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Vulnerable to HIV But Neglected

Focus on trafficked women serving as sex workers
Michel ODIKA

Crucial necessity for a wide-reaching approach

Every year large numbers of women are trafficked, either across international
borders or within their own countries. All regions of the world are affected,
although there are some well-established routes. Despite the magnitude of the
phenomenon, highly variable from place to place, the world is still slow in
recognizing its gravity and, as a result, human trafficking often remains off the
political agenda.
On the whole, trafficked women forced to go into exploitive work situations are
largely under-represented and voiceless in the decision-making processes aimed
at affecting their lives, starting with those related to HIV transmission. No
matter how human trafficking takes shape in any given country, it always shines
a spotlight on human rights and societal issues of global significance.

Lack of evaluation
Little is known about the number of trafficked women forced to enter sex work.
However, more is known about their social background and economic profile.
Around the world, for example, a high proportion of trafficked women are
young migrants moving from low- to high-income countries. For the most part,
they come from sectors of society and settings where there is endemic poverty,
indebtedness, unemployment, gender discrimination, and low level of education.
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Human trafficking: a potential bridge of HIV transmission

Globally, there are few data on HIV prevalence among trafficked women.
However, many, if not most of them are highly vulnerable to HIV transmission.
Overall, they lack information about HIV and adequate services that might help
protect them. Added to that, independent studies conducted along major
transport routes in Africa, Asia and Eastern Europe show that few trafficked
women know that unprotected sex makes them at high risk of becoming HIV-
infected. Rarely, if ever, do they report seeking HIV counselling and testing
services. Still, those women are frequently less likely than the general
population to access public services, and may not know about or be able to
afford treatment for sexually transmitted infections, which are known as
increasing physiological vulnerability to HIV contamination. Moreover, they are
often placed in situations where they cannot negotiate condom use, are forced to
endure multiple sex partners, and are subjected to violent sex.

Far from a standardized package

Trafficked women from low-income countries serving as sex workers in high-
income countries operate in a variety of different environments, ranging from
street-based sex work to highly organized brothels, bars, hotels, and homes.
Each location carries with its own degree of vulnerability in terms of stigma,
discrimination or the potential for violence, as well as the obvious danger of
HIV infection. Another key point to insist on is the fact that sex trade involving
trafficked women is not fixed but is evolving in reaction to social and economic
conditions. Prevention programmes, therefore, must adapt to address these
permanent changes.

Need for a global response

Human trafficking stands as a complex process that cannot be captured in a
single universal metric. Only in recent years has it been possible to better
evaluate the magnitude of the phenomenon as analytical tools begin improving.
Globally, human trafficking accentuates existing difficulties, compelling us to
confront many simultaneous problems, all of which need solution. The key
challenge with regard to addressing this specific issue is to grasp things at the
root. The point, then, is to criminalize human trafficking, not sex work involving
trafficked women, who have the same rights as everyone else, especially rights
to education, information, the highest attainable standard of health, and, not
least, freedom from discrimination and sexual violence.

Need for a scaled-up and sustained response

On one hand, available data underscore the need for HIV prevention efforts to
be scaled up among trafficked women serving as sex workers. On the other, HIV
prevention programmes work best if they have the active involvement of
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trafficked women themselves in all stages, from elaboration to evaluation, and

aim to decrease their vulnerability by addressing the global context surrounding
human trafficking across the world.
Now more than ever, the challenge is to mount an effective response to human
trafficking, globally and within countries. What remains to be done, ultimately,
is to understand once and for all that overcoming such a challenge must become
a shared agenda. Why?
In the 21st century, we are all part of the problem, and we must all be part of the
response. That’s the only way to take the problem one step further out of
shadows…

Illustration:
Photo – street-based sex worker  UNAIDS

References
1. Burkhalter H (2003). Sex traffic and the HIV/AIDS pandemic. Washington, Testimony
for Physicians for Human Rights before the House International Relations Committee.
Available at http://www.phrusa.org/campaigns/aids/news062403.html
2. ILO (2004). Protecting migrant women workers from going into exploitive work
situations. Geneva.
http://www.ilo.org/public/english/employment/gems/advocacy/protect.htm
3. Lübker M (2004). Globalization and perception of social inequality. Geneva,
International Labour Office, Policy Integration Department.
4. UNAIDS (2005d). Intensifying HIV prevention: UNAIDS policy position paper.
Geneva.
5. US department of State (2004). Victims of trafficking and violence protection act.
Washington, United States Department of State.
Available at http://www.state.gov/g/tip/rls/tiprpt/2004/