WASHINGTON As the world's largest AIDS conference kicks off in the United States for the first time in 22 years, activists want to ensure the voice of sex workers is not silenced in the discussion of how to overcome the global epidemic.
As many as 20,000 people -- including top scientists, politicians and celebrities -- are expected to attend the week-long International AIDS Conference in Washington, which began on Sunday. But while the United States lifted a travel ban on people infected with HIV in 2009, it has clung to a prohibition on the entry of foreign sex workers established more than two centuries ago.
Activists, and some conference officials, say that runs counter to a goal of achieving an end to the epidemic that affects more than 34 million people worldwide. On Sunday, a group of sex-worker activists carrying red umbrellas and noise-making vuvuzelas crashed the AIDS gathering's kick-off news conference.
Other events planned for the week include a protest in front of the White House on Tuesday and daily live video link-ups with the Sex Worker Freedom Festival -- an alternative satellite event taking place in Kolkata, India, in response to the exclusion from Washington of foreign sex workers.
Along with drug users and men who have sex with men, sex workers make up three of the most critically affected, yet often isolated populations affected by HIV/AIDS.
"I don't know how we're going to ever see an end to AIDS in our lifetime -- and we believe we can, especially with scientific advances -- and have an AIDS-free generation, without including all of those populations who must be involved as part of this solution," said U.S. Rep. Barbara Lee of California.
Lee was instrumental in lifting the travel ban on human immunodeficiency virus patients and last week introduced a proposed law in the House of Representatives to do the same for sex workers.
A landmark study published earlier this year in the Lancet Journal of Infectious Diseases showed that sex workers' risk of HIV infection is 14 times higher than the general population. They also play a role in the global transmission of the disease.
In Asia, for example, home to an estimated 10 million sex workers, "men who buy sex are the single-most powerful driving force" in that region's rising epidemic, according to the Commission on AIDS.
Michel Sidibe, executive director of the United Nations AIDS program, said it was "outrageous" that in 2012 "when we have everything to beat this epidemic, we still have to fight prejudice, stigma, discrimination, exclusion, criminalization."
He called for a new paradigm where the people most at risk -- including sex workers -- were placed at the center of the global response to HIV/AIDS.
LAW ENFORCEMENT VERSUS PUBLIC HEALTH
Meg, a former sex worker from Chicago who asked to have her last name withheld, is one of the few voices representing the female sex worker population at this year's conference.
She blames what she calls a "systematic exclusion" of sex workers from policy discussions by academics, reporters and lawmakers for prevailing stereotypes of "people thinking of sex workers as vectors of diseases. "
Sienna Baskin, director of the Sex Workers Project of the nonprofit Urban Justice Center which provides legal and social services, said tackling infectious disease transmission in this population will require a much broader view of its role in society.
"To reduce HIV prevalence among sex workers, we have to look at this broader human rights framework," she said. "We need to create a better human rights situation overall for sex workers -- that's the only way we can get to this part of their lives -- HIV transmission."
In the conference host city of Washington, HIV infection rates are among the highest in the United States and have drawn comparison to sub-Saharan countries. A report released last week by Human Rights Watch suggested that police practices in the U.S. capital may even be fueling the HIV epidemic.
The report cited complaints from hundreds of sex workers in Washington and three other cities who say they were subjected to police threats, harassment and even arrests for carrying condoms. In many cases, police officers were said to be confiscating the same condoms distributed by city public health departments to prevent HIV transmission.
According to Megan McLemore, senior researcher on the Human Rights Watch report, the disconnect between law enforcement and public health shows that many have not recognized sex workers as allies in the fight to curb HIV infection.
"The public needs to be asked: ‘Is it more important that an individual person is charged with prostitution and convicted ... because there is a condom involved, or is it more important that the condom be protected from criminalization for HIV prevention?'" McLemore said. "That's the decision that has to be made by everyone at all of these levels."
(Editing by Michele Gershberg and Matthew Lewis)