Researchers put lens on sexual violence and sex work

Over 350 researchers, gender activists, policy makers, practitioners and survivors from around the world convened in South Africa for the Sexual Violence Research Initiative Forum this week.

Over 350 researchers, gender activists, policy makers, practitioners and survivors from around the world convened in South Africa for the Sexual Violence Research Initiative Forum this week.

The three-day forum, hosted by the Medical Research Council of South Africa, which took place in Stellenbosch (15-17 September), aims to foster and strengthen research in the areas of sexual violence, intimate partner violence and child abuse. The event also provides ways of strengthening innovative work in low and middle income countries by strengthening partnerships between organisations and across sectors to build the health sector’s capacity to effectively respond to gender-based violence in the global South.

Links between gender-based violence and HIV, including in relation to sex workers, were highlighted on the first day of the conference. In many settings, sex work is criminalised and sex workers are often open to exploitation, harassment, physical and sexual abuse making it difficult for them to negotiate HIV protection and to get access to health care and justice.

Sex workers at high risk of violence

During her presentation on gender-based violence among female sex workers in Cameroon, Michele Decker, associate professor at the Johns Hopkins Bloomberg School of Public Health, outlined the links between abuse of sex workers with sexual risk behaviour.

“Across a range of studies, violence was experienced by as much as three-quarters of the sex worker population. Sex workers continue to be at risk of HIV, and gender-based violence – one of the structural drivers of their risk – is mounting. We need to promote safety for this vulnerable population, and reduce the HIV risk that is underpinned by violence and related trauma,” said Decker. “More advocacy for policy promoting access to health care and justice is urgently needed for sex workers.”

Throughout the conference, emphasis was made on the importance of including gender-based violence as part of a comprehensive HIV strategy and the need for policy and practice to be expanded to include the needs of sex workers; especially in settings where sex work is criminalised, such as Cameroon.

Sexual violence and HIV

Sexual violence leads to higher incidences of unsafe sex, inability to negotiate condom use or discuss safer sex practices, and a tendency among men who perpetrate violence to have had more sexual partners, more unsafe sex and higher prevalence of HIV and other sexually transmitted infections.

Also, forced or violent sex increases the risk of trauma and bleeding which in turn increases the risk of sexually transmitted infections including HIV.

Parinita Bhattacharjee, trust programme director for Karnataka Health Promotions, spoke about the findings from a participatory research focusing on forms of intimate partner violence and associated HIV risk and vulnerability among sex workers in North Karnataka state, India. The research found that HIV prevalence among female sex workers is 34.3 per cent while the state average is just 5.5 per cent.

“Programmes preventing HIV or violence against female sex workers must recognise the complex nature of intimate partner relationships,” said Bhattacharjee.

Tackling sexual violence

What became clear throughout many presentations is that many systems are failing when it comes to tackling sexual violence. In particular, justice systems are failing to protect the rights of sex workers who are prone to slip through the cracks of violence prevention and support infrastructures. It is imperative that states create policies and laws that punish perpetrators of physical and sexual violence against all sex workers, regardless of whether these acts occur within the confines of marriage, or in settings where sex is criminalised. Without such action it will not be possible to better tackle the risk of HIV transmission within this population.

Professor Rashida Manjoo, UN special rapporteur on violence against women, emphasised the need to develop substantive and transformative measures, including those which are legally binding, to address violence against women.

“We need to hold not only the direct perpetrators accountable but the states for failure to protect women,” Ranjoo told the conference participants. “More specific laws may not solve the problem but will ensure a greater understanding of what the violation is and what is not acceptable.”

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