Pages

Tampilkan postingan dengan label sex work. Tampilkan semua postingan
Tampilkan postingan dengan label sex work. Tampilkan semua postingan

‘Confront legal and policy barriers to HIV’: Sub-Saharan Africa Regional Dialogue on HIV and the Law

Via UNAIDS.

In Sub-Saharan Africa, the region most heavily affected by HIV, legal, policy and social barriers, including stigma, discrimination, gender inequality and the criminalization of key populations at higher risk of HIV infection, continue to make people vulnerable to HIV and hamper the ability of individuals, communities and states to respond to the epidemic. This was the conclusion of the Regional Dialogue for sub-Saharan Africa, part of the Global Commission on HIV and the Law, held at the beginning of August in Pretoria, South Africa.

No taboo should be left unchallenged

A significant breakthrough came from the pledge of participants to highlight and discuss all aspects of the legal environment relating to HIV, including laws and practices related to stigma and discrimination, access to affordable treatment, children and adolescents, women’s rights and gender-based violence.

“This regional dialogue is a great opportunity for us, as Africans, to confront the difficult issues including discriminatory and punitive laws that target sex workers and men who have sex with men, and other populations vulnerable to HIV,” said Bience Gawanas, African Union Commissioner for Social Affairs.

The criminalization of drug use, sex work and same-sex sexual relations was also confronted by the participants in a bid to challenge all taboos. This is remarkable as recent punitive legal and policy developments in a number of countries in sub-Saharan Africa relating to the situation of members of key populations has raised concerns about the readiness of stakeholders in the region to confront this issue. Some 31 countries in the region criminalize sex work, and same-sex sexual relations constitute a criminal offence in at least 30 countries.

Read the rest here.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Laws fail to protect HIV patients, says advocate

Via The Fiji Times, by Frederica Elbourne.

PACIFIC political leaders have remained silent over the protection of the rights of people vulnerable to and affected with HIV, an organisation that champions AIDS awareness said.

The Pacific Islands AIDS Foundation said laws governing those infected with the virus failed to protect their privacy.

The existing legal frameworks condemned behaviour such as anal sex, sex between men, and sex work, the PIAF report launched by Minister for Women Doctor Jiko Luveni in Nadi last month said.

Such denunciation drives these practices underground, the PIAF said in a report that highlighted the plight of HIV positive women in Fiji and Papua New Guinea.

"Public Health Acts also reflect mentalities of the colonial periods and these acts usually provide wide powers to public health authorities, impose heavy duties on infected people and others who must notify and take precautionary measures," the report pointed out.

The acts rarely gave privacy to people who are subject to these provisions, PIAF said.

"These legal frameworks are outdated and are in many instances inappropriate for HIV. Most legal systems in the Pacific lack legislation that protects the rights of people living with HIV," PIAF said.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

IAC 2012: No Progress on Visas for Drug Users or Sex Workers

Via Housing Works.

One year from the International AIDS Conference in Washington, D.C., prospects are looking dim for sex workers and drug users who want to attend.

The International AIDS Society has announced that it will release a document in August that details the U.S. visa process for IAC 2012. That document will describe entry restrictions for sex workers and drug users, and it will provide instructions on how to apply for a waiver if a delegate’s visa is denied. IAS will post that information here.

Still no obvious solutions

Strict U.S. regulations that block entry for people who admit to sex work or drug use could keep hundreds from participating in the world’s largest gathering on HIV/AIDS. Recognizing the key role these individuals play in charting the future of the fight against the disease, the IAS formed a working group to troubleshoot avenues for getting marginalized groups into the country.

The working group, however, has already explored—and discarded—a number of options. In June, it released a document stating that it will not lobby to change U.S. immigration policy before the conference.

The group did meet with U.S. officials to ask the federal government to issue a blanket waiver for all conference delegates who are denied a visa. The U.S. government rejected that proposal, and immigration authorities will have to review each waiver individually—a process that will cost delegates both time and money.

