The second day of the International AIDS Conference saw what was possibly the shortest side session in its history. Entitled ‘Sex workers are everywhere’ Andrew Hunter of the Asia Pacific Network of Sex Workers addressed the delegates and explained that due to the political opportunity afforded elsewhere in the conference there was a change to the planned agenda. Impassioned, he introduced the process behind, and content of, a new UNAIDS Guidance Note on Sex Work – a policy that will shape the UN’s response to sex work and influence other actors programming in this area. This is a piece of policy that the sex worker rights movement vehemently disagree with.

With this in mind Andrew encouraged delegates of an activist bent to attend a session that was in progress in the next room to try and encourage Peter Piot of UNAIDS to offer some explanation on the status of the guidance note. Others were directed to a session at which Meena Seshu of SANGRAM was presenting on the advocacy work that has accompanied the development of this document.

Meena explained how when they began drafting the guidance note in 2006 UNAIDS conducted a meaningful and representative consultation process with sex workers. This is in line with their own policies about involving affected populations in the development of laws and policies that affect their lives – a concept that is often referred to as ‘nothing about us without us’. However, sex workers were disappointed upon reading the first draft of the policy to see that their recommendations had not been taken on board and the guidance concentrated on preventing sex work rather than HIV. To this end it prioritises encouraging sex workers to abandon their occupation and preventing people from entering the industry in the first place. It does not focus on harm reduction with people working in the sex industry – for which there is an evidence base. Interventions based around this would include information for sex workers and their clients, access to prevention commodities (for example, contraceptives, food, clean water, medication), safe spaces for sex workers, psychosocial support, voluntary counselling and HIV testing, antiretroviral treatment etc.

Sex workers point out that rescue and rehabilitation programmes have sometimes been used as a cover for state sanctioned sexual and other violence, illegal detention and denial of the human rights of sex workers. Increasingly these type of programmes are funded by the US Government which has a policy that requires all funding recipients to sign a pledge opposing sex work. Sex workers believe that, although not finalised, the Guidance Note has had an influence on UN agency’s actions in developing countries. They cite UNICEF’s sponsorship of recent anti-trafficking legislation in Cambodia as an example.

In response the Guidance Note sex workers conducted a worldwide advocacy campaign to push for its revision. As a result the issue was discussed at the UNAIDS Programme Co-ordinating Board who passed a motion calling for the policy to be reviewed but as yet sex workers do not know what the final outcome will be.

Among other things, the story of the Guidance Note on Sex Work points to the way in which United States policy on HIV and AIDS is shaping the response to the epidemic in ways that further abuse the rights of some of the most marginalised. With the recent reauthorisation of the US President’s Emergency Plan for AIDS Relief (PEPFAR) this pattern looks set to continue.

For more on this please see the Guardian online.