性工作: May 2011的归档






  Globally, women constitute approximately fifty percent of all HIV infections. Women may eventually comprise the majority of people living with HIV/AIDS in the world; this is already true in Sub-Saharan Africa where women constitute sixty percent of the individuals living with HIV. The recognition that women's inequality may be a driver of women's vulner- ability to contracting HIV has led to a series of feminist legal responses in an effort to address HIV.


  This Article assesses feminists' conflicting legal, policy, and regulatory proposals to address sex workers' vulnerability to contracting HIV. This Article employs a Governance Feminism ("GF") analysis that allows us to assess feminists as powerful actors in the institutions that govern HIV. This Article focuses on two cases in which particular legal and policy proposals can be traced directly to feminist engagement and disagreement: the drafting of the United Nations Joint Programme on HIV/AIDS Guidance Note on Sex Work and the creation and implementation of the Anti-Prostitution Loyalty Oath.

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作者:Aziza Ahmed




  本文分析了不同的女性主义者针对性工作者感染艾滋的脆弱性所提出的相互冲突的法律、政策和管理方面的提案。文章采用Governance Feminism分析法让读者了解女权主义者作为有影响力的行动者,积极参与对艾滋问题的管理。本文关注的两个案例可以清晰地表明女权主义者如何参与不同的法律和政策提案,以及如何表达不一致的意见。这两个案例分别是:《联合国联合项目:艾滋指南与性工作须知》和《打击卖淫效忠誓言》的制定和实施。



Iwag Davao--达沃市之光(菲律宾)

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1994年5月,Iwag Davao起初是一个对25名男同性恋者开展艾滋朋辈教育培训的研讨会。该培训受到了男同参与者热烈地回应和积极地参与,之后Iwag Davao有继续为另外25名男同性恋者继续开展培训。在此基础上,1994年10月,Iwag Davao在男同性恋者委员会的组织下正式成立为一家非政府组织。Iwag在宿雾语中意为光,因此Iwag Davao代表了"达沃市之光 "的意思。








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By Tan Ee Lyn and Fitri Wulandari

JAKARTA | Tue Apr 12, 2011 10:28am EDT

Liana, who holds an economics degree, is one of 300,000 Indonesians in the world's most populous Muslim nation who have fallen victim to widespread ignorance about AIDS, and the government's inability to campaign effectively against it for fear of being accused by conservatives of promoting promiscuity.

Social taboos and strict laws that ban prostitution also work against those most vulnerable to the incurable disease, because police often use condoms -- one of the best protection against AIDS -- as evidence against sex workers.

Although HIV prevalence in Indonesia's population is low at 0.2 percent, the government and health experts are worried because the number of newly confirmed cases has more than doubled to 4,158 in the five years to 2010.

"When I started the job, I did not know anything about HIV/AIDS or that condoms can prevent you from getting infected with the disease", said Liana, who quit her job and turned to prostitution after her husband died in 2007 because she needed to pay off a mortgage and support their daughter.

A few months after she started sex work, Liana heard about HIV and tried getting tested. But was turned away two times by healthcare workers, who often do not understand the disease and are afraid of getting infected themselves.

Liana tested positive last year after falling ill and is now on AIDS drugs, which cost her 30,000 Indonesian rupiah ($3.5) a month as they are subsidized. Until today, she doesn't know how she became infected. Her 4-year-old daughter is uninfected.

"Thinking it over, I'm not lacking in education. But how is it that I never heard of this disease nor how to prevent it? Why does the government not spread the information," said Liana, a graduate of an East Java university who now insists all her clients use condoms.

"How can we prevent HIV/AIDS if we can't use the only protection that we have?


There is no cure for Acquired Immune Deficiency Syndrome (AIDS), which is caused by the Human Immunodeficiency Virus (HIV), but drugs can help to control the replication of the virus and prolong life.

While Liana uses condoms, she says many of her friends do not as they are tempted by offers of more cash from clients who don't want to practice safe sex. They are also afraid they may be thrown in jail if police find condoms on them.

Health Minister Endang Sedyaningsih told Reuters the government faced enormous opposition in the fight against AIDS in this country of 238 million people. "We cannot put ads for condoms openly on television or promote their use, or people will say the Ministry of Health promotes promiscuity," she said in a recent interview.

Islam is the dominant religion in Indonesia and society remains largely conservative. "We have a program for methadone substitution and clean needle exchange (for drug users) but it's very difficult to expand it as it is seen as legalizing narcotics use."

Indonesia's approach is in sharp contrast to the aggressive interventions taken in nearby Thailand, which implemented a high-profile "100 percent condom use campaign" in the early 1990s to rein in an explosive HIV epidemic.

That campaign was hugely successful and brought down drastically new HIV infection rates particularly in young men.

The disease, which has killed 4,539 people so far in Indonesia, used to be spread mainly by injecting drug users. Eight out of 10 addicts have HIV. But in 2010, 65 percent of newly confirmed HIV infections came through unsafe heterosexual sex between sex workers and clients, who went on to infect their wives or girlfriends. The government estimates there are 200,000 female sex workers in the country and a male clientele of up to 3 million. Only 10 to 15 percent of clients use condoms.

