Some of the best news for some of those hit hardest by the epidemic came early in AIDS 2012 with Secretary Clinton’s welcoming remarks, when, citing progress in both science and implementation, while emphasizing the impact of the epidemic on sex workers and people who use injecting drugs, she told the audience ” . . .if we’re going to beat AIDS . . . we can’t fail to reach people who are the highest risk.” The words were greeted with applause. But although the secretary hailed the end of the HIV travel ban, saying “We are so pleased to have you all finally back here,” activists throughout the week pointed to a void — the US travel bans on people involved in sex work and people who have used illegal drugs had kept many of the people at highest risk from coming to the conference.
The result, observers said afterward, was a larger conference with fewer sex workers than had brought their first hand experiences and concerns to Vienna and Mexico City. While some used the words “colder” and “more anemic” to describe the difference, the loss was consequential and of lasting impact, said Allan Clear of the Harm Reduction Coalition.
“When you have doctors and scientists talking about people’s lives, and you don’t have anyone talking about the lived experience, you don’t have a balanced view. The biomedical side is only half the picture.”
Barriers to attendance by drug users and sex workers also highlighted hypocrisy, he said, the International AIDS Society’s decision to hold the conference in the United States coming as it did after the previous conference at which the group joined other signers of the Vienna Declaration, which called for decriminalizing the lives of drug users. And, while the reduced ranks of sex workers might have been more noticed at the Washington conference, Clear said, one telling result of the entry ban for people who admitted to past drug use was documented: not one person signed up in advance for methadone dosages made available to travelers. “That was highly unusual,” Clear said.
This time, signers to A Call to Change U.S. Policy on Sex Work and HIV demanded the repeal of the fund-restricting anti-prostitution oath, attention to evidence-based, best practice prevention, care and treatment efforts aimed at sex workers, redress for human rights violations in detention, mandatory-testing, and “rehabilitation” programs targeting sex workers, the engagement of sex workers in efforts to address exploitation, and of course, a repeal of the prostitution travel ban.
But the people who could make the best case for all of those demands were in no position to do so, advocates who did attend the conference pointed out.
From Jonathan Cohen, deputy director of the Open Society Foundations’ Public Health Program: “Sex workers and drug users we spoke to chose to stay home from the conference rather than disclose their status on a visa application. This is not a choice anyone should be forced to make.”
A choice some made was to go to the alternative Sex Worker Freedom Festival in Kolkata, India, but that was no substitute, advocates point out.
India’s visa obstacles provided their own barriers, Carlos Laudari, senior technical advisor for HIV AIDS prevention at Pathfinder pointed out: “Not many from overseas were able to go there. The great majority of sex workers there were from India.”
On this end, the loss was twofold, he added: “We had not just the missing voices, but there was a feeling they couldn’t speak for themselves. And so it was disempowering.”
He and others said those in absentia were not the only ones disempowered; the loss of sex worker and drug user input on how to realize the goals of treatment as prevention, on barriers to funding, testing, health care access, and for that matter, on the difference between sex work and sex trafficking — commonly, and erroneously equated — weakened the dialogue and the action they were intended to inform.
“I jumped on one panel,” said Darby Hickey, a Washington-based sex worker advocate and policy analyst for Best Practices Policy Project. “There were great researchers, but it would have been a different panel. Five researchers and not a single person from the community. That was missing.”