Read the rest here.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

New Light Shed on Male Sex Work


Commercial sex work, dominated by a focus on women, could be redefined as new research launched today in Nairobi, Kenya, sheds light on the complicated HIV prevention needs of what may be Africa’s most deeply underground group at high risk of HIV - male sex workers.

The report co-authored by the United Nations Development Programme (UNDP) and South Africa's Sex Workers Education and Advocacy Taskforce (SWEAT) seeks to better understand the social contexts, sexual practices and risks, including that of HIV, among these men.

The professional debut of many of the 70 male sex workers surveyed in Kenya, Namibia, South Africa, Uganda and Zimbabwe was often prompted by the family rejecting the men’s sexual orientation; for others, it was a way to survive in a foreign country.

Men reported being at risk of HIV in many ways, including the unavailability of speciality health services, the premium clients placed on unprotected sex, violence and the lure of substance abuse. Although the work often placed them at risk of substance and physical abuse as well as HIV infection, the researchers found that it also provided the men with a sense of freedom and empowerment.

The report cautions that mitigating these risks may require specialised HIV prevention services unlike those targeted at female commercial sex workers or men who have sex with men (MSM).

A series of interviews with male sex workers at a five-country workshop in Johannesburg, South Africa, and country visits to Kenya and Namibia has produced a significant addition to the paucity of data on male sex workers, according to Paul Boyce, a UNDP researcher.

While data on MSM from Malawi, Namibia and Botswana indicated that about 17 percent were HIV positive - almost twice the national prevalence rates of their respective countries - not much has been written on the specific HIV risks of male sex workers, which may be higher than those of MSM.

While male sex workers reported working at a range of venues, including Namibian truck stops and Zimbabwean mines, most of the available information on male sex work has come from those operating in the sex tourism hot spot of Mombasa, Kenya, with limited data from a 2009 study in South Africa that showed male sex workers were twice as likely to engage in anal sex than MSM who were not selling sex.


Not necessarily the same old risks:

Unprotected receptive anal sex carries almost 20 times the HIV risk associated with unprotected vaginal sex.

Interviewees told researchers that the unavailability of water-based lubricant, which reduces the risk of condoms breaking during anal sex, and the higher financial reward of unprotected anal sex, made consistent condom use difficult.

Some clients forced unprotected intercourse on sex workers, while others admitted to practicing unsafe sex due to the disinhibition often brought about by the drug and alcohol abuse that is reportedly part of the social scene in sex work. Drugs and alcohol also helped the men mentally cope with the omnipresent risks of this lifestyle, including police harassment.

South African male sex workers said substance abuse - not HIV infection - was the greatest threat to their health.

Those who tried to access health services for HIV testing and treatment, or the diagnosis of sexually transmitted infections (STIs), reported being ridiculed and stigmatized by health workers, even in countries like Kenya, where the Ministry of Health has introduced new guidelines on MSM and sex work, and health and HIV.

"[At the] government hospital, the nurses just [stand] in front of everyone and shout out loud to the people waiting for assistance: 'If you have HIV, go to room nine, TB room 12, STD [sexually transmitted disease] room 8,'" said one man quoted in the report.

Read the rest here.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

AIDS Summit at the UN: Not Enough Talk About Sex

Via the Huffington Post, by Evelyn Leopold.

World leaders gathered at the United Nations to mark the 30th anniversary of the HIV/AIDS epidemic and put out a 102-paragraph declaration. Adrienne Germain, the president of the International Women's Health Coalition (IWHC), has been working on women's issues all her adult life and was active in the 1994 Cairo conference on women, also known as the CPD (International Conference on Population and Development). In an interview with the Huffington Post, Germain and Alexandra Garita, an international policy program officer at IWHC, discuss the declaration and the controversies that arise whenever sex is on the agenda. The declaration, produced every five years, gives U.N. agencies a mandate for their programs and advises governments where best to spend monies.

Q: What about access to family planning, to birth control?

