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UGANDA: ‘Why Waste ARVs on Sex Workers?’

Evelyn Matsamura Kiapi

KAMPALA, Dec 3 2010 (IPS) - Sex workers, among the populations most at risk of HIV infection in Uganda, say they are yet to realise their right to health.

Sex workers say they have been left out of national HIV prevention programmes and have difficulty accessing life-prolonging drugs.

“Its not that these [HIV/AIDS] services are not available, it’s about the stigma attached to the sex worker,” says Maclean Kamya, a sex worker and human rights defender in the capital, Kampala.

“When we visit health centres, some health workers say, ‘But you are just a sex worker and we are just wasting our ARVs. Why should we give you our treatment? We have to give it to someone who needs it.’ That is total discrimination,” she said in an interview with IPS.

According to the latest UNAIDS report, sex workers constituted 10 percent of new HIV infections in 2009. Yet government is using punitive laws to discriminate against the groups considered most at risk, such as sex workers and homosexuals. Activists say this creates stigma and discrimination and leads to denied access to treatment, care and support.

Over the past few months, Uganda’s parliament has been considering several controversial laws, among them the HIV/AIDS Prevention and Control Bill, which human rights activists say can only act as catalysts for the AIDS epidemic by forcing sex work underground. Sex work is already criminal under Uganda’s penal code.

The Prevention and Control Bill criminalises the spread of HIV; far from slowing the spread of the virus, the bill’s opponents say it only makes it more difficult for at-risk populations to get treatment and information about sexual health.

Because of the stigma attached to sex work, Kamya revealed, sex workers who discover their status often become desperate and resort to alcohol and drugs rather than seek help.

“They feel that the world has forgotten them,” said Kamya, who is also coordinator of the sex workers’ fraternity in Kampala.

‘Illegal and criminal’

For the sex workers, it’s not just about access to medicines but also striving for the right to assemble, share ideas and forge ways on how to guard against violence, human rights abuses and HIV/AIDS.

Uganda’s government recently prevented the staging of a regional conference on advancing sex workers’ health rights and economic empowerment. The conference, organised by pan-Africanist women’s rights group Akina Mama wa Afrika (AMWA), had attracted sex workers from across the East African Community (EAC) economic bloc and was scheduled to take place in a Kampala hotel.

In a strongly worded letter to the hotel, State Minister for Ethics and Integrity, James Nsaba Buturo, warned that hosting a sex workers conference would be abetting illegality in Uganda.

Buturo later told IPS that there was no way a “prostitutes’ workshop” could take place on Ugandan soil. He defended his actions using provisions in the Penal Code Act and the Uganda 1995 Constitution to justify his actions.

“We have a position as a country which is supported by our laws. So to demand that even when their activities are illegal they should be recognised and supported is criminal really. They should be grounded and reminded about this,” he said.

Compromised rights

Kamya said Buturo misunderstood the agenda of the conference which was to focus about leadership skills, building self-esteem and entrepreneurial skills. It also looked at health rights like HIV/AIDS, sexual and reproductive health and economic empowerment.

“Personally I felt really terrible. So ashamed, embarrassed and hurt. We were trying to bring out issues that affect us as sex workers and thought the government would come out and support and appreciate us in our economic empowerment and reproductive health issues. But we were wrong,” Kamya said.

AMwA Executive Director Solome Kimbugwe said government’s actions were discriminatory and in violation of women’s rights as the issues for discussion that day were pertinent to women’s health and HIV issues.

“We had a big block around sexual and reproductive health and well-being because we are very conscious of the [HIV] statistics. We are also very conscious of the fact that sex workers have been dying of the HIV epidemic and that they are denied even the inherent rights that all of us abuse; like information, education and health. Many of them are also far away from accessing free ARV’s just because they say they are sex workers,” she said.

The sex workers said the minister’s actions were also in contravention of Article 29 the Constitution of Uganda, which guarantees the Freedom of Assembly, Speech and Non-discrimination. They also said the actions were denying them access to information on how to prevent and treat HIV/AIDS amongst them.

“Now we can’t have conversations; we can’t engage. Of course now they are going to go back to hide because it’s very scary. You don’t want to be arrested and wait in any of the jails in this country. The justice process is so long and protracted.

“Most importantly, such conversations allow for sex workers to know that they are active participants in their own journeys, in issues around sexual health, issues around choices and issues around managing the HIV epidemic. The biggest impact is the UNAIDS statistics. It’s very clear,” Kimbugwe said.

UNAIDS Country Coordinator Musa Bungudu expressed concern. “The right of an individual to access information, treatment and services should not be compromised for any other thing. We must all be inclusive and not exclusive. By denying the sex workers what they wish to do, we are not being inclusive,” he said.

Responding to a statement by Buturo that the current law on prostitution is not strong enough and that the government would want to “draft a new one that responds to the times we are now in,” Bungudu cautioned that such a move would need to be in line with international human rights instruments that government has signed up to.

“Whatever [the government] wants to do, it should be in line with the norms of the global community. And whatever human rights commitments Uganda has signed up to, it’s important that they respect it,” Bungudu said.

“It’s also important to look at how certain governance policies can support or make a situation worse. Uganda has 1.2 million people living with HIV. As at December 2009, there were 124,000 new infections. Ten percent of these were among sex workers.

“I think we need to be extra careful on doing anything that will help promote these statistics even higher,” Bungudu stressed.