This week we are going to focus on the problems associated with providing health care to sex workers in South and Southeast Asia and what is being done to overcome these obstacles.
An article from [IRIN](http://www.irinnews.org/Report.aspx?ReportID=90782) reports on the dangers of Asian governments harassing and cracking down on sex workers. When forced into hiding, sex workers’ ability to protect themselves and prevent the transmission of HIV through the use of condoms is hindered. This is particularly dangerous in a region where 10 million women sell sex to 75 million men, who then have sex with another 50 million people. These crackdowns have specifically hurt successful programs targeting HIV/AIDS, such as the [100% Condom Use Program](http://healthmarketinnovations.org/program/100-condom-use-program?displa...), being implemented in a variety of countries, including Cambodia, Thailand, China, Indonesia, Myanmar, Vietnam, Laos and the Philippines. This program fights the spread of HIV/AIDS by removing the economic disincentives for sex workers to not use condoms (something which many clients prefer) by encouraging ALL sex workers to use them. In this way, when a sex worker requires the use of a condom, clients cannot go anywhere else to obtain unprotected sex.
In another article from [IRIN](http://www.plusnews.org/Report.aspx?ReportId=90747), members of civil society in Bangladesh are accusing the government of sending mixed messages to sex workers by excluding “prostitution” as a profession on new voter cards. Prostitution is legal in Bangladesh for women over eighteen and sex workers are supposed to receive no-cost health care from the government. However, the mixed messages from the government and harassment by police and government workers have caused most sex workers to avoid government clinics altogether in favor of those run by NGOs. In fact, in 2009, the Health Ministry reported that only 2,000 sex workers (.5% of all estimated sex workers in the country) used these services. Civil society leaders warn that, although Bangladesh currently has a relatively low prevalence of HIV, this could change if the government doesn’t actively reach out to sex workers.
A radio report from the [Australian Broadcasting Corporation](http://www.abc.net.au/correspondents/content/2010/s3046438.htm) highlights some of the necessary steps to provide health care to sex workers in Thailand. Steven Kraus, the Asia Pacific Director of UNAIDS, comments, “Criminalisation of adult behavior is not the way to go. If adults practice certain behavior at a high enough scale, don’t criminalise it, what you’ve got to do is say ‘how do we make it safer? How do we make it healthy?” Andrew Hunter describes some of the things that his organization, the Asia Pacific Network of Sex Workers, is trying to provide for sex workers: “A doctor who won’t tell them to go away, a doctor who won’t sit them in a separate chair in the waiting room. A pharmacist that will sell them medicine for the same prices as everyone else instead of double the price because they know they’re a sex worker.” Finally, this report stresses the need to include sex workers in the conversations that take place about these issues. Kraus describes how the sex workers who made up a third of the participants at a meeting in Thailand were saying, “Trust us, work with us, allow us to empower our own communities and a lot of solutions will come as a result.”
[The New York Times](http://www.nytimes.com/2010/10/19/health/19global.html?ref=health) reported on related news on a different continent. In South Africa, the first all-black pornographic movie has been released in which all of the male cast members wear condoms and the entire cast was tested for HIV. The producer is hoping that the movie will be “a gentler message about safe sex,” and he plans to distribute the sequel with safe-sex material.
These articles all show that there are significant obstacles to overcome when protecting the health of sex workers. Nevertheless, they also highlight a number of innovative ideas and concrete steps that can be taken to help ameliorate an otherwise discouraging situation.