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Commentary :: Gender & Sexuality : Government & Elections

Media Alert: Thought-Provoking Analysis Of Link between HIV Prevention and Condemning Prostitution

U.S. policy makers should make their decisions based upon clear objectives and sound research. This article questions the efficacy of a new policy that requires international HIV Prevention Agencies to condemn prostitution in order to receive federal funding.
Amy Weiss, Community Education Coordinator
Santa Cruz AIDS Project
(831) 427-3900, x226
amyw (at)


The United States provides large amounts of funding to AIDS organizations each year with the intent to curb the rate of HIV transmission both nationally and internationally. While everyone can agree that working to prevent new cases of HIV is a worthwhile investment in both humanitarian and economic terms, there are differing ideas about how to best go about it. Case in point, the United States recently implemented a controversial policy that requires international AIDS organizations to sign a pledge that publicly condemns prostitution in order to receive federal grant money. This policy made headlines last month (May 2005) when Brazil refused to sign the pledge and thus turned down $40 million of U.S. aid.

Some people might read this and wonder “What’s so controversial about requiring organizations to sign a pledge that condemns prostitution? Don’t most people think that prostitution is bad for society?? However, there is a major difference between recognizing the detrimental affects of a behavior and requiring organizations to condemn a behavior; one is a moral judgment while the other is a matter of national legislation. Whether or not you, or I, or the Bush administration take an ethical stance against prostitution, it is important to question whether requiring organizations to make a moral judgment about prostitution is instrumental in the prevention of HIV transmission. Therefore, the most important questions to ask of this new policy are:

1) What outcomes are anticipated as a result of condemning prostitution?
2) Does existing research give us any indication that condemning prostitution will lead us towards the intended outcomes?

In a nutshell, what do the U.S. Representatives that put this policy into motion hope to achieve and what is the research that supports their decision? These questions must be adequately addressed because it is the responsibility of our representatives to make decisions based upon clear objectives and solid research when they pass legislation that impacts national and international HIV prevention strategies.

1) What outcomes are anticipated as a result of condemning prostitution?

Since the policy requiring organizations to condemn prostitution is directly linked to AIDS prevention funding, we can assume that its desired outcome is to decrease HIV transmission rates. Senator Brownback (Republican-Kansas), a leading Senate conservative, implied that there are additional objectives with this policy when he told the Wall Street Journal “Obviously Brazil has the right to act however it chooses in this regard. We're talking about promotion of prostitution, which the majority of both the House and the Senate believes is harmful to women.? The statement made by Senator Brownback elicits further questions, such as “Is a country or agency actively promoting prostitution if it refrains from criminalizing or condemning it?? and “Will condemning prostitution bring less harm to women??

2) Has research been conducted, both nationally and internationally, that explores the impact that condemning prostitution will have on lowering HIV rates and bringing less harm to women?

A logical starting point when examining the impact of attitudes towards prostitution on HIV rates and safety for woman is Nevada, the only state in our country that allows for legal prostitution in counties with populations under 400,000. Nevada state law requires weekly testing for several sexually transmitted infections (STI’s), monthly testing for HIV, and mandatory condom use for all oral sex and sexual intercourse in all of its registered brothels. Many people morally object to idea of legalizing prostitution, but as a country, it is important to objectively look at what research can teach us about the pros and cons of regulating prostitution. If HIV rates and women’s safety are the objectives, how do we make use of research that indicates lower HIV rates and safer conditions for sex workers in legal brothels? Is it possible for our country to grudgingly accept that prostitution occurs whether it is legal or not? Is decriminalizing and regulating prostitution the same as promoting it? Are there ways that we can create viable economic alternatives for women are currently involved in sex work?

We can also learn a lot from international studies in which HIV prevention programs worked directly with sex workers in order to increase condom usage and lower HIV transmission rates. In 1996, studies were conducted in three different countries (Thailand, Indonesia, and Zimbabwe) that used various methods to lower HIV transmission, including combinations of community building, outreach, peer education, national advertising campaigns, involvement of public health professionals and community leaders, increased condom accessibility, mandatory condom use for sex workers, and input from commercial sex workers. These studies showed great success in their intended goals, with condom usage increasing by up to 76% and sexually transmitted infections reduced by up to 85%. What can we learn from programs that successfully reduced HIV transmission rates without condemning prostitution?

Lastly, we should compare our country’s chart topping rates of STI’s, teen pregnancies, abortions and sexual assaults with those of other countries in which prostitution is not condemned or criminalized. Canada, Israel, and Brazil are all countries in which prostitution is legalized, but the United States has at least 2 times the amount of HIV/AIDS infections per capita when compared to these countries. In fact, the Netherlands, known internationally for its redlight district, has much lower rates of HIV transmission, sexual assault, and murder than the United States.

What can we make of this research? At the very least it shows us that the United States has higher rates of HIV transmission, sexual assaults, and other undesirable consequences of sex than other industrialized countries that have legalized prostitution. If that is the case, how can Congress substantiate the opinion that condemning prostitution will help to lower HIV transmission rates and create safer conditions for women? Does it make sense for the U.S. government to attach moral judgments to international HIV prevention funding, especially when we might have something to learn from the success that other countries have in achieving those outcomes? If not, then we must be willing to thoroughly investigate the adjustments that can be made in an effort to make progress. While there are no easy solutions or sure-fire methods to achieving healthy minds, bodies, and communities, our country can strive to address these issues head on and utilize successful strategies, not mere judgment or opinions, in its approach.

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