"Sometimes because they are the funders, they think they know what's best for
us, when in fact it should be the other way around," she told Reuters on the
sidelines of an international AIDS conference in the western Japanese city of
Kobe.
"We're the ones in contact with the community, not them," she added. "They're
only in their offices, sitting down and waiting for their reports. And
sometimes reports are not true."
Though she acknowledged that agencies can provide a badly needed structure for
prevention efforts, she urged them to make more of an effort to include the sex
workers, who as peers are able to reach out to their communities most
effectively.
"There should be greater participation from us -- and they should put us
first."
The UN estimates 8.2 million people are infected with the human
immunodeficiency virus (HIV) in Asia, about 5.1 million of them in India. The
Chinese government says there are 840,000 patients in China.
Worldwide, about 39 million people have HIV/AIDS, including 25 million in
sub-Saharan Africa.
Commercial sex is one of the main forces behind the spread of HIV in many
countries in Asia, where the United Nations says that 12 million people could
be newly infected in the next five years if prevention programmes are not
intensified.
Huge Numbers
Though the infection rates of AIDS are highest among injecting drug users in
Asia, the huge numbers of people involved in buying and selling sex makes it a
critical concern.
"How we deal with the sex trade will have a decisive effect on HIV epidemics in
Asia and the Pacific," Cheryl Overs, an activist with International HIV/AIDS
Alliance, told a session of the conference, which lasts until July 5. "The
effort must be massive in scale and as diverse as the region itself."
Prevention efforts face new challenges, however, as the sex industry changes in
response to modernisation.
The spread of karaoke bars, where sex workers can often make more money than in
brothels, and widening use of mobile phones that mean sex workers no longer
congregate in specific "red light" areas, make it harder to target specific
prevention programmes to the people who need them most.
While women still make up the overwhelming number of sex workers, there is also
a need to reach other groups, such as men who sell sex to other men, and
transgenders such as Tonette, who tend to be ignored altogether.
The conference is stressing the importance of condoms, whose use varies widely
according to the nation and the situation.
One survey conducted last year in East Timor, Asia's newest nation, found that
four out of 10 sex workers did not recognise a condom when shown one.
Even when condoms are available and their effectiveness known, decisions on
using them can be highly arbitrary. Young men in Laos often base their choice
on the woman's body temperature and whether she seems "promiscuous," researcher
Soutchay Pheualavong said.
Thailand and Cambodia have had noted successes with education and condom
outreach programmes among sex workers and other vulnerable communities. In
Thailand, annual new HIV infections fell from nearly 143,000 in 1991 to 21,260
at the end of 2003.
For the greatest success, such outreach programmes should involve other sex
workers, Tonette said.
"You have the experience, you know how it is, you know how it feels -- and you
can get through the message to everyone."
Reuters
