In thinking about what I want my topic to be for my final project, I came up with the idea of looking more into sex work in Madagascar and what efforts are being taken to keep the women in Madagascar healthy. Unfortunately, sex work in Madagascar is legal (Stoebenau 2009). While there are no brothels or pimps in Madagascar, women generally exploit themselves for sex in exchange for monetary gain (Stoebenau 2009). One would think that women doing this to themselves, the rate for diseases such as HIV and AIDS would be rather high, but that is just the opposite. In fact, the rate for HIV and AIDS in Madagascar is even lower than the US where sex work is not legal. To be up front, Madagascar has a lot of programs that target HIV prevention due to the sex work that is happening and because of this, the prevalence of HIV in Madagascar has actually dropped since 2003 (Lanouette article) (Stoebenau 2009). As far as efforts being taken to keep these women health, it is stated in one of the previously talked about articles stated that “local health and law enforcement authorities most actively regulated the health of sex workers in areas of the city where antonony (middle) sex work was practiced. NGOs conducted educational outreach concerning condom use and sexually transmitted infections (STIs). The police together with the health ministry ‘encouraged’ sex workers to participate in a monthly STI surveillance program through random raids: sex workers without updated health cards were rounded up, jailed, and 1–3 days later escorted to a government health clinic to be tested and (if necessary) treated for STIs (Stoebenau 2009)”. More efforts are being implicated, but for now, that is the one we are looking at.
Sex work in Madagascar is a health issue worth discussing from a cultural standpoint because it allows us to evaluate what is working within our culture and what isn’t. Like mentioned before, sex work in the US is not legal, yet so many people are getting diseases like HIV and AIDS. Not to say we should legalize sex work in the US, but to be honest the spread of diseases is happening whether it is legal or not. And to be honest, no matter if it is legal or not, if a person wants to sell themselves for money, they are going to do so. Having the stats on Madagascar allows us to be able to pinpoint what we need to work on in the US so that what is happening in Madagascar does not happen here. In an news article by the Huffington Post, it is stated that women are talked into sex work by their families in order to help with family finances (The Horror 2016) . In some instances, women are even given French and Italian lessons in preparation for sex work (The Horror 2016). In our culture (US), as parents, it is looked down upon to go into sex work. If your daughter came home and said she sells herself for money, it is such a negative thing. So we also get to compare and contrast the thoughts of our culture and the Madagascarian culture.
As far as a public health issue, we certainly need to be talking about sex work in Madagascar. Although Madagascar has a low HIV prevalence for a Sub-Suharan African country (0.2% in 2016) (Madagascar 2016), it has of the highest rates of sexually transmitted diseases (STIs) in the world (Health 2008). Even though the rates for HIV are not that high, there are high rates of syphilis, hepatitis B virus, and other sexually transmitted diseases (Lanouette 2003). Women need to be not only protecting themselves from the risks of their sexual behavior, but also protecting other people. “Sex worker organizations, such as Fikambanaina Vehivavy Miavotena Toamasina (FIVEMITO) and Femmes Interessee au Development de Antalaha (FIDA), have reached agreements with local governments to issue sex workers over the age of 18 identity cards. These identity cards allow access to free healthcare (Neglecting 2015)”. We need to see more organizations such as this because this will encourage women to seek health care in order to stay in their best health and it will also be a step toward keeping the public safe from the diseases going around due to lack of knowledge or care by these women.
Lanouette, Nicole M. et al. “HIV- and AIDS-Related Knowledge, Awareness, and Practices in Madagascar.” American Journal of Public Health 93.6 (2003): 917–919. Print.
Neglecting sexuality in sexual and reproductive health: A case of sex workers in Madagascar”. Kumud Rana. 4 February 2015.
Stoebenau, K. (2009). Symbolic capital and health: The case of womens sex work in Antananarivo, Madagascar. Social Science & Medicine, 68(11), 2045-2052. doi:10.1016/j.socscimed.2009.03.018
The Horror of Sex Tourism in Madagascar”. HuffPost UK. 28 June 2016.