HEALTH-PAKISTAN: Cracking HIV/AIDS In Lah

HEALTH-PAKISTAN: Cracking HIV/AIDS In Lahore Brothels

InterPress News Service (IPS) - Tuesday, August 4, 1998
Arif Shamim


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LAHORE, Aug 4 (IPS) - Peer counsellors in 'Heera Mandi', Pakistan's most famous red light district, have proved very effective in raising awareness of HIV/AIDS and safe sex practices among the largely illiterate sex workers.
The results of a recent sample survey revealed that an overwhelming majority of the younger women in the brothels were aware that the Acquired Immuno Deficiency Syndrome (AIDS) disease was fatal, and insist their clients use condoms.

Lahore, the capital of prosperous Punjab province and Pakistan's second largest city, has a legendary red light district and daughters have been following mothers into the profession here for generations.

Eighteen-year-old Shireen (not her real name), born in 'Heera Mandi', has known no other home than the brothel she now works in. The only difference in her life so far, is that unlike her mother she has studied up to middle school.

She wants to continue in the business, she says, and hopes fervently that she will never contract the many sexually transmitted diseases that are rampant in brothels. She thinks she may have found a solution to the problem in the age-old proverb, 'Prevention is better than cure' -- clients who refuse to wear condoms are not entertained, she says.

The study commissioned for UNAIDS-Pakistan by the Social and Marketing Research Consultants, a component of the non- governmental AIDS Awareness Group (AAG) confirms that women in 'Heera Mandi' have indeed been able to demand protection for themselves.

This could be because of 'Heera Mandi's' almost historic reputation. It was amongst the best known places in undivided India for the now dying tradition of 'tawaifs' or courtesans who were patronised by the nobility and rich land owners.

According to the 1997-98 impact study titled 'HIV/AIDS Awareness Among CSWs', 93 percent of commercial sex workers (CSWs) in the brothels were able to identify AIDS correctly.

"It was a multi-purpose study and we got many interesting revelations from it," says sociologist Daud Saqlain, a senior researcher at Social and Marketing Research Consultants.

The study focussed on calculating the level of awareness among sex workers about their health with particular reference to HIV/AIDS. "It also assessed the impact of the phase-1 awareness project of AAG, which was conducted a couple of years ago, and we are happy that we have achieved great success," asserts Saqlain.

Independent groups are at the forefront of HIV/AIDS awareness initiatives in Pakistan, since the authorities here like elsewhere in the region tend to think the virus will infect only high risk categories.

'Heera Mandi', which literally translates as diamond market, is a city landmark though infuriated conservative "Lahoris", as the residents are known, consider prostitution indecent and a crime.

"The circumstances that push women into the profession may be unfortunate, but that doesn't change the fact that prostitution does exist as a profession," sociologist Saqlain pointed out. "We have to accept and respect their basic human rights, by providing, for instance, health care to them, or at least treating them as human beings."

According to the study for UNAIDS, there are 16,000 CSWs in the red light area, most of whom were reached by peer educators selected from among them who also sought to involve them in implementing the awareness raising programme better. In the second part of the programme, sex workers were selected to participate in two discussion sessions, for peer counsellors and their target audience separately. Sex workers were vocal about the need for more sessions on HIV/AIDS, the study states.

Another interesting view that emerged was that many CSWs talked of wanting to leave the profession and lead a "respectable life". What stopped them was the fear of losing their financial independence, which some of them reasoned could be dealt with if non-governmental organisations would launch micro-credit schemes for brothel women.

Considering that large numbers of sex workers are illiterate (Pakistan is among the most illiterate countries in South Asia and the adult literacy rate hovers around 24 percent for females), the survey has painted a very positive picture of HIV/AIDS awareness among the younger women in 'Heera Mandi'.

Sex workers who were interviewed, in the 15-30 year age group, listed the sources of their information as television (95 percent), newspapers (15 percent) and other printed material (23 percent), apart from peer educators and seniors in the profession.

More than 70 percent were primary school drop-outs, while 13 out of 100 respondents had studied up to the middle level, seven went up to secondary school and nine completed high school.

The large majority also seem to be taking preventive measures like safe sex. Only eight said they did not insist on clients using condoms, while 12 others chose not to respond at all -- which is most encouraging for campaigners trying to turn the HIV/AIDS tide. (End/IPS/as/an/98)