By Deepa Ranganathan
Covered from head to toe in a black burqa, her face looks tired. Her eyes are moist as she fights tears. She rubs them every time she mentions she is a sex worker.
Fatima*, a 20-year-old resident of Yeshwantpur and a sex worker “by chance and not by choice,” as she puts it, is a typical example of a woman who was driven into the sex trade as a result of being caught in a bad marriage.
Married at the age of 17, Fatima was impregnated by her husband, whom she describes as “a drunkard,” months after their marriage. He abandoned her last year, but has continued to demand sex and impregnated her again five months ago. Poverty forced her into this profession. Her 18-month-old old son, who hardly knows what his father looks like, is the only hope left in her life, she said.
She pulls her veil back to reveal her left ear, which is stitched at the top—a mark left a few days ago, when her husband assaulted her. A victim of a marriage gone wrong, Fatima is a pregnant mother with no money to have an abortion or raise another child.
And with sex work, she is invariably exposed to all the dangers of the job—the risk of being infected with HIV being the biggest one. If there is one thing she can be thankful for, it is the fact that she did not test positive when she took the HIV test four months ago. But this relief may be short-lived as there is uncertainty attached to the result of the report. She is in a job that can infect her with the deadly virus anytime, and even safe sex practices can sometimes fail.
5 million HIV cases in India
Sex workers, like eunuchs and transgenders, are one of the high-risk groups most prone to contracting HIV and other sexually transmitted diseases. Other high-risk groups include men who have sex with men, migrants and truck drivers, among urban poor, according to HIV/AIDS specialists.
According to the latest National AIDS Control Organization report, India has an estimated 5.1 million cases of HIV, the second-largest per capita number in the world, and Karnataka is one of four large states of southern India, along with Tamil Nadu, Andhra Pradesh and Kerala, with a relatively advanced HIV epidemic. The adult HIV prevalence in several districts has exceeded 1 percent for the past nine years, according to Karnataka State AIDS Prevention Society (KSAPS) statistics.
People living with HIV and AIDS are often victims of stigma and social discrimination, regardless of their economic status. But being poor adds to the misery an HIV-infected person faces in society. Though not affected by the virus yet, Fatima is a case in point. Abandoned by her husband and living with a family that already has to feed three other mouths, she is struggling to make ends meet.
The KSAPS statistics show that out of a total of 1,127 people tested in the Yeshwantpur area alone this year from January to September, 29 have been identified as HIV-positive. How many of them are sex workers is unknown as KSAPS does not maintain records on the basis of the economic status of the patient, only on age and gender. Fatima belongs to the high-risk 25-34 age group.
“Given the very nature of their job, sex workers are the most vulnerable lot of the high-risk population. And since their entire economy depends on sexual activity with multiple partners, the aim of spreading AIDS awareness becomes all the more necessary and challenging,” said Dr. Vijay Inamdar, a consultant for HIV-TB, KSAPS.
Bhoruka Charitable Trust (BCT), a nongovernmental organization supported and funded by KSAPS and under the supervision of the Health and Family Welfare Ministry, launched its Female Sex Workers HIV-testing program in 2005, when an estimated 4,400 sex workers were identified for the project. For the current year, the target is to test 2,729 sex workers.
A BCT report says 26 women, who are all members of the Karnataka Sex Workers’ Union, tested positive out of 1,195 tested in Integrated and Counseling Testing Centers between May 2009 and August 2010.
Deepa Vasanthkumar, program officer and counselor at BCT, said: “Even if a sex worker has tested negative for HIV, it certainly does not rule out the possibility of their acquiring it in the near future, given that the nature of their work invariably involves multiple partners. We try and educate them about safe sex practices and distribute free condoms, asking them to insist their clients to use the same.”
‘It’s all about the money’
Sometimes clients lure sex workers into unsafe sex practices by offering them more money in exchange for not wearing a condom during the intercourse—an act that puts them doubly at risk.
“What do you do in such a scenario? You’re getting more money at the cost of your life. It becomes a matter of priority then. Often, money wins over almost everything,” Fatima said. But she says she has not yet faced this problem with her clients.
“I tell them about HIV, how it can spread to both the partners, and brief them about its fatal consequences. That usually scares them into wearing a condom,” she said.
Fatima, too, might get infected someday, given the risk factor involved in her profession, but she says she fears some things more than AIDS. If she doesn’t work, her child goes hungry.
“I don’t wish to do this work,” she said. “But who will support my fatherless child? Which other job can fetch me 1,000 bucks in an hour? And that, too, isn’t enough. It’s all about the money.”
*Name changed to protect the individual's identity
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