POSITIVELY NEGLECTED

POSITIVELY NEGLECTED

PREETU NAIR
preetu_nair@gomantaktimes.com

(This article appeared on GT Weekender, Panjim edition, October 29, 2006)

Women in commercial sex work are seen as agents of HIV and their clients unwitting victims. But in the absence of any economic rehabilitation or community based services, the HIV positive trafficked victim, the marginalized section of the society, continues to be commercially sexually exploited. PREETU NAIR goes behind the obvious and discovers that if HIV/AIDS is an epidemic of bad choices then it is also an epidemic of the choiceless and voiceless.

Rehana has just resumed her night job at Vasco after a brief illness. If luck is smiles she will earn anything between Rs 100 and 500, from what she calls the only work she
has.

And because she and her family must survive, she fails to insist that the customer to use condom though she is HIV positive and aware that using condom decreases the risk of HIV transmission. "Most often we are not in a position to negotiate safer sex” she said.


When Rehana (one of her many names) was 15, she caught a morning bus to Goa from Karnataka, along with her lover. By evening she was sold to a brothel keeper in the unofficial red light area of Baina for Rs 10,000. At the age of 23, she tested HIV positive.

Rehana, who till then wanted to live a normal life and get rid of the world of drinks, diseases, beatings and neglect in utter disbelief started drinking heavily.” I began drinking heavily because I knew I was dying. Besides, I drink to reduce the pain I undergo while having sex with a customer".


She knows that she can still live well and long, if she gives up her addiction to alcohol, gutka and beedis coupled with a careless attitude to medication and failure to adopt lifestyle changes. But what's killing her more than the virus is the lack of hope, the
absence of family and community support, tension and their poor socio-economic condition.

"I am aware of the community care services for HIV positive persons, but don’t want to avail them as of now I don’t want to leave Baina, my home, where I am not stigmatized and treated differently," she admitted.

Rehana is not alone. There are many like her who want to leave commercial sex work (CSW) and live a healthy life but are unable to as there is no alternative. However, she added, "If these services are made available to me at home along with economic rehabilitation then I would definitely leave CSW and live a healthy and less painful life".

Living with HIV is not easy. And for a HIV positive trafficked victim it is a bigger struggle. Despite their suffering they are rarely able to express themselves. To survive, majority of
them hide their HIV status.
What is really alarming is that though there is awareness about risks, use of condoms is low, both with non-paying and paying partners, thereby increasing the risk of transmitting the virus. A Behavioural Surveillance Survey 2003-04 at Baina showed that only 69 percent used condoms regularly.

Goa State AIDS Control Society (GSACS) sentinel surveillance estimates that in 2003, around 30.14 percent sex workers in the state were HIV positive. However, the real figure would be probably much higher now.

The United Nations recently reported that that India with 5.7 million infections has become the HIV/AIDS capital of the world surpassing South Africa’s 5.5 million. Though there is dispute regarding the number of infections, no one denies that despite various attempts the spread of the virus shows no sign of slowing down.


Talking to GT/Weekender, Dr Prakash Kanekar, Project Director, Goa State AIDS Control Society (GSACS) admits that they can't afford to be complacent and need greater commitment to reverse HIV/AIDS epidemic as the task has become more difficult after Baina demolition. "It is now extremely difficult to identify a commercial sex worker”


Even Arun Pandey from Arz, an NGO working with trafficked victims in Goa, candidly admits that HIV positive trafficked victims continue to be victimized due to lack of community based services and failure of the state and even NGOs to protect them. Instead of making them independent we make them dependent. We not only put their life at risk but also fail to control the spread of the virus.” Arun added.


Interestingly, majority of targeted interventions undertaken by NGO's through GSACS among CSWs are focused on free condom distribution and creating awareness through peer educators. Besides, GSACS also funds two community care centres with 10 beds each –Freedom Foundation in the North and Aasro in the South – but they are short stay home providing services required in between a home and hospital.

However, Ninoshka Norton, Project Coordinator, Freedom Foundation, admitted
that they have often observed that HIV positive trafficked victims put on DOTS or ART don't continue treatment once they leave the home. "Once out of the home, they go back to their normal routine and start drinking and smoking. This deteriorates their health further," she added.


No easy choices

Though it is difficult to describe the predicaments and circumstances women
in CSW face, GT/ Weekender tries to comprehend a few of them to better understand their lives and situations under which they live

ALL ROADS LEAD TO …

The eldest daughter of the family, Surekha was dedicated to Goddess Yellama as soon as she gained puberty and brought to Baina by a brothel keeper for CSW. Three years back she was tested HIV positive and was also found to be suffering from TB. “I wanted to leave CSW but there was no alternative. Besides there is no one to take care of me,"
she said.

Though her CD4 count is low, doctors can't put her on ART, because she is taking treatment for TB. However, her TB can't be cured because she doesn't regularly take medicines.

NO DATE WITH MEDICINES

Madhumita is just back from a date in Mysore. Date means going out of the state for CSW. She is fully educated about the pros and cons of HIV, yet hardly practices what she has been preached.

Two years back when she tested positive, she expected support from her mard (lover). He was at first sympathetic but when he needed money, she was back on the streets. She protested but he threatened. "I started to go on date, 15 days after I was detected positive. I was feeling week but then got tired of the abuses hurled at me by my mard.
When I work, he is happy and there is peace at home", she reveals. However, what she reveals later after is much shocking, "whenever I go on a date, I stop DOTS treatment,"
she admitted

HOME IS WHERE YOUR HEART IS

In a police raid at Baina recently, a HIV positive trafficked victim was rescued and sent to the State Protective Home. At that time she was taking DOTS treatment, but stopped it when sent to the home. Her condition deteriorated and she started vomiting blood at the Protective Home. Thus forcing D.C. Kundalkar, In - charge, Protective Home to write to the Mormugao Deputy Collector Levinson Martins, "it is not possible to take care of her and medically treat her in the Protective Home."

As the medical tests confirmed that she was HIV positive and suffering from TB, Martins shifted her to Assro and meanwhile tried to make arrangements to send her back to her home in Karnataka. But she escaped from there within a few days and returned to her home in Baina.

*(Names of HIV positive trafficked victims have been changed in order to protect their identity)

** (This story was made possible by a financial grant from The EU-India
Media Initiative on HIV/AIDS implemented by The Thomson Foundation)