A sharp jump in mother-to-fetus HIV infections is one of the clearest signs that the AIDS epidemic may be moving from particularly vulnerable groups, such as injecting drug users and sex workers, into the general population. These perinatal infections made up 3 percent of all newly confirmed HIV cases in 2010, up from 0.2 percent in the 1990s. "This means that HIV transmission within the family is increasing ... If we have no new approach for HIV prevention within the family, it (the HIV epidemic) may become generalized. We should think out of the box to protect the family from AIDS," said Inang Winarso, assistant deputy secretary of the National AIDS Commission for program coordination.

When HIV/AIDS becomes generalized and widespread, as in many parts of Africa, it takes a huge toll on countries, draining them of resources and economic productivity.


In many parts of Asia, HIV has made a comeback in recent years among vulnerable groups. Governments and concerned groups in China, Hong Kong, Australia and Cambodia are battling hard to contain the epidemic. Through the use of high-profile campaigns, sometimes even involving state leaders as in China, they push hard for the use of condoms and clean needles to prevent the disease from spreading into the general community. But such high-profile interventions cannot be adopted in conservative Indonesia.

Winarso, who was involved in a successful campaign against HIV transmission among gay and bisexual men, hopes to stop the virus from spreading among sex workers through empowering the women, quietly. "In every story that was told to me, nobody said they liked or that they trained to be sex workers. They all started because of trafficking or because of poverty, but they have no awareness that they are victims," he said.

Winarso and his colleagues plan to reach out to sex workers in a pilot project in Semarang in East Java.

"We will visit brothels, we will avoid the pimps. We will spread awareness, get them to tell us their stories, so that they realize they are victims, and continue to be victims under their pimps," said Winarso. "How do they fight? They need to fight their customers (for condom use) and they must fight the government to provide them with jobs."

The World Health Organization estimates there are 300,000 people in Indonesia living with HIV/AIDS, with the worst affected places being Jakarta and Papua province, where 2.3 percent of the population is infected. Some 50,000 HIV patients require drugs but only 20,000 are getting them. "There are several reasons: no access and shortage of drugs even though there are 200 (HIV drug distribution) sites all over the country," said Khanchit Limpakarnjanarat, the WHO's representative in Indonesia. The WHO has a 10-member team in Indonesia and one of its missions is to train medical personnel in treating HIV patients. "We need to strengthen the healthcare system in terms of human resources ... To provide HIV services requires human resources, like counseling and testing. Drug treatment is complicated. These remain a challenge," he said. ($1 = 8,677.5 Rupiah)

(Editing by Alan Raybould and Miral Fahmy)

Weblink: http://www.reuters.com/article/2011/04/12/us-indonesia-aids-idUSTRE73B18H20110412?feedType=nl&feedName=ushealth1100






    由人类免疫缺陷病毒(HIV)引起的获得性免疫缺陷综合症(AIDS) 无法治愈,但药物可以帮助控制病毒细胞的复制,并延长生命。

    卫生部部长Endang Sedyaningsih向记者表示,在这个拥有2.38亿人口的国家,政府对抗艾滋的努力面临巨大的挑战。"我们无法公开在电视上播放安全套的广告,也不能倡导使用安全套,不然大家会说卫生部在宣传混乱的性关系。"她在一个最近的采访中表示。


    目前,印尼艾滋感染已从注射吸毒人员和性工作者等高危人群向普通大众过度,母婴传播的增长成为这一现象的显著标志。该传染率从上世纪90年代初的0.2%增长至2010新增感染者中3%。国家艾滋委员会项目协调中心助理副秘书长Inang Winarso 表示:"这说明家庭内部的艾滋感染在不断增长。如果我们不采用任何新方法应对这种传播途径,艾滋感染将会进一步扩大化。我们需要跳出过去的条条框框,用新方法防止家庭内部成员间的传染。"




    世界卫生组织预计印尼约有30万艾滋病感染者,雅加达和巴布亚省为重灾区,2.3%人口感染艾滋。5万名患者需要药物治疗,但只有其中2万人能获得所需的药品。世界卫生组织印尼代表Khanchit Limpakarnjanarat 表示:"即使印尼全国有超过200处艾滋药物发送站,但还是缺乏足够的药品和获得药品的途径"。世界卫生组织在印尼有10名工作人员,主要的任务之一是培训更多艾滋医护人员。他继续表示:"我们需要根据现有的人力资源增强卫生系统的能力。相关的艾滋服务要求足够的人力资源,例如开展咨询和检测的医护人员。药物治疗就更加复杂了,这些都是挑战。"

Asia Report 翻译

原文链接: http://www.reuters.com/article/2011/04/12/us-indonesia-aids-idUSTRE73B18H20110412?feedType=nl&feedName=ushealth1100


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