Other organizations have sought to alter or restrict programs dealing with sex worker communities: for example, an established NGO might cut resources for an affiliated sex worker health project. Or a small grassroots grantee might refrain from publicizing sex worker condom-distribution programs. Overall, researchers found, groups felt pressured to limit programs that might be viewed as supportive of sex work, even as sex workers continued to suffer some of the worst effects of the epidemic.
While the court ruling has spared U.S.-based groups from these restrictions, non-U.S. grassroots groups like SANGRAM are still subject to PEPFAR’s moralistic anti-prostitution dictates. Across the Global South, the politics of PEPFAR ironically feeds into the same structural barriers thatput sex workers at risk of AIDS and other social threats. By marginalizing an “underground” labor force, the humanitarian aid system perpetuates the social disenfranchisement of sex worker communities, exposing them not only to disease risks, but also a culture of discrimination and oppression.