Karen McManemin
Legalization of Sex Work in Kenya: Public Health Promotion and Economic Opportunities
Gender inequality in Kenya is rampant and contributes to underdevelopment and high rates of HIV transmission. Almost 7% of the total population of 39 million is HIV-positive (CIA, 2009). Women account for the majority of new HIV-infections in Kenya. Women age 15-49 years have an HIV prevalence of 8.7% compared to only 4.5% among their male counterparts (UNAIDS, 2006). With a Human Development Index of 0.541, Kenya is the 35th poorest nation (UNDP, 2009). As a result of colonialism and structural adjustment programs, Kenya has an external debt of US$7.7 billion (CIA, 2009). Kenya’s public debt accounts for 54.1% of its GDP (CIA, 2009). Recently, Kenya’s debt has increased from borrowing money to fight HIV/AIDS. In 2008, the World Bank lent Kenya US$40 million for HIV prevention (Booth, 2004). GDP per capita in 2008 was US$1,580 (UNDP, 2009). Over 40% of Kenyans are unemployed and most of those that do work are in the informal sector (CIA, 2009). It has been estimated that the informal sector accounts for 35-50% of Kenya’s GDP (Mayabi, 2008). Women that are employed currently only make about 55% of men’s earnings and spend fewer of their working hours in paid employment (Booth, 2004).
Although Kenya does receive international aid, the government only spends about 5% of its GDP on health care (Allianz Worldwide Care, 2010). This is far less than the average spending for high-income OECD countries, which use about 9% of their GDP for health care (OECD, 2009). Total health spending in Kenya is about US$6.2 per capita (Allianz World Care, 2010). The WHO estimates that even a very basic set of services for prevention and treatment would cost more than US$34 per capita (Carrin et al, 2008). Thus, access to health care and quality services in Kenya is very poor. The Kenyan government should consider alternative HIV prevention strategies that empower women and generate revenue for health care such as legalizing, controlling, and taxing sex work.
Gender inequality throughout Africa puts women at increased risk of HIV infection because they are denied economic opportunities, autonomy and control over their personal lives (Booth, 2004). Lack of access to education and jobs forces many women to use sex as the primary or supplementary means of income. Sex work is illegal in Kenya, but research has shown that women in economically and socially constrained situations engage in a variety of behaviors that involve transactional sex (Harcourt & Donovan, 2004). The sad reality is that sex is often the currency that poor African women are forced to use in order to survive. A global typography in 2004 highlighted at least 25 behaviors that could fall under the category of “transactional sex” (Harcourt & Donovan, 2004). There is no way for a government to realistically establish which women are “prostitutes” or control the sexual behavior of a population through criminal laws. Criminalization of sex work is especially detrimental in light of the fact that many women have very few options for other means of economic or social mobility. When the state refuses to recognize a type of profession (e.g. selling sex), they don’t have to worry about working conditions, safety, health, or the subpopulation’s ability to make a decent living (Oakley, 2007).
Women’s decision to engage in transactional sexual relationships is motivated by lack of social and economic capital. The highest paying profession for a female in Kenya is as a sex worker (UN-OCHA, 2007). For many poor Kenyan woman, sex becomes a last resort for ensuring that the rent is paid and her children do not go to bed hungry (Booth, 2004). Reliance on men for economic support has resulted in a continuum of selling sex throughout many areas and a blurring of social categories (i.e. prostitute/wife/mother). Both single and married women engage in number of different economic, domestic, romantic, and sexual relationships that involve some type of payment from a man (Booth, 2004). Sex work in Kenya is illegal and highly frowned upon by the majority of Kenyans, but it is also a flourishing business due to high client demand. The Kenyan government should recognize the reality that sex work will exist whether it is legal or illegal and policies should promote decent working conditions for all professions, including the selling of sex. Sex work is not the sale of the body or body parts; it is merely the provision of another type of personal service (Law, 2000). Sex should not be considered any different than other of types of labor (Law, 2000).
Throughout my field work in Kenya, I discovered a range of laws and practices that are counterproductive to preventing HIV and that actually increase gender inequities. Women in Kenya can be arrested for carrying a condom or for testing positive for gonorrhea at a public clinic. Women are thus afraid to carry protection methods and do not have access to reproductive or sexual health care. Criminal law enforcement in Kenya is also highly corrupt. Police are often the clients of sex workers or demand sex as a bribe to not arrest a known prostitute. Lastly, the sex workers with whom I spoke described how the law reinforces gender disparities. For example, a female sex worker can be arrested or fined for selling sex, but there is no legal repercussion for a man buying sex.
Criminalization of sex work marginalizes poor women and prevents them from practicing safe sex in their transactional relationships; thus increasing the spread of STIs/HIV (Booth, 2004). Sex workers have been considered the core group driving the HIV/AIDS epidemic in Kenya. The epidemic reached its peak in the mid 1990s, when 80% of Kenyan sex workers were thought to be HIV-positive (UNIADS, 2006). At the beginning of the twenty-first century, up to 70% of Nairobi prostitutes were thought to have at least one STI (Booth, 2004). Currently, it is estimated that 40% of HIV infections in Kenya are the result of sex with prostitutes (Booth, 2004). Men’s risk of getting infected in Kenya is also determined by whether or not they pay for sex (Booth, 2004). Women who engage in these transactional relationships and men who frequently pay for sex are among the most likely groups of people to contract HIV. Legalizing prostitution in Kenya would protect and empower women, ensure 100% condom use, decrease HIV transmission, and generate revenues for social services and the health care system.
Commercial sex is a profitable economic sector; it has been estimated that the commercial sex industry has a global turnover of $5,000 to $7,000 billion, greater than the combined military budget for the whole world (Monzini, 2005). For example, the U.S. sex industry alone is estimated to be around $12 billion annually and employs upwards of six million people (Oakley, 2007). In the state of Nevada, sex work is legal and sex workers are allowed to be licensed and formally employed by brothels. Sex workers in Nevada undergo periodic mandated medical examinations for gonorrhea, herpes, venereal warts, and syphilis. They are also required to test HIV-negative in order to get licensed and must continue to have negative monthly tests thereafter as a condition of employment. (Albert et al, 1995). Clients are also required to use condoms during every sex act with a sex worker in order to protect themselves, the sex worker, and the general population (Albert et al, 1995). In Nevada in 1995, there was a 0% prevalence of STIs or HIV among sex workers (Albert et al, 1995).
Legalizing prostitution in Kenya would make the practice state controlled and create economic opportunities for the government by taxing the purchasers of sex. Revenues from the sex industry could be used for social services, including increased access to quality health care. Revenues from the sex industry could also help pay for some of Kenya’s increasing external debt. In addition, legalization would decrease the rate of HIV transmission, ultimately decreasing the disease burden on the health care system. Discriminatory laws against sex work in Kenya not only hinder women’s ability to have a legitimate income and practice safe sex, but also prevent economic and social development opportunities for the country as a whole. It would be in the best interest of Kenya to reexamine the policies, practices, and logic of criminalizing sex work.
References
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