AG: We lost reproductive rights and reproductive health language from the 1994 Cairo document and from early drafts here. Reproductive rights, for example, also includes the right to freely and responsibly decide on the number and spacing of one's children. If you lose that and you have no reference to family planning services in the document, then you basically have no reference to contraception for women. You also don't have protection for women living with HIV who are sterilized without their consent and who are forced to have abortion. It is not a rare occurrence in southern Africa (including South Africa).

Q: And how about the new studies on early intervention of Antiretroviral drugs (ARV) to reduce transmission, which are welcomed as a major breakthrough?

An important development is using ARV treatment much earlier in a person's life in order to reduce the amount of virus in the body. Therefore the person will be less able to transmit the virus to someone else and you can use treatment as prevention. In this document, it is treated as a miracle breakthrough. We don't look at it that way. Probably about half the people in the world who are living with HIV don't know it. You are most infectious right after you have been infected. But at that time you have no symptoms at all so why would you go forward with testing? So to think that a medicine, a drug, is going to end this epidemic when we don't even know how to get more people to come forward for testing -- is really foolish. But debates on how best to end the epidemic go on all the time -- how we should all be giving much more time to prevention. Yet this document ends up with four paragraphs -FOUR!-on prevention. Does that make much sense? No. Not in our book.

Q: Homosexuals and prostitutes were a big issue five years ago, even among some delegates from the Bush administration. Has this changed?

They are in the document for the first time. There was one paragraph that names the community of drug users, men who have sex with men and sex workers. That is very good. But this listing is used once only and then there is UN mumbo-jumbo in other paragraphs where you should have specific references about the kinds of interventions needed to reach this population and what they face in their lives. And there is nothing on human rights for these people (despite the UN secretary-general's speech).

Read the rest here.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

What's preventing prevention?

How national AIDS responses are failing in prevention efforts for key populations – an analysis of available data


via International HIV/AIDS Alliance

Several decades after the start of the global AIDS pandemic, data confirms that most low- and middle-income countries still do not adequately focus their HIV prevention efforts on the key populations of sex workers, men who have sex with me, transgender people, and people who use drugs.

Of all low- and middle-income countries that report standard information to the United Nations on their AIDS responses, more than half fail to include timely data concerning these key populations.

According to the International HIV/AIDS Alliance, which has conducted a review of 132 country reports, this is a strong indicator of the current level of national AIDS efforts devoted to reaching populations that are most affected by HIV.

Read more.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Acceptability of pre-exposure prophylaxis as an HIV prevention strategy: barriers and facilitators to pre-exposure prophylaxis uptake among at-risk Peruvian populations

IRMA Steering Committee member Jerome T. Galea is lead author of this fascinating paper. Here he provides an overview of the study.

Click here to access the full paper.

"The study examined pre-exposure prophylaxis acceptability (PrEP) among female sex workers, male-to-female transgendered persons and men who have sex with men in Lima, Peru.  Focus groups explored social issues associated with PrEP acceptability and Conjoint Analysis – a consumer research market technique – assessed the preferences participants had with regards to eight hypothetical PrEP “scenarios”.  This was the first study of it's kind to apply this technique.

"Each scenario was made up of the same characteristics but differed slightly (for example, higher cost versus lower cost; daily dosing versus non-daily dosing; some side effects versus no side effects, and so on).  Participants had to rank the scenarios in order of preference taking into account all of the product’s chacteristics, and in doing so expressed the value they placed on the various characteristics.  Focus groups helped to explain the reasons behind the preferences made.

"There were some unexpected findings. For example, cost trumped effectiveness; a low-out-of pocket cost had the single greatest impact on PrEP acceptability. While we expected cost to be an important factor we were surprised that it was more important than the ability of the product to actually prevent HIV infection. 

"Another surprise was that in the focus groups we learned that participants preferred that PrEP be dispensed in health centers as opposed to pharmacies. This surprised us as we hypothesized that pharmacies would provide faster, easier and more widespread access, but participants cited privacy concerns with PrEP being dispensed by pharmacies.

