funding on prevention, an area the second evaluation has admiteed that UN joint programme has neglected. He also expressed concern around punitive laws as a barrier for key populations to access to HIV services. As a result we didn’t follow up spefcially with him on the idea of a thematic issue of punitive laws affecting key population. Vince of seven sisters who is also on the Bureau raised this issue of thematic on punitive laws but was informed that there is a list of themes already slated. He said he would email list to APNSW. However on a positive note, the PCB NGO delegation have also committed that that in view that stigma and discrimination is an agenda item for the June 2010 PCB, punitive laws which act as barriers to key populations would definitely be raised at the meeting.

Rathi Ramanathan, APNSW and Gulnara Kurmanova, Tais Plus

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