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Commercial sex workers face HIV threat

[Pakistan] Women from Heera Mandi - tough lives behind the venner. Although claiming to be dancers, the vast majority work as commercial sex workers putting them at serious risk of contracting HIV. [Date picture taken: 01/31/2007]
(Tariq Saeed/IRIN)

Beena, 50, runs an 'establishment' in Pakistan's eastern city of Lahore, where her two daughters and a niece sell their bodies. "Most of us here know all about this AIDS thing. Some NGO people keep coming and talk to the girls about it – but just knowing about it is not always of much use," she mused, chewing on a wodge of tobacco.

It's a good point: the fact is that although many sex workers in Lahore's red-light area may have some awareness of the HIV risks they face, they can, in real terms, do little about it.

In a 2006 update on the AIDS epidemic in Pakistan, the World Bank noted most sex workers lacked the power to negotiate condom use with the clients on whom they depend.

"Our job is to keep our clients happy. Sometimes they get very angry if we produce a condom, because it is a reminder to them that we have had sex with other men," said a young woman, sitting on one of the shabby, over-stuffed sofas in Beena's sitting room.

She introduced herself as "Dolly", using a pseudonym like almost all the women here, and says she has been in the "business" for nearly 10 years, since she was 15.

There are an estimated 25,000 sex workers in Lahore, Pakistan's second most populous city, the majority based along the winding alleys of 'Heera Mandi' or the 'Diamond Market', which has existed for centuries.

The district reached the height of its glory under the flamboyant Mughul Emperors, who ruled the Indian sub-continent from 1526 to 1857. Famous courtesans were visited by men from aristocratic households, and people came from across the Indian sub-continent to admire the dancing and singing of the legendary 'dancing girls' of the area, who were known also for their charm, wit and ability to recite Persian poetry.


Since those heady days, the area has declined into a sordid tawdriness. A clamp down against prostitution under the Islamization policies of Pakistan's military dictator, the late General Ziaul Haq in the 1980s, led to many of the women leaving the area to take up residence – and continue their business – in other parts of the city.

Those left behind are often the most impoverished and the most vulnerable. Apart from the traditional families who have lived in Heera Mandi for centuries, taking pride in their classical dancing skills and maintaining they are entertainers, possibly descended from the royalty that once thronged Heera Mandi, many young women from villages around Lahore, or even from Afghan refugee camps, have ended up here.

Looked down upon by the established families, they often tell terrible stories of brutality and exploitation.

"I come from a respectable family in Sheikhupura (a small town on Lahore's outskirts). I was married off to a man in my late teens. He treated me well for a while, but then he accumulated massive gambling debts, turned to drink and brought me here and sold me," said Shahzadi.

She now lives in a small room, at the top of a rickety old house, and entertains her clients in a room tucked away at the back.

Along the narrow alleys of Heera Mandi, in lonely, stark, rented rooms, many women tell similar stories. Some talk of violent husbands from whom they escaped, others narrate being lured away from their villages by promises of jobs or a role in a film, and then sold here. Most yearn for stability and security in their lives – and also respect in a society that looks down on them as "fallen" women.

The streets, silent in the day time, bustle at night, as music from the balconies where the women, with heavily powdered faces and gaudy clothes, dance and sing, to draw in customers. The area houses not only the 'dancing girls', but transvestites, drug addicts, down and out musicians and others considered, for one reason or another, to be social outcasts.

Strung along the shops selling musical instruments and the food stalls are the 'money' shops that sell crisp notes of small denominations that are flung before the women as they dance by clients to express admiration. Garlands made of currency notes are available, for men to drape around a favourite performer.

While the women of Heera Mandi, like the svelte Neena, with her henna-reddened hair, are street-wise, and well aware of the risks they live with constantly, AIDS is something many are still reluctant to discuss, despite the fact that the global epidemic is now making rapid inroads in Pakistan.

In April 2006, the World Health Organization (WHO) reported there could be 70,000 to 80,000 unreported HIV cases in Pakistan – a number making up 0.1 percent of the adult population. There are 2,998 reported cases.

According to the WHO/UNAIDS, Pakistan is classified as a low prevalence but high risk country for the spread of HIV, due to the presence of a growing number of injected drug users, unscreened blood donations and unsafe sexual practices by both male and female sex workers.

Recent findings by Pakistan's Ministry of Health have found that while prevalence remained below one percent among prostitutes, over 20 percent in Karachi and Lahore had sold sex to injecting drug users, and condom use was low in those encounters. The same study found high rates of STDs among sex workers and other high risk groups.


In most cases they are in no position to demand safe sex from clients. But there are also other factors; many of the women, especially those from 'traditional' Heera Mandi families, maintain that dancing is their main profession and the sex a kind of 'side line' that they occasionally engage in.

While this claim is not borne out by independent analysis, it is used by the women as a means to show their 'respectability' in a society where sex outside marriage is both against the law and taboo.

"I have some regular clients, with whom I spend the night. But these are men from noble families, they are 'clean' and they cannot make me sick," maintained Kiran, taking a rest from dancing practice on her large double bed, where a small group of ragged pink and grey stuffed animals sat.

She also insists, shyly bringing her hand up to her mouth, that she does not know what a condom is, but has heard it is kept by "promiscuous women" who have "sex with everyone". She maintains that her mother, who acts as a chaperone, vetting clients for her daughter, would "not allow anyone 'dirty' with me".

The combination of the women's own low status, exploitation, and the social attitudes towards sex that prevail in society, make sex workers especially vulnerable.

"There is a very real risk of a rapid spread of HIV/AIDS among this population, and other high risk groups, including migrant truck drivers who engage in sex with [sex workers] in many parts of the country," said Dr Qaisar Rana, who for several years ran a small clinic in the Heera Mandi area.

Others, who have emerged as spokespersons for the women of Heera Mandi, including leading artist Iqbal Hussain, whose own mother was a sex worker, emphasise their "lack of empowerment, exploitation and helplessness".

Despite attempts to raise awareness about HIV, it seems the message has not yet hit home in Heera Mandi. This means that apart from all the other risks they face, the women working here could soon confront another, still more alarming danger.

Certainly, the shadow of AIDS seems to be lurking everywhere amidst the narrow alleyways and carved balconies of Lahore’s unique entertainment district – and no one can predict how long it will be before it strikes, claiming more victims among the women who walk the streets here each night, until the call to prayers from the Badshahi Mosque announces the arrival of dawn.


This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information:

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