HIV prevention while the bulldozers roll

HIV prevention while the bulldozers roll: Exploring the effect of the demolition of Goa’s red-light area.

Shahmanesh M, Wayal S, Andrew G, Patel V, Cowan FM, Hart G. Soc Sci Med. 2009; 69:604-12.

Interventions targeting sex-workers are pivotal to HIV prevention in India. Community mobilisation is considered by the National AIDS Control Programme to be an integral component of this strategy. Nevertheless societal factors, and specifically policy and legislation around sex-work, are potential barriers to widespread collectivisation and empowerment of sex-workers. Between November 2003 and December 2005 Shahmanesh and colleagues conducted participatory observation and rapid ethnographic mapping with several hundred brief informant interviews, in addition to 34 semi-structured interviews with key-informants, 16 in-depth interviews with female sex-workers, and 3 focus-group-discussions with clients and mediators. This article provides a detailed examination of the demolition of Baina, one of India’s large red-light areas, in 2004, and one of the first accounts of the effect of dismantling the red-light area on the organisation of sex-work and sex-workers’ sexual risk. The results suggest that the concentrated and homogeneous brothel-based sex-work environment rapidly evolved into heterogeneous, clandestine and dispersed modes of operation. The social context of sex-work that emerged from the dust of the demolition was higher risk and less conducive to HIV prevention. The demolition acted as a negative structural intervention; a catastrophic event that fragmented sex-workers’ collective identity and agency and rendered them voiceless and marginalised. The findings suggest that an abolitionist approach to sex-work and legislation or policy that either criminalises this large group of women, or renders them as invisible victims, will increase the stigma and exclusion they experience. For the targeted HIV prevention approaches advocated by the National AIDS Control Programme to be effective, there is a need for legislation and policy that supports sex-workers’ agency and self-organisation and enables them to create a safer working environment for themselves.

The authors of this thoughtful analysis were engaged in a study developing a participatory evidence-based HIV prevention intervention when the demolition of Baina started following a high court judgement. Because the dispersion and marginalisation of women following eviction would make the study impossible the researchers began documenting unfolding events and their effects on the community, as well as on the evolving relationship between the researchers and the community. This rich description helps understand how abolitionist discourses, whether religious or social reformist, converge to strip women who are sex workers of any agency, either by stigmatising them or by depicting them as victims by conflating sex work with trafficking, If you have wondered what a negative structural intervention is and does, and if you ever worked with communities, this is an article that you won’t be able to stop reading.