Confronting structural violence in sex work: lessons from a community-led HIV prevention project in Mysore, India

Abstract

Evidence from community-led HIV prevention projects suggests that structural interventions may result in reduced rates of HIV and STIs. The complex relationship between empowerment and confronting stigma, discrimination and physical abuse necessitates further investigation into the impact that such interventions have on the personal risks for sex workers. This article aims to describe lived experiences of members from a sex worker's collective in Mysore, India and how they have confronted structural violence. The narratives highlight experiences of violence and the development and implementation of strategies that have altered the social, physical, and emotional environment for sex workers. Building an enabling environment was key to reducing personal risks inherent to sex work, emphasizing the importance of community-led structural interventions for sex workers in India.

Keywords:

• sex work
• HIV prevention
• structural violence
• community-led intervention

Acknowledgements

The first author would like to thank her research colleagues and friends, Katie Brushett, Vanessa Dixon, and Nadia O'Brien, for providing incomparable support and sharing in his enthusiasm for this project. She also offers her sincerest gratitude to all members of the Ashodaya community for their inspiring determination and willingness to participate and share their stories with her. Support for this study was provided by the Bill & Melinda Gates Foundation through Avahan, its India AIDS Initiative. The views expressed herein are those of the authors and do not necessarily reflect the official policy or position of the Bill & Melinda Gates Foundation and Avahan.

Notes

1. DMSC is a sex workers' organization in Kolkata that implements the Sonagachi Project's philosophy.

2. Ashodaya's members include FSWs, MSWs, and TGSWs who work together to reduce the personal risks inherent to sex work. Although there has been little research done on MSWs and TGSWs within the context of sex work in India, the public health community is beginning to recognize the vulnerability of these populations to HIV, as well as to severe forms of stigma and physical violence (Lorway Reza-Paul, & Pasah, 2009).

3. Most FSW have "regular partners" or boyfriends. Sex workers usually have a deep emotional dependence on these men, who provide some support and security. Most often, the boyfriends will live on the earnings of the sex workers. HIV transmission risk is high because condom use is compromised with regular partners, who often have multiple sexual relationships.

4. Brokers are usually older men or women (sometimes former FSWs) who facilitate clients for FSWs.