Sex workers speak out on HIV

For the first time, female Pakistani sex workers have been given a chance to talk about the difficulties of protecting themselves from HIV, at a national meeting in the city of Karachi.

Although Pakistan is a low-prevalence country, there are fears that a concentrated epidemic among injecting drug users could spread to female sex workers and other high-risk groups, such as men who have sex with men.

Ministry of Health data from 2006 to 2007 showed that female sex workers were a high-risk group in at least 12 cities.

Less than a quarter of the 4,639 female sex workers surveyed reported using condoms consistently, and 10 percent had had sex with an injecting drug user in the past six months. Illiterate sex workers were much less likely to use condoms than those with some level of education.

The meeting in Karachi - National Consultation on HIV and Sex Work - organised by the National AIDS Control Programme and the UN Population Fund (UNFPA), sought to improve HIV programming targeted at sex workers by consulting them.

"Although a few of our clients agree to wear a condom, the majority of them prefer sex otherwise," said Nasree*, a female sex worker and peer educator who attended the conference.

"It is very hard for us to convince them to put on a condom, but I feel that a female condom would put us in a position where we can protect ourselves against HIV and sexually transmitted infections." She added, however, that female condoms were hard to come by.

Another sex worker, Naila*, said legalising sex work would make it easier to protect their rights. "The police harass us for no reason; female sex workers who are working as outreach workers also get into trouble," she commented.

"For a way out, many times sex workers succumb to pressure and end up having sex with the policemen; those who don't, end up getting a beating and being violated forcefully."

Read more:

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Daniel Baker, UNFPA's country representative for Pakistan, said sex workers should have greater involvement in the design and implementation of HIV programmes. "The female sex workers have to be in there as managers, workers and leaders to benefit in the long run," he said.

UNFPA's Dr Safdar Kamal Pasha confirmed that the recommendations made by the sex workers who attended the meeting would be crucial to future programming.

"The female sex workers agreed that there should be vocational training and the means for alternative work opportunities for those who want to move out of sex work, as well as those who are past their prime and do not find sustainability in sex work," he said.

Other recommendations included prioritising HIV testing and referral services for sex workers, and finding ways to curb the stigma and discrimination they faced.

*Not their real names

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