Last year I contributed comments and resources to a UNAIDS paper written to support discussion for their Thematic Segment on People on the Move—Forced Displacement and Migrant Populations. The paper gives basic information on types of movement and links between mobility and HIV vulnerability, including how to achieve universal access to HIV prevention, treatment, care and support. ‘The paper points out that mobile people and international migrants are diverse, ranging from highly educated and high-earning professionals, to low-earning unskilled and exploited labourers. Although very different circumstances may drive migration and mobility, it is not mobility per se, but the conditions under which people move—and the ways they are treated throughout the migration cycle—pre-departure, in transit, at destinations and upon return—that most determine their vulnerabilities, which in turn affect their risks of acquiring HIV.’
This language and tone are to be celebrated, departing as they do from the usual crude separation assumed to exist between a freely-choosing middle class that always travels happily versus a downtrodden, forced poor that ‘migrates’, often unhappily. The paper is available as People on the move – forced displacement and migrant populations
I’m pleased that a boxed highlight in the report called Mobile sex workers reads pretty straightforwardly (no heavy emphasis on victimhood) and refers to clients without demonising them.
Sex workers are highly mobile both within and across national borders. Documented and undocumented migration for sex work often occurs between neighbouring countries, but there is also considerable inter-regional movement. The migration and mobility of sex workers can significantly increase their vulnerability to HIV and sexually transmitted infections. Many migrant and mobile sex workers, especially those who are undocumented, are excluded from basic education, legal and public health-care systems, and are vulnerable to violence and other forms of abuse from customers, criminal gangs and corrupt law enforcement officials, with little or no social or legal support and protection. In addition, migrant sex workers face additional cultural and linguistic barriers that adversely impact upon their ability to access local services and support networks. To reduce HIV risk and vulnerability for mobile and migrant sex workers there are key actions that need to be funded and implemented for all sex workers irrespective of their gender (women, men, transgender) or legal status. These include access to HIV prevention and treatment services, comprehensive sexual and reproductive health services, legal information and advice and necessary social services. To support these services, training of healthservice providers and law enforcement agencies addressing stigma, discrimination and violence needs to be developed along with occupational health and safety standards to make sex work safer.
Clients of sex workers are also highly mobile and their behaviour determines epidemic speed and severity (Commission on AIDS in Asia, 2008). Currently, few programmes target clients directly to promote safer sexual behaviour. Such programmes should: be provided in the workplace (where appropriate); be based on the different settings where sex work occurs; provide clients with information to protect sex workers, their regular sexual partners and themselves from HIV and other sexually transmitted infections; emphasize client responsibility to treat sex workers with dignity and respect; and incorporate approaches to eliminate genderbased violence in the context of sex work.