"The next step is to replicate this sort of research to more populations at risk in different settings. We have learned that the existence of an effective product does not guarantee its use (recent studies on the female condom, for example, highlight the challenges of understanding the needs and perceptions of the target user and also the necessity of dispelling myths that often arise when new products are introduced). 

"We cannot generalize our findings to all persons at risk for HIV, in Peru or elsewhere, but do propose it as a model for future exploration of the topic now that oral PrEP has been shown to work but has not yet been scaled up for widespread use."

*Read AIDSmeds coverage of this study here.


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

VIDEO: Melvin and his sister: A gay Kenyan's struggle to survive

via guardian.co.uk

As discrimination against homosexuals in Africa reaches a new murderous peak, Guardian Films travels to Mombasa, Kenya, to hear from a male prostitute who risks his life to support his younger sister.



[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Kenya: How discrimination is a barrier to good health

via guardian.co.uk

Complex issues, such as health and poverty, are often best illustrated by following individuals and showing how the issues affect their lives. That is why the Guardian is producing a series of films about some of the global issues that feature in Christian Aid's manifesto for change, Poverty Over.

The first film – on sexuality-based discrimination, human rights and HIV in Kenya – is available to view here on the Guardian's Christian Aid website from Monday. Same-sex relationships are illegal in the country, but prejudice and fear about them go far deeper than that. This film shows how hatred has a negative impact on the health of gay people in Kenya.

Anti-gay feeling is common in Kenya. Some politicians, religious leaders and sections of the media have stirred up this hatred. In November last year, for instance, the prime minister, Raila Odinga, called for a nationwide crackdown on gay people. Odinga ordered the police to arrest anyone found having sex with someone of the same gender and said that the country's constitution made it clear that homosexual activity was not to be tolerated.

This has obvious implications for men who have sex with other men, as they are often unable to access care if they become infected with HIV. Clinics that are known to treat gay men are threatened, medical practitioners may be unwilling to help them, they are often isolated and unable to access any kind of information. Many of these men are married, and risk infecting their wives with HIV.

The red-light areas of large cities in Kenya also show that, despite the rhetoric, there is a thriving gay sex industry. Many of the male sex workers have been thrown out of their family homes for their sexuality; they report that they are often compelled by clients to have sex without condoms.

Yet a growing gay community, and some inspiring gay rights and HIV activists, are doing their best to ensure that more people in Kenya are made aware of safer sex, condoms are made available, and prejudice against men who have sex with other men is addressed.

To find out more, view the film online from Monday, March 14. The site also has other interesting content that will engage, outrage, inspire and inform you, including Thursday webchats (1pm-2pm) when you can post questions for Christian Aid advisers. Additional films will be uploaded every week.

Source.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

New Report: World’s Premier AIDS Event Neglects Populations Most at Risk for HIV

 via Global Forum on MSM and HIV

Independent assessment indicates severe underrepresentation of gay men, transgender people, sex workers and people who use drugs at the biennial International AIDS Conference

A new report indicates that the International AIDS Conference (IAC), a biennial event convened by the International AIDS Society (IAS) that has become the world’s premier gathering for people working in the field of HIV, suffers from gross underrepresentation of populations most at risk for HIV infection, including men who have sex with men (MSM), transgender people, sex workers and people who use drugs.  The independent audit, conducted by the Global Forum on MSM & HIV (MSMGF), confirms suspicions long-held by activist groups and calls for a comprehensive review of IAC governing structures.

Produced in response to growing concern among community groups that the IAC has repeatedly neglected these key populations, the report focuses on program content at the most recent IAC, held in Vienna, Austria in July 2010.  The analysis reveals that the percentage of all sessions at the conference exclusively focused on these groups was limited to 2.6% for MSM, 1.1% for transgender people, 3% for sex workers and 4.5% for people who use drugs.

