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Our View from the Ground: Prohibition and Prostitution

Photo of Paul Perchal

Paul Perchal is director of EngenderHealth’s HIV and STI Program. Here, he speaks about EngenderHealth’s new HIV prevention project in Ethiopia, which focuses on some of the most at-risk populations: women, men, and young people engaged in transactional sex.

Tell us about EngenderHealth’s new initiative in Ethiopia.

The project is unique because it addresses the behaviors that put people at risk for HIV infection and their underlying roots: poverty, gender, and stigma. It is timely because there is a growing recognition that unless we also address these factors, we are not going to be able to curb HIV. We will reach women and men and young people involved in transactional sex in urban areas. By transactional sex, I mean both those who are engaged in conventional sex work as well as those who rely on men for shelter or money for food, and who in turn are faced with providing unwanted and unprotected sex as “payment.”

We offer safe, stigma-free spaces where individuals can receive HIV prevention information and services, including life skills training and peer counseling and support. To address gender inequalities, the project provides occupational training and seed money to women who want to start a business in another line of work—so they have an opportunity to pursue a different life where they are not directly dependent on men for income. Additionally, we target male clients of sex workers, urging them to take greater responsibility for HIV prevention and raising awareness about the negative impact of prevailing gender stereotypes.

Why is this work important to you personally, not just as an HIV expert?

Over the last 14 years, I have been involved in HIV work focused on the most at-risk populations, including young and destitute women, injecting drug users, gay men, and sex workers. Their human rights—especially their right to access to health care—are violated on a daily basis. They have the same rights to safe, healthy, and productive lives as anyone else, and we have to ensure these rights are met. It is particularly important for them to have access to HIV prevention, care, and treatment, as well as other much-needed services. 

While the work can be challenging, it is very gratifying to be involved in programs that reach out to people, regardless of their socioeconomic status, gender, sexual orientation, HIV status, race, or religion.

What inspired your career?

Two of my closest friends died of AIDS in the mid-1990s. Being a part of the small group of people who took care of them provided me with a very different perspective on my life. With some reflection, I decided that I wanted to do something to address the HIV epidemic in my own community, and that is how I got started working with HIV and AIDS programs.

How does the government-mandated antiprostitution oath impact your work? 

The antiprostitution oath is intended to stop prostitution and trafficking, however what it has done is prevented sex workers from receiving critical information and services. For example, in the Ethiopia project, the policy has prevented us from marketing specific brothels/bars that promote safe sex and provide condoms and other HIV prevention services because this is seen as promoting prostitution.