Wall Street Journal - December 17, 2003
Donna M. Hughes**

Networks of sexual gulags like this exist all over the world. There are millions of victims of the sex trade in need of assistance. They are lucky if they get out alive, though their minds and bodies will be scarred for life. They die from assaults, diseases, overdoses and suicides. However, the biggest cause of death is AIDS.

Because of their high risk of contracting and transmitting HIV, prevention projects target women and children in the sex trade for condom distribution and safe-sex education. Prevention of AIDS is a worthy goal, and the criterion for evaluation, if there is one, is reduction in new cases of HIV. The sole focus of the HIV/AIDS prevention projects is stopping AIDS; the operation and slavery of the sex trade as significant contributing factors in the spread of HIV are usually ignored.

An example of the condom-based policy is the "100% Condom Use Program" (100% CUP) in the brothels of Thailand. The 100% CUP was initiated with the support of the Thai National AIDS Committee. Its only goal is preventing the transmission of HIV in brothels by creating a "monopoly environment," in which condom use is required in all brothels: "No condom -- No sex." The program is credited with a dramatic decrease in the number of new cases of HIV and other sexually transmitted infections stemming from the sex trade.

Getting a significant number of men to use condoms in brothels reduced the transmission of HIV, but this success came at the price of allowing the continued abuse, exploitation and slavery of women and girls, almost all of whom were underage when they were sold to the brothels. In order to implement the 100% CUP, the participation of the brothel owners was needed.

With explicit support of government and law enforcement, brothel owners were implicitly told that their illegal activities would be overlooked (unless they became too egregious) as long as they supported the 100% CUP. The result of this is the de facto decriminalization of the sex industry.

World-wide, many of the projects that distribute condoms and safe-sex materials to victims of the sex trade and run needle-exchange projects for drug addicts are known as "harm-reduction projects." Harm reduction is more than an approach to combating AIDS; it is a movement with an ideological agenda to normalize and decriminalize the sex trade and drug use. People and organizations with these fringe political agendas have hijacked many of the HIV/AIDS prevention projects.

In the harm-reduction approach, the aim is to reduce the harm of certain activities, not to prevent or stop the harmful activity. These programs claim they are saving lives, and indeed, with the deadly virus, a condom can represent the difference between life and death. Yet in a harm-reduction approach, the aim is to reduce the risks of working in prostitution, but allow prostitution and "migrant sex work," a euphemism for trafficking, to continue unimpeded.

The legitimization of prostitution is a name game as well. It redefines prostitution as a form of work for women: prostitutes become "sex workers," pimps become "managers," even "protectors," and traffickers become travel agents assisting women to cross borders to destinations where there is a demand for "migrant labor" in the sex trade.

HIV/AIDS prevention programs, particularly those that target women and children in the sex trade are badly in need of reform. The Bush administration's shift away from the condom-only approach in HIV/AIDS prevention to the "ABC approach" (Abstinence, Be faithful or use Condoms) is a good strategy for the general population, where most people have a choice of whether or not to have sex. In the sexual gulags, however, women do not have such choices.

Instead of harm reduction, we need "harm prevention" and "harm removal." Traffickers and pimps should be arrested and removed from communities where they cause so much human destruction. Victims of the sex trade should be rescued or offered assistance and shelter so they can escape and rebuild their lives.

Laura Lederer, a political appointee in the U.S. State Department and executive director of the Senior Policy Operating Group on Trafficking in Persons, has proposed a policy of report and rescue, which puts the safety and freedom of women and children first. This approach builds responsibility into HIV-prevention work by requiring personnel to report the abuse and enslavement of women and children to the appropriate authorities.

The U.S. Agency for International Development has already created a policy to put the first half of that policy into action. When implemented, this policy will give victims hope for freedom. No longer will slavery be ignored. No longer will aid workers give victims a condom and walk away.

This year, USAID's Bureau of Europe and Eurasia launched a small five-year, $10 million initiative to encourage the development of values that support democracy and human rights. HIV/AIDS prevention programs, particularly the harm-reduction variety, need an ethical dimension that includes new awareness and approaches for dealing with victims of the sex trade. A values initiative needs to be implemented across all bureaus at USAID to stimulate new ethical thinking and action plans to combat both the spread of HIV and the enslavement of women and children in the sex trade.

There are places where the sexual gulags are deeply entrenched and places where the AIDS epidemic is destroying entire communities. U.S. President George W. Bush has made both of these humanitarian disasters priorities for action. Where both exist, they must be combated, without one being left behind. This dual approach is going to require new thinking and new players not afraid to challenge ideological rigidity.

**Ms. Hughes is a professor and the holder of the Carlson Endowed Chair at the University of Rhode Island.

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