This article from PlusNews, Global HIV/AIDS News and Analysis, discusses the National Consultation on HIV and Sex Work meeting in the city of Karachi, Pakistan, in which female Pakistani sex workers were given a chance to talk about the difficulties of protecting themselves from HIV. The meeting was a result of fears that a concentrated epidemic among injecting drug users could spread to female sex workers and other high-risk groups, such as men who have sex with men.

Ministry of Health data from 2006 to 2007 showed that female sex workers were a high-risk group in at least 12 cities. Less than a quarter of the 4,639 female sex workers surveyed reported using condoms consistently, and 10 percent had had sex with an injecting drug user in the past six months. Illiterate sex workers were much less likely to use condoms than those with some level of education.

The meeting was organised by the National AIDS Control Programme and the UN Population Fund (UNFPA). It sought to consult sex workers in order to improve HIV programming focused on them. The UNFPA representative pointed out that sex workers should have greater involvement in the design and implementation of HIV programmes. "The female sex workers have to be in there as managers, workers and leaders to benefit in the long run," he said.

Sex workers reported that it was difficult to convince clients of the necessity to use a condom, and that female condoms were difficult to obtain. One sex worker felt that legalising sex work would make it easier to protect their rights, including protecting them from police harassment. She reported that "...many times sex workers succumb to pressure and end up having sex with the policemen; those who don’t end up getting a beating and being violated forcefully."

Recommendations resulting from the meeting include:

• vocational training and the means for alternative work opportunities for those who want to move out of sex work;
• prioritising HIV testing and referral services for sex workers; and
• finding ways to curb the stigma and discrimination.

Global Health Weekly Update and IRIN News, May 18 2009.