Should police suspects reveal their HIV statuses when arrested?
Lilongwe – Disclosure of one’s HIV and AIDS status in Malawi continues to be associated with high levels of stigma and discrimination, one of the most notorious abuses of human rights in regards to HIV and AIDS, but should police suspects reveal their status when arrested? Malita Sikono, not real name, is a prostitute who plies her trade in the township of Likuni, on the edge of Lilongwe city, and sometimes tests her luck in the lush sex market of the city. Unfortunately most of her exploits in the city have ended up in police cells. Sex trade is illegal in Malawi and commercial sex workers know that they cannot justify their actions on account of their need to earn a living, since their trade is a source of the spread of the virus. But most of the practitioners, who also are the most at risk, will argue that poverty is their main driving force for their chosen trade. Sikono narrates that prostitutes undergo dehumanizing times when rounded up by police on charges of ‘rogue and vagabond’ or ‘idling’ on the streets. “To secure our release the police demand money, phones, or unprotected sex,” she said adding that HIV positive sex workers face nightmares when there are arrested and do not have ARVs with them. “You cannot just bring yourself to tell an officer that he must release you because you will miss out on the ARV dosage,” she said pointing out that this makes HIV positive sex workers vulnerable to ARV drug resistance. Victor Kamanga, programme officer for an HIV NGO suggested that police stations should start thinking of having health facilities. “The health facilities will have to deal with the issues of HIV, diabetes and other emergency health problems that suspects bring along,” he said. Malawi Human Rights Commission lawyer, Chrispine Sibande, said the country faces numerous problems to combat the virus because it crimilnalises sex work, making it hard for prostitutes to access health care services or report abuses by clients and the police. Sibande said some of the barriers to the realisation and enjoyment of sexual health rights by prostitutes in respect to HIV include criminal sanctions, culture, and religion, lack of politic will and discrimination and stigma. “You can’t talk of HIV in isolation of the sex workers’ rights,” said Sibande, a specialist in reproductive health rights, arguing that the abuse of sex workers rights contributes to high HIV infections “since the police confiscate hand bags containing condoms thereby forcing them (prostitutes) to have unprotected sex.” A 2007 National AIDS Commission report indicates that there is a 70 per cent HIV prevalence among sex workers in Malawi with transmission crossing over from the general population to sex workers and vice versa District Manager for Family Planning Association of Malawi (FPAM) Temwa Kasakula said a study involving 152 sex workers revealed that half of them had attained some secondary education. “They were knowledgeable on the transmission, signs and symptoms and prevention of HIV and other sexually transmitted infections and yet continue to expose themselves despite knowledge of risks to infections, due to the higher monetary value offered,” she said adding that this, the study found out, was due to low self esteem, poor perception on risks, power imbalance and lack of skills to negotiate for safer sex increase the chances for HIV transmission in sex workers. Kasakula said her organisation was currently working on creating awareness on the dangers of sex work, and addressing their livelihood skills through safer sex promotion and improvement of their economic options for livelihood. “The objective is to empower vulnerable sex workers with information and skills to practise safer sex and provide options and alternatives for livelihood,” she said pointing out that such interventions for sex workers act as transmission barrier between sex workers, as a vulnerable population, and the general population. The debate rages on “Should police suspects, not only prisoners, reveal their HIV statuses when arrested?” HIV in prison impacts on general population.