290 The Global HIV Epidemics among Sex Workers
occupational health-informed intervention that quickly became a catalyst for sex worker participation and collective mobilization. The legal environment for sex workers in India is informed by a number of laws, primary of which is the Immoral Traffic and Prevention Act (IPTA). In India, sex work is not explicitly illegal, but sex workers and others who profit from sex work such as brothel owners are restricted under the IPTA, which was first enacted in 1956 as the “Suppression of Immoral Traffic Act.” IPTA is the main statue addressing the criminalization of activities related to sex work and is based on the principle that sex work is exploitation and is incompatible with the dignity and self determination of those who engage in sex work (Jayasree 2004). Although IPTA focuses on trafficked women, the law is broadly applied to arrest sex workers for soliciting, rather than its charge to focus on traffickers. Technically sex workers are guaranteed human rights under the Constitution of India, though there has been limited interpretation of such rights to meaningfully improve the health and wellbeing of sex workers. The Indian government has enacted an extensive response to HIV that targeted the general population with education, surveillance and STI/HIV testing as well as efforts specific for sex workers and other marginalized groups. The success of this response is questioned given the continued rise of HIV over the past two decades (2008). In addition to the government’s efforts, a number of community-initiated responses were conducted by community-based and sex worker NGOs, the most comprehensive of which is the Sonagachi project in Kolkata. Sonagachi in effect represents a landmark example of sex work organizing and empowerment for HIV risk reduction. Sonagachi quickly gained international recognition with reports on the project emerging as early as 1993 (1993); the combination of its efficacy and international publicity enabled it to inspire similar efforts in a range of settings (Kerrigan, Moreno et al. 2006; Kerrigan, Telles et al. 2008; Reza-Paul, Beattie et al. 2008). Government Response. The government response to HIV followed closely on the heels of the first documented cases of HIV in India in a study of female sex workers in in1986 in the city of Chennai (Simoes, Babu et al. 1987). In 1987, the government established the National AIDS Control Program (NACP) that was charged with the coordination of the national response through establishing monitoring and prevention programs including a national surveillance system, blood screening, and health education programs. During the 1990s, the Government’s response was characterized by a “top down” approach with the establishment of several centralized bodies at the federal and then provincial level to build the communication, surveillance and testing and treatment infrastructure to respond to HIV.