Actor and humanitarian Ashley Judd, board member of Population Services International (PSI) and the Global Ambassador for YouthAIDS, will be writing posts for the ONE Blog during her March 2007 travels through India. During the trip, Ashley will address women’s issues, and have the opportunity to discover how families can be empowered to protect themselves against HIV/AIDS and unintended pregnancies.

Saturday, March 17, 2007

A few background details:

-20% or fewer of commercial sex workers (CSW) are literate. Grade 4 is the average amount of schooling.

-The average CSW has 2 children; madams like them to have children, which keep them in the poverty cycle. Sex work is not illegal in a ‘home,’ hence within brothels it is legal. Soliciting, however, on the street is illegal. Thus is created a highly ambiguous and ambivalent environment in which paid sex flourishes, with no protections whatsoever for girls and women who are bought and sold.

As Mumbai continues to explode in numbers, the strain on services, such as running water and electricity, increases; soon, the electricity in the areas I visited today will be on a few hours a day basis. If a CSW were to complain to the police about anything, it is highly likely she would be harassed and probably exploited sexually. Madams and pimps pay for police protection. A girl 18 years of age is considered underage and is illegal, however, age verification is impossible and a madam will simply train the girl to say she’s 19. Another common ruse is, “She has 2 children!,” which unfortunately, is true: she is child, a mother, and a sex worker. Awareness of STIs and HIV in these areas is high and condom availability and use is also fairly high, thanks in large part to risk perception, behavior change, communication outreach, and subsidizing by PSI, which have raised it from negligible levels in 1990 to over 70%.

How PSI/India has been making a difference since 1990 in Mumbai brothels:

In this high risk area, our primary goal is to reduce the incidence of HIV/AIDS in sex workers and their clients. We have had a mandate to do this since 1990. I saw a fraction of our efforts today:

1. Our interpersonal communicators each have 300 women they personally visit. They make 2 rounds daily of assigned brothel buildings, 5 days a week, working one-on-one and in groups. They wear yellow coats so as to be easily recognized and over time gain trust and build rapport. They track what each woman has received by way of sex education: what was said, what did she learn, did she express willingness to use products (male and female condoms, for example)? In this way, we can help account for the health of each CSW, infections that need treatment, and stay on top of new health interventions as they are needed. The communication style is upbeat, positive, and often involves clever games, activities, and shows.

2. Our peer educators are former CSWs we are able to pay enough to get them out of sex, and who have a special credibility in the brothels. They share personal experience to highlight the importance of healthy sexual behavior.

3. Obviously, we also have a traveling brothel doctor (TBD). She sees the karza and those too ill to get out of bed, as well as the elderly. (That is a special sort of CSW, the elderly. They have gone from karza, to “50-50’s” (meaning they share profits with the madam) to independents (who rent beds for 10 rupees a client) to madams themselves. I am not even going into that here; I met a 60 year old who began before she menstruated, about 11 or 12. Dr. Singh has a special tenderness and compassion for old women in the brothels, watching her with them is extremely moving.)

4. Sanghamitra, the project named providentially for a great Buddhist figure, aims to empower sex workers via engendering healthy behaviors, self esteem, self efficacy, collective bargaining and the sense of their right to use their voice. It also provides products and services, vocational skills, cultural and creative activities.