From choice, a world of possibilities HIV Prevention Report Cards for Sex Workers © IPPF EN/Layla Aerts/Kazakhstan 2013 Lena Luyckfasseel 20 July 2014

Partners and geographical location

Methodology Desk Review – e.g. reports, articles, preliminary reports, shadow reports, statistical data… One-to-one Interviews – semi- structured interviews with 6-8 key stakeholders (UN agencies, CSOs and governmental representatives) Focus group discussions – at least 3 with members of the SW community

Focus of the Report Cards – 5 Prevention Components Legal and social context Laws, regulations, protocols, cultural context Availability of SRH and HIV services Number of sites and range of services for SW Accessibility of SRH and HIV services Affordability, location and user-friendliness of services Participation and Rights Rights based approach, participation of SW in decision making processes Violence Type of violence faced by SW

MAIN FINDINGS OF THE RESEARCH

We do not know any laws that affect sex workers, we only know about our rights as citizens of this country and that we are supposed to have the same rights as the rest of the population, but in reality we have almost no rights. (Focus group discussion with SWs in Kyrgyzstan)

We very rarely visit unfamiliar support groups and centers because there is no trust. There are only a few organizations that have the capacity to help us. (Focus group discussion with SWs in Tajikistan) There is no culture among medical workers in Kazakhstan to safeguard confidentiality of patients/clients. Sex workers are often stigmatized and treated negatively by health staff. As a consequence sex workers are afraid to seek for health services. (UNAIDS coordinator in Kazakhstan)

The service providers from the AIDS center request sex workers to present information about the place of work and residence. Often, sex workers will use a nickname or another name to anonymously pass the test. If the test is positive, sex workers will have to sign a paper on “non-spreading” of HIV. The law on confidential HIV testing should be adequately executed. (Interview with SW organization in Kazakhstan)

It happens that police invite TV reporters without the permission of sex workers and they take pictures of the girls to show them on local and national media. Sex workers don’t know how to protect themselves from these abuses. (Interview with SW organization in Kazakhstan) There is a need to destroy the stereotypes government officials have of sex workers, to have them sit together, involving sex workers in any kind of meetings in a way that sex workers do not feel that they have to hide the fact that they represent this community. (Interview with HIV activist in Russia)

My friend and I were detained and taken to the police department to identify someone. When we arrived at the department, the head of the department had his birthday and we were “offered” to him. When we refused, they beat us, abused and kicked us out without any money in the early morning. (Focus group discussion with SW in Tajikistan) Last year the police staff forced us to get HIV tested and we had to pay 50 soms ($1) for this test. The test was done by their physician but who he was, we do not know. They said that there was a regional raid and this was by order of the prosecutors, but no papers had been shown (Focus group discussion with SW in Kyrgyzstan)

Overview of main recommendations Legal and social context -Decriminalization of SW -Simplify procedures regarding ID and propiska -Create safe opportunities for constructive dialogue between SW and decision makers Availability of services -Ensure prevention and services have a Human-rights based approach -Increase and sustain government funding for HIV programmes and services Accessibility of services -Install clear mechanism to report clients’ rights violations in healthcare centers -Ensure confidential services and availability of condoms and lubricant Participation and Rights -Create an enabling environment for SW lead advocacy efforts -Ensure meaningful involvement of SW in programmes addresses to them Violence -Document HR violations -Train law enforcement officials on HR and the consequences of violating them -Ensure safe and accessible mechanisms to report abuse against SWs