Traditional Sex workers in India: Are they adding to Vulnerability to HIV/AIDS?

R.S. Goyal

Indian Institute of Health Management Research, Jaipur, India

Since HIV began to spread around the world, people have ben trying to understand why some countries, societies or people are more affected by it than others. At the global level, analysis of the relationship between HIV/AIDS and education or poverty shows a direct positive correlation. However, it gives a very different pattern when examined regionally or locally, where relationship between HIV and literacy, becomes a curvilinear one. This dichotomy is explained on the basis of variations in the behaviours that emerge from the differences and disparities between the social, economic and cultural status and values of the people (UNAIDS: 1998). It indicates that at the core of epidemic lies the differences between regions, countries and communities in terms of social and cultural values, demographic and economic status, and related behaviors and practices, which determine the pace of spread of HIV in different regions. However, these factors and associated behaviors particularly those related to culture have not been adequately studied or explained (UNAIDS: 1998).

The cultural practices that influence the spread of HIV/AIDS are largely related to the sex activities of men and women. Women engaged in commercial sex work have been identified as one of the major carrier of HIV virus. World over, women entry into this profession has generally been governed by economic considerations, family environment and similar factors. However, in India, several other factors also play a role. Women from particular caste (sects) groups have traditionally been encouraged to enter in to sex trade. Though, over time this culture termed as traditional sex workers has been modified several times over, the core feature has not only remained the same but also expanded.

This paper discusses the findings of an exercise carried out in 2002-3 to map the traditional sex workers in Rajasthan (India) and to assess the vulnerability of state to HIV/AIDS due to their presence in conjecture with other risk behaviour factors.

The study is based on primary and secondary data collected from a range of stakeholders. The mapping exercise has yielded a large number of traditional sex workers in Rajasthan (62200+). Their number is particularly large in the districts of Alwar, Ajmer, Bundi, Tonk etc. and in the Nats and Kanjars castes. A composite index called "index of vulnerability" was developed to depict the vulnerability to HIV/AIDS on the basis of presence of factors depicting risk behaviour. These include, temporary and long term mobility, school drop out, length of national highways passing through, prevalence of sexually transmitted infection, traditional sex workers, poverty etc. The analysis shows that presence of traditional sex workers adds to the vulnerability of particular region to HIV/AIDS. However, it has less predictive value as a stand alone factor than taken in conjecture with other risk behaviour variables.