“While the International AIDS Society turns a blind eye, HIV rates among these populations continue to climb around the world,” said Dr. George Ayala, Executive Officer of the MSMGF.  “The IAC is the world’s most important opportunity for international exchange and collaboration on HIV and AIDS.  Such abysmal representation of most-at-risk groups only serves to reinforce the invisibility, discrimination and disregard that drive the epidemic among these communities.”

Research has shown that these four populations are at higher risk for HIV infection than the general population in nearly every country context where reliable data exist.  MSM represent more than a quarter of HIV infections in Latin America and the Caribbean, people who inject drugs account for more than half of HIV infections in Eastern Europe,  and sex workers across Sub-Saharan Africa experience HIV prevalence rates of up to 50%.  Infection rates among transgender people in El Salvador, Indonesia and India are as high as 25%, 35%, and 42% respectively. 

The IAC takes place in a different city every two years, gathering tens of thousands of experts and advocates from around the world to share the field’s most recent developments and engage in strategic collaboration.  The most recent conference hosted an estimated 25,000 people.

“Ostensibly, the IAC offers chances for local healthcare providers to learn ways to improve their services, provides channels for advocates to engage in dialogue with powerful decision-makers, and creates opportunities for community members to shape global funding and research agendas,” said Dr. Mohan Sundararaj, Policy Associate at the MSMGF.  “This really is a phenomenal platform, but how useful can it be when those who need it most are locked out?”

The report recommends a number of steps to bring the IAC’s program coverage of these key populations up to a level proportionate to their epidemiological burden.  Among these recommendations are efforts to ensure transparent processes for abstract review and program design, the development of targeted support to authors developing abstracts focused on key populations, and open representation of civil society on the committees responsible for developing conference programs.

“The International AIDS Conference has unparalleled potential to impact the global AIDS epidemic,” said Dr. Ayala.  “It is incumbent upon the organizers to ensure that the IAC becomes a vehicle for change, shifting the global landscape so that funding, research and programs are directed to those who need them most.  Right now it’s part of the problem.”

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Sex Work, Criminalization, and HIV: Lessons from Advocacy History

via San Francisco AIDS Foundation's BETA,  by Anna Forbes

Sex workers are frequently omitted from discussions about the links between criminalization, marginaliza­tion, and increased HIV transmission. We talk a lot about the effects of this dynamic on men who have sex with men, injection drug users, and peo­ple living with HIV—as we certainly should—but not about sex workers. Why is this group not like the others?

Read the rest.


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Case Study: Alcohol Consumption and HIV Risk in Chennai, India

Alcohol Consumption and HIV Risk
A Peer Education Strategy for Bar Patrons

via AIDSTAR-ONE, by Reshma Trasi

In a busy neighborhood in Chennai, cars, motorcycles, bicycles, and pedestrians jostle for space on the narrow streets. Small shops line the sidewalks, offering everything from bright silk saris to auto parts. From a nondescript storefront comes the sound of clinking glasses and loud voices. Inside, one wall has shelves stocked with beer and hard liquor. In a back room are groups of men at counters and tables, laughing with friends or arguing about politics or cricket. Each has a glass and sometimes an entire bottle of alcohol in front of him.

One of the largest cities in South India, Chennai attracts men from all over the country seeking seasonal, unskilled, or hourly wage work. Away from their families, these men go to bars to socialize. Establishments that sell alcohol in Chennai range from holes-in-the-wall offering home-brewed toddy to high-end clubs selling expensive foreign alcohol. Somewhere in the middle of this spectrum are more than 600 wine shops, popular among men of all ages.

But the wine shops offer more than just a chance to relax and drink. Female sex workers also frequent many of the shops; at some locations, younger boys and hijras (transgendered persons) solicit sex. As male customers consume alcohol, inhibitions loosen, peer pressure builds, and the temptation to engage in high-risk commercial sex becomes harder to resist.

