pp. 118-119 in
Bioethics in Asia
Editors: Norio Fujiki and Darryl R. J. Macer, Ph.D.
Eubios Ethics Institute
Copyright 2000, Eubios Ethics Institute
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3.6. HIV/AIDS and Prostitution: Feminist Perspective
Zhejiang Academy of Social Sciences, Hangzhou 310025, China
The spread of HIV/AIDS has become a worldwide trend in recent years. There is a common view that the commercial sex trade, and especially the womenfs commercial sex trade is one of the main ways that HIV/AIDS is spread, and because of this high risk behaviour, women sex workers are a high risk group for infection with of HIV/AIDS., Therefore the women sex workers are seen easily to be condemned.
There are mistakes in the view. Firstly, the experiences around the world show that to improve taking preventive measures such as using condom is an effective way to reduce HIV/AIDS transmission. It means that one of the important factors to the spread of HIV/AIDS is the shortage of safety precautions in commercial sex trade but commercial sex trade itself. Because it is difficult for women sex worker to protect themselves effectively in commercial sex trade under the power of male visitor, the commercial sex trade become one of the important ways to spread HIV/AIDS. For example, a survey on women sex workers made by me in 1996 found that male visitors often refuse to use a condom in commercial sex trade, for getting themselves a more pleasant sexual feeling. So the great majority of women sex workers have to use condoms less or never use it. The '95 surveillance report on HIV/AIDS in mainland China said that in this year, the first surveillance survey (from Apr. to Jun. ) on 3297 prostitutes found that the prostitutes who use condom in commercial sex trade 'every time' was 13%, 'often 'was 6.7%, 'raref was 14.6%, 'never' was 65.6%, 'unclear' was 0.1%. The second surveillance survey (from Oct. to Dec.) on 3160 prostitutes found that the prostitutes who use condom in commercial sex trade 'every timef was 12.9%, 'often 'was 4.2%, 'raref was 14.1%, 'never' was 68.3%, 'unclear' was 0.6%. So, I think that the commercial sex trade that shortage of safety precautions is just the high risk behaviour but all commercial sex trade, and male visitors rather than the women sex worker should take the chief responsibility for the shortage.
Secondly, it is a fact that healthy male clients are infected HIV/AIDS by the women sex workers with HIV/AIDS in commercial sex trade, but it is also the fact that healthy women sex workers are infected with HIV/AIDS by the male clients with HIV/AIDS in commercial sex trade. As I know lately, some cases where healthy prostitutes are infected by the foreign male clients with HIV/AIDS are found in mainland China every year, even the cases that healthy girls or wives are infected by their foreign male friends or husband with HIV/AIDS are not rare. For example, twenty-one persons with HIV/AIDS were found from 1988-Jun. 1996 in Wenzhou municipality, Zhejiang Province, in which two Chinese domestic residents were both infected with HIV by their foreign husbands. Another case is about a girl from Yunnan Province. After being infected AIDS by regular foreign male visitor in commercial sex trade, she swore that she make reprisal to men by her body with AIDS. Then a lot of men became her visitors. I think that we should not only regard women sex worker with HIV/AIDS as the origin to transmit HIV/AIDS and ignore the dangers of male visitors with HIV/AIDS, who are the origin to transmit HIV/AIDS. As another high risk group, male client should be under surveillance and be controlled effectively as women sex worker also ought to be done. The idea to regard the women sex worker as more dangerous than male client should be challenged.
Thirdly, the women sex workers with HIV/AIDS are patients as the patients with other kinds of diseases; HIV/AIDS are occupational diseases as other kinds of occupational disease if we regard sex service as a kind of job. From humanitarianism, the first things we should to do for the women sex workers with HIV/AIDS are that care the sickness and save the women patients, but criticize them on morality. Additionally, the facts show that the shortage of safety precautions is the important factor leading to spread HIV/AIDS in commercial sex trade, a lot of women sex workers are victims but the origin transmitting HIV/AIDS. To protect women sex worker from HIV/AIDS effectively is more important compare with regarding critically them simply as demoralized or law-breaker. It is necessary to inform women sex worker of the prevention knowledge and way effectively, the workstyle and lifestyle which will be advantageous to their health and how to say "no" to those dangerous visitor and so on. Besides, since the male visitors with HIV/AIDS are also the origin transmit HIV/AIDS, since the power of male visitor is the factor leading to women sex workers use protection such as condom less or never in commercial sex trade, it is also necessary for prevention and control HIV/AIDS to strengthen education to male visitor so that them change their high risk behaviour in commercial sex trade.
For more insight, there are various causes for those women to become sex workers or be engaged in commercial sex trade. For example, a survey on 389 prostitutes in Zhejiang Province China made by me in 1990 found in the 389 prostitutes who responded to the question about what direct causes lead them to be engaged in commercial sex trade, 16% said "disappointed in love or for love", 13% said 'be instigated by somebody', 13% said ti 'be neglected or doted by their parents', 12% said to 'retaliate against a man', 12% said 'domestic economic difficulty', 10% said to 'abandon themselves to despair', 9.5% said 'to be at odds with husband', 5.7% said to 'seek pleasure' , 4% said to 'try sex behaviour', 2.6% said to 'look for dependence and care', 1.3% said 'the need of sexuality', and 1.3% gave other reasons. Some of those prostitutes told me that they were engaged in prostitution to build a home. Some women said that they were forced by husband to make money through doing prostitution to pay gamble debts for their husband. It is clear that a lot of prostitutes or women sex workers are victims of male power and patriarchy. However, it is a free choice for some women sex workers or prostitutes to exchange sex service with money. All of women sex workers or prostitutes have the right to get self-protection and be protected from occupational diseases include HIV/AIDS in sex work; have the right to be willing to choice and practice this or that protective way under knowing the facts either those who are forced to do sex work or those who are willing to do sex work.
It is my conclusion that the commercial sex trade has a shortage of precautions but all of commercial sex trade is high risk behaviour for spread of HIV/AIDS, and all persons in the commercial sex trade, including the women who exchange sex service for money and the men who exchange money for sex service belong to a high risk group. So we should control more strictly the commercial sex trade that has a shortage of precautions, and place the group of sex service customer and sex server under surveillance to protect them from HIV/AIDS effectively.
Furthermore, there is a social background behind the spread of HIV/AIDS. I think that these are essential to improve the social existence of womenfs life and reduce the factors which force women to be engaged in high risk commercial sex trade. The equality between genders and womenfs betterment will be extremely helpful to prevent and control the HIV/AIDS spread.
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