This programme is premised on the notion that woman in prostitution are human beings and potential agents of change, not vectors or victims of HIV. Rather than holding women responsible for the spread of the HIV virus, SANGRAM's initiator sought to empower women in prostitution to protect themselves from infection. Her reflections on strategic changes since the organisation's inception are as follows: "As our involvement in the programme deepened, our beliefs, ideas and notions about prostitution underwent a seachange. Even our language changed. We slowly started revising our vocabulary to a non-judgemental frame of reference. Hence the importance of the term 'women in prostitution', instead of the commonly-used term 'prostitute'. Women who practice prostitution use the term 'women in business' while referring to themselves. Now, after much discussion, we have adopted the term People in Prostitution and Sexwork (PPS) to include all persons who make money out of sex."
SANGRAM's peer education model involves learners-teachers - themselves women in prostitution - in every seventh brothel talking to their colleagues/neighbours about HIV, and providing them with the tools to protect themselves against infection. Specifically, a peer educator has two key areas of responsibility: first, educating women in prostitution about HIV/AIDS, distributing condoms among them, and training and counselling women who are unable to enforce condom usage; and, second, helping women with sexually transmitted infections (STIs) and other health problems to access medical care and related services.
Peer educators are free to choose their own methods of working. Some distribute condoms door-to-door, others have women pick them up, some plan a week ahead. They are motivated by the fact that condom distribution and use is entirely dependent on a sense of common identity. The idea is that women must work together to engender real change: In the ideal scenario, a customer who refuses to use a condom is turned away; if he does not change his ways, he will then also be rejected by another woman in prostitution, who will also insist that he uses one.
SANGRAM has also initiated a district campaign that runs in 713 villages in Sangli district and focuses on women who contract HIV from their husbands without knowing it. This campaign also addresses adolescents, who form a significant proportion of the clientele of women in prostitution. Exhibitions, street plays, and poster displays at fairs and festivals are among the tools used to create awareness about HIV/AIDS among rural audiences. Sex education programmes in schools are regularly conducted. These courses do not stop with anatomy and reproductive biology; they include a component on societal and personal values, with basic facts about sexuality, separate group discussions for boys and girls, a session on myths and misconceptions, and ethical issues related to sexuality.
Based on organisers' observation that women in any community tend to have diminished access to information on taboo subjects like HIV and sexuality, and are rarely seen in public fora like schools, colleges, and village gatherings, SANGRAM runs a 'mantrin' programme. On this model, girlfriends who are easy to relate to conduct open discussions on intimate matters. A volunteer programme and overall advocacy for policy changes are other initiatives.
Women, HIV/AIDS, Youth, Gender, Reproductive Health.
In 1996, the peer education programme broadened into VAMP - the Veshya AIDS Muqabla Parishad - a collective of women in prostitution. Although VAMP and SANGRAM are closely interconnected, VAMP is separately registered and has its own board of members drawn from women in prostitution. The goal is to get VAMP to function independently. The collective has a clear hierarchical structure with different levels of responsibilities and pay scales. At the top of the pyramid of field workers and community workers is the 'tai', designated board members who distribute and ensure a continuous supply of condoms, provide the names of the ill to community workers, and offer care and support to ill women.
Along the way, SANGRAM has encountered resistance from brothel-keepers and criminals. One peer educator was killed; in early 2002, SANGRAM had to shut down because of incessant violence, threats, and abuse. Furthermore, the enforcement of condom usage is, in organisers' experience, far from total. Women who work as itinerant workers often remain out of reach. The poor quality of government-supplied condoms causes lapses in usage. About 20% of all sexual encounters are with 'malaks' (lovers) who differ from clients. The absence of a condom is the instrument of differentiation. Pimps, male brothel owners, and the police still - according to organisers - wield the power to refuse to use a condom.
As of 2004, roughly 120 peer educators in 6 districts of Maharashtra and the border areas of northern Karnataka distribute 350,000 condoms to 5,000 women in these communities every month. In the areas in which SANGRAM works, the programme cannot be location-specific. Women in prostitution operate out of hutments in slums or pucca houses in industrial centres. They are also itinerant workers on highways and at weekly markets.
"SANGRAM: A war for all women", by Lalitha Sridhar. InfoChangeIndia News & Features, May 2004.