In 2002, the Y.R. Gaitonde Center for AIDS Research and Education (Y.R.G. CARE), a nonprofit known internationally for its comprehensive HIV prevention, care, and treatment programs, initiated a five-year research intervention to study alcohol consumption and risky sex among male patrons of Chennai's wine shops. The Collaborative HIV/STD Prevention Trial identified, recruited, and trained peer outreach workers called Community Popular Opinion Leaders (CPOLs). CPOLs disseminated HIV prevention messages to their peers, delivering them as personal endorsements of risk-reduction and health-seeking behaviors. The Research Triangle Institute and Johns Hopkins University partnered with Y.R.G. CARE on the research, which was funded by the U.S. National Institute of Mental Health.

Read the rest.


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

UNAIDS Director Praises Pope's Condom Shift

via CNN.com
There could be single cases that can be justified, for instance when a prostitute uses a condom ...

Pope Benedict XVI's possible shift on condom use is a "significant and positive step forward," the head of the United Nations anti-AIDS campaign said, welcoming the potentially historic remark.

"This move recognizes that responsible sexual behavior and the use of condoms have important roles in HIV prevention," UNAIDS executive director Michel Sidibe said in a statement.

"This will help accelerate the HIV prevention revolution," he said Saturday.

Read the rest.


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Laws Driving HIV Prevention Underground

from iRIN News


In a region where carrying a condom has been construed as evidence of illicit activity, 10 million women sell sex to 75 million men, who then have sex with another 50 million people, according to the multinational Independent Commission on AIDS in Asia. 

"The technology is there to prevent infections, but punitive laws get in the way," said Steve Kraus, regional director of UNAIDS Asia Pacific. 

Asia's AIDS epidemic is linked primarily to unprotected paid sex, according to the commission, but policies outlawing sex work are undermining HIV/AIDS prevention efforts by fragmenting and stigmatizing the sex workers and turning condom possession into an act that could lead to jail time, NGO officials say. 

Until recently, Cambodia was praised by the international community for its implementation of the 100 percent Condom Use Programme, which allowed for selective enforcement of anti-sex work laws and required condom availability and use for sex workers. But a national anti-trafficking law introduced in 2008 broadly criminalized sex work, and sent sex workers into hiding.


Read the rest

Read a report from Human Rights Watch on the subject

Is Development Management failing Development?

Who and what is this “We”, what authority does this “We” have to make such a statement, what power and means does this “We” have to empower men who have sex with men, sex workers, and transgender people?

by Roger Tatoud,
IRMA Steering Committee Member
Senior Programme Manager, International HIV Clinical Trials Research Management Office at Imperial College, London

In July 2010, the United Nations Development Programme (UNDP) released a draft of its Business Case on MSM, transgender people and sex workers.  This Business Case is UNDP’s plan to operationalize the new UNAIDS indicators focussed on these populations within the UNAIDS Joint Outcome Framework. The “aim of all UNAIDS programming is that every person should have the ability to avoid HIV infection and achieve full health and realisation of human rights.”



The goals and ambitions of the Business Case are intentionally bold and broad: “Men who have sex with men, sex workers and transgender people will be empowered to prevent HIV infection and to claim their human rights in at least 15 countries by the end of 2011, and at least 50 countries by the end 2015.” (Draft 0, 25 June 2010, emphasis mine).The strategy is firmly rooted in the empowerment of all marginalised populations, because “empowerment is the first foundation for action” and again because “a core aim of UNAIDS programming will be that men who have sex with men, sex workers, and transgender people should be empowered to avoid HIV infection and achieve full health and realisation of their human rights (emphasis mine).

Despite all UNDP’s good intentions, the strategy is methodologically flawed, defining objectives without having established first the baseline of what it aims to change, targeting metropolitan areas without acknowledging their diversity or having asserted their suitability, ignoring exiting power structures that will either be unable or hinder the implementation of a top-to-bottom framework designed with what seems to be limited input from its beneficiaries or awareness of how it will affect local and regional interventions.

