Learning from Sonagachi and Mumbai: Decreasing HIV prevalence in Maharashtra

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A sobering statistic has recently come to light in WHO’s 2011 Global HIV/AIDS Response; 29% of sex workers in Maharashtra are HIV positive. This is nearly five times higher than India’s average among sex workers and perplexing when compared to the state’s largest metropolis, Mumbai, and other regions of India notable for sex work such as Kolkata, both of which have achieved an extremely low prevalence among sex workers.

On the one hand, we must be cognizant of the public health risks associated with such a high prevalence. On the other, we must avoid the stigmatizing response and punitive policies for sex workers which runs the risk of hiding the epidemic and infringing on their human rights. This point, it has been argued, has been responsible for the low rates in Mumbai and Kolkata through empowering, community-based initiatives such as the highly regarded Sonagachi project.

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Sonagachi and other related initiatives in Mumbai have focused on both decreasing stigma and HIV through organizing and mobilizing sex workers to advocate for their rights. They have made considerable gains for themselves and for public health in India. However, they face several challenges and repressive policies by the state’s courts, police, and legislators. Sex workers, NGOs, and policy makers in Mumbai and Kolkata have creatively worked together to minimize these barriers and HIV prevalence by recasting the roles and rights of sex workers. It is time for policy makers in Maharashtra to take stock of these lessons and foster a friendlier policy environment for sex workers.

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3 Responses to “Learning from Sonagachi and Mumbai: Decreasing HIV prevalence in Maharashtra”

  1. carolyneclark Says:

    The Sonagachi Project has indeed gotten a lot of publicity because of their supposed successes in empowering sex-workers and keeping HIV prevalence down. But as NY Times journalists Nicholas Kristof and Sheryl WuDunn point out in their very well-researched book, Half the Sky, these successes have been exaggerated, “simply an illusion peddled to outsiders” (p.29). Unfortunately, it seems that all the praise for this model from the outside has served as a cover for traffickers, and the trafficking of underage girls, the sale of virgins, and abusive pimping is alive and well in the Sonagachi brothels. The book details the research of Anup Patel, a Hindi-speaking Yale medical student, who visited the brothels and covertly interviewed the sex-workers there. “He found that not only is the price of sex in Sonagachi negotiated between the customer and the brother owner (rather than with the girl herself), but the customer can pay the brothel owner a few extra rupees for the right not to use a condom. The girl has no say in that.” (p 29). Another sex-worker he talked to told him quietly that “almost none of the prostitutes in Sonagachi came with aspirations of being a sex worker. Most of them, like herself, were trafficked.” (p.30). Patel and his group raided one brothel where dozens of underage girls started fleeing when the pimp gave the urgent call, “Visitors are here!” (p.30). One of the sex workers that Kristof had the opportunity to interview said that during 3 her years in Sonagachi, she “was not allowed outside and had none of the freedoms that DMSC [the sex workers union] claims exist. She was beaten regularly with sticks and threatened with a butcher’s knife.” (p.29)
    In terms of the success in curbing HIV prevalence Kristof and WuDunn cite a study done by the Harvard School of Public Health that found that “at the time the Sonagachi Project bagan in Kolkata, HIV prevalence among sex workers in Mumbai was already 51 percent and in Kolkata 1 percent.” (p.28). So it is unclear that the Sonagachi Project was actually responsible for this difference.
    Unfortunately, atrocious human rights violations are still rampant among the sex workers of Sonagachi. The sex workers there still do not have a voice; it is only their exploiters who are being heard and who are hawking their success stories to the West as a smoke screen to protect what is for them a lucrative business.

  2. preetyr Says:

    The discussion on Sonagachi project has brought in facts beyond success story. It is considered to be one of the successful model of community empowerment and creating enabling environment for safer sexual behavior.

    However, the situation discussed above highlights the flaws in the system, not only in respect to health but also violation of human rights. Recently, i watched a documentary on trafficking of girls from Nepal to Mumbai and how they are forced the girls into sex trade. The documentary have shown that the local cops are aware of this issue but they are not doing anything to stop it. Instead they are making money out of it.

    It is an irony that the system is unable to address these known issues even after repeated evidences.

  3. yungchinglin Says:

    I completely agree with the statement that the stigmatization and punitive policies for sex workers should be avoid. Indeed, stigmatization imposes the great barrier to addressing HIV/AIDS problems, especially among the high-risk populations. Some people would question the validity or legitimacy of needle exchange program or methadone substitution therapy. Are they actually the encouragement of illicit drug use? However, the policy and the treatment do bring positive effects on those drug users’ health. Although their drug using behavior is illegal, they still have the rights to receive adequate health care.Blaming for their illegal behavior only does not solve the problem, but generates more.
    Instead of blaming for the sex workers’ prostituting behavior, the Sonagachi initiative works on eliminating the stigmatization, which encourages the sex workers to fight for their rights: the rights to access to preventive measures and health care. I believe that ”Health for All” will be an achievable goal in the near future.

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