But most importantly, the strategy is confusing aims and goals by setting up a framework around empowerment as the de facto solution that will lead MSM, transgender people and sex workers to avoid HIV infection and achieve full health as well as realising their human rights. It is not that empowerment, which is at no point defined in the draft document, may not be what the targeted population needs or wants, but because the empowerment response automatically implies that MSM, transgender people and sex workers are powerless entities unable to achieve their human potential without the help of an external intervention, in this case forcefully lead by UNDP.

Indeed, the UNDP brochure affirms “We can empower men who have sex with men, sex workers, and transgender people to protect themselves from HIV infection, achieve full health, and realise their human rights” (emphasis mine). Who and what is this “We”, what authority does this “We” have to make such a statement, what power and means does this “We” have to empower men who have sex with men, sex workers, and transgender people? These are questions worth asking because results or lack thereof will depend on the answers.

The proposal was presented during a discussion group organised at the Be Heard pre-conference in Vienna on July 17, 2010. It was pleasing to hear that UNDP has adopted SMART objectives (Specific, Measurable, Achievable, Realistic and Timely). The problem is that deciding bold objectives without knowing the environment in which the intervention will take place makes the whole plan rather meaningless.

The reception was rather cold and critics fumed from the audience, starting with a Russian representative who had never heard of the year-old proposal, which incidentally had not been translated into Russian and willingly exclude drug users (another problem since vulnerable populations often overlap). One of the most constructive and valuable remarks came from an African representative who thought the proposal was too bold and should start with a feasibility study in a limited number of countries. I fully support a feasibility proposal as I am very much concerned with the soundness of the Business Case in its current version. Human rights, their violations and how the Business Case intends to address these issues would also be worth discussing, but I will limit my discussion to empowerment.

In 2000 I visited Thai university friends in Bangkok for the first time. I was
seduced by Thailand which I would discover is not the Land of Smiles of tourist brochures or naive backpacker’s memories (recent civil unrest, as well as a surreal coup d’état in 2006 which I witnessed, are permanent reminders of a turbulent political history). I visited again in 2003 and every year after. In 2006, I had the opportunity and sometimes I think the privilege, to live for 18 months in Bangkok. I came for a job I never got and ended sharing the life of men who have sex with men, sex workers,transgender people and a few non-injecting drug users.

Thailand is a relevant country for the Business Case, with an HIV prevalence of about 30% amongst MSM in the capital’s hotspots (saunas, bar, cruising areas). But don’t make the mistake thinking that the country is MSM-and-gender-variant-friendly; scratch the surface and stigma and discrimination are all around. I met many of these allegedly disempowered and vulnerable people that the Business Case wants to empower; here are a few of them.


Silom Soi 4 is a well know Bangkok cul-de-sac where Thai, other Asian, and Western men meet in the evening to enjoy, amongst other things, a beer and a beauty contest. In May 2007, the Miss and Mister Pink beauty contest saw a large pageant of men and Ladyboys (or Katoey as they are commonly referred to locally). Though the custom can easily be misunderstood by Westerners, it is an occasion to show off your best smile and physical attributes and make some money; often more in one night that can be earn in one month working in a factory. Setting judgement on beauty contests and economics aside, note the second contestant starting from the left, holding her “Miss trying to be beautiful” prize.


The same night saw the election of Mr Pink. That year, the winner then nicknamed Koh, won nearly all male contests as he did the year before and the year after. Not all contestants are MSM; beauty contests are a source of income for all. Koh now has a different name and is a well known model strolling more conventional catwalks. He has a large crowd of online followers and magazines picture him selling products like the once famous Bangkok Roti Bun (which originated in Malaysia and got Bangkokian queuing for hours to buy one and street urchins to set up a re-sale business without the need for a UNDP economic empowerment framework).

Bangkok also used to have its own Pride but the event has not been running for a few years. The year 2006 saw a particularly impressive parade followed by a party in Lumpini Park during which a condom fashion show took place with the participation of SWING members. The show was later repeated on World AIDS Day in December. SWING stands for Service Workers in Group an organisation set up in September 2004 by Surang Janyaem in response to the demand for male sex worker support groups. “Sex Workers” would not have gone down well with the local authorities and “cultural sensibility”. Surang previously volunteered for 20 years for another group of sex workers rightly called “Empower”.

Nevertheless, that did not stop the service workers to come together to support each other and to put a fantastic show and to promote condom use. One of the bold objectives of the Business Case is to ensure that 50% of large municipalities will have informed vocal and capable organisations of men who have sex with men, sex workers and transgender people that are recognized as partners to advance universal access. SWING and other groups such as M-Plus and Fasirong did not wait.





This picture of Sak (middle, above) was taken whilst a friend was helping him dressing up as a Katoey in my room (a 30 sq. meter, no air-con, neon-bleached space where the temperature rarely fell below 30C) before "going to work". Sak used to live an extravagant city lifestyle, changed from boy to girl many times, but has now disappeared. In deep North-eastern Thailand, aka Isaan, some populations will never be reached by UNsDP’s empowering programme, should they need it, like the young ladyboy pictured here near Mukdahan a border town with Laos, 10-hours from Bangkok by bus.

Paradiso is one of my favourite hangout in Bangkok, very few if any foreigners go there as it is well hidden from the mainstream places. It is a place to enjoy a Karaoke night with the locals until morning lights, something impossible in the centre. Something to do with the police, who usually more interested in money than in people's sexuality as
shown on this picture taken when Bangkok set up a new record (since then beaten) for the longest condom chain, an event organised by UNESCO.

Behind each of these pictures is a story. I have hundreds of other pictures from the time I spent living in Thailand. Though these may only represent the high
end of a spectrum and are definitively not representative of all that is going on (which is more difficult to immortalise in pictures and that I have left aside in this occasion). The people who shared bits of their lives with me were and remain instrumental in my understanding of the life of those who were not "as lucky" as I am to have been born in the "Wonderful West". They continually influence and contribute to my views on ways of enabling "good change" (a basic definition of Development put forward by Chambers in 1997).

Empowerment is an unknown concept to them (and to many other) and I doubt it would score high on their agenda or that they would understand why good doers in the Global North are so obsessed with it. Empowerment has come to represent the latest incarnation of colonialism, a well meant, cuddly way not only to tell people what they should do, but also what they should need and what they should ask for on the ground - we can do something for them.

Empowerment is not part of my equation, as I have no power to give, and neither does UNDP or any other NGO.




As someone put it to me talking about previous similar documents, “Though well-intentioned, they [...] frequently reflect an attempt by the big agencies to catch up with realities they had only begun to discover and explore, which was laudable on their part, but meant that they were being led by the representatives of the presumed beneficiaries, who sometimes were quite well empowered themselves but who rarely had the kinds of social science training and background that were required".

To its credit, UNDP is doing a lot of good work particularly in capacity building, which may be a better means than empowerment to achieve the Business Case’s goals, but there seems to be little connection between this work, the planned work proposed in the Business Case and the outputs it identified. A way forward is to ditch the institutional “cheap talk” of empowerment and identify SMART, meaningful, and relevant objectives for the target populations the proposal is focussing on and to developed a rigorous, dare I say scientific, approach to implement them.

Ensuring that everybody is heard will be crucial. Remarkably, the draft Business Case, still under consultation, states that UNAIDS will be accountable for achieving its stated bold results in at least 20 of the world’s 144 low and middle income countries by the end of 2011, with clear allocations of effort and responsibility in each region and country.

What it if fails?


***


Empowerment is an Anglo-Saxon concept which has no direct translation in French, Italian, Spanish or German or, I believe, any other language than English (if mistaken please empower me with that knowledge). For more on empowerment and how to use it, see Mick Moore's “Empowerment at last” published in 2001 and which discuss “cheap talk”. See also Laura Agustin on why Empowerment is failing people who “need to be empowered.” And do not miss reading a few life stories collected by Chris Littleton for UNESCO Bangkok, in “Mekong Erotics: Men Loving/Pleasuring/Using Men in Lao PDR.”