Norwegian Directorate of Health, HIV groups criticise sex purchase ban

I’ve been meaning to blog about this since I ran across it last month, but other things kept getting in the way.

What follows are excerpts from Norway’s 2010 Progress Report to UNAIDS, the Joint United Nations Programme on HIV/AIDS. This is an official Norwegian government report, published by the Norwegian Directorate of Health, which is described on its website as “an executive agency and competent authority subordinate to the Norwegian Ministry of Health and Care Services”. The UNAIDS website states that “Each report is presented exactly as submitted by the country, without editing or other alteration.” It was presented in English, and therefore there can be no suggestion of any mistranslation on my part, as some readers of this post might have hoped for. I think the broad thrust of my Google Translations in that post can now be safely seen as confirmed, because the UNAIDS report backs up several of the key points I cited.

In the section on National response to the AIDS epidemic – Prevention (page 36), it states that since the sex purchase ban was introduced:

Experience shows that it has become more difficult to have a good overview of and gain admittance to prostitution circles. In addition, it is reported that individual sex workers no longer want to carry condoms and lubricants out of fear that they will be used by the police as indicators of sale of sexual services. The support and health services for sex workers in Norway, describe increased vulnerability for sex workers. They argue that due to increased competition and greater stress on the market, sex workers are forced to offer clients e.g. unprotected sex. In addition, sex workers in escort services are forced to sell sex at the customer’s arena, which makes them more vulnerable to violence and abuse.

While much of this is simply quoting what others have “reported”, no attempt is made to challenge or counter these reports, which suggests that the Directorate considers them credible.

More detail appears in the appended National Composite Policy Index, a Q&A survey for UNAIDS with data compiled by the Norwegian Directorate of Health in conjunction with other government departments and NGOs. The NCPI submission was overseen by two Senior Advisors in the Directorate, and carries the Directorate’s imprimatur.

Part A of the survey, which was replied to solely by Norwegian government officials (i.e., not NGOs), contains the following very interesting Q&A:

Does the country have laws, regulations or policies that present obstacles to effective HIV prevention, treatment, care and support for most-at-risk populations or other vulnerable subpopulations?

Yes

IF YES, for which subpopulations?

…Sex Workers – Yes…

The survey then asks for the description of any such laws, and the first law cited is the sex purchase ban. This is, however, qualified to some degree, as it is stated that

The potential negative consequences the new law against buying sex presents for the HIV preventive work, is unclear.

Later, in Question 79 about HIV prevention, one of the “remaining challenges in this area” is cited as

Possible weakening of preventive measures targeting sex workers as a result of the ban on purchase of sexual services

So the government officials who compiled this report are clearly hedging their bets about the actual negative impact of the law – which is entirely reasonable and appropriate given the lack of firm research data. Nonetheless, it cannot be ignored that the Directorate of Health is sufficiently concerned about the implications of the sex purchase ban to identify it as one of the policies that “present obstacles to effective HIV prevention, treatment, care and support”.

Part B of the survey was answered by six NGOs, five of which appear to be exclusively HIV/AIDS-focused (the sixth is the sex worker organisation PION). As you might expect, their replies are a bit harder hitting than those from the government officials. On the issue of obstacles, the NGOs state:

The effects of police enforcement has affected the sex workers’ relation to other services, such as harm reduction services, as many refuse to associate with anything or anyone that may give the police a suspicion of sex work. Condoms are used as evidence, hence the sex workers position for negotiation with the client about safe sex as [sic] been weakened. (Question 128)

And asked about “remaining challenges” in the area of HIV prevention (Question 186), the NGOS say that the sex purchase ban

makes it increasingly difficult to reach sex workers with prevention work and information

But has the ban achieved its aim of reducing the amount of prostitution and trafficking? I’ll go back to the main body of the report for this one. Bearing in mind that the law only came into effect around 15 months earlier, the Directorate is equivocal on this subject too:

it is difficult to judge whether there has been a reduction in the number of women being trafficked into Norway, due to shortcomings in the methods for counting trafficking victims… The main social and health oriented services in Norway, report a reduction in the number of sex workers in street prostitution in Oslo by 58% from 2008 to 2009 (from 1200 to 500 persons), in Bergen by 7 % (from 125 to 116) and in Stavanger by 49% (from 61 to 31). In 2009, Pro-centre (low threshold harm reduction centre for men and women selling sex and national resource centre for prostitution) estimated that the number of sex workers on the indoor marked in Oslo is reduced by 16 % from 2008 (in total 900 persons in 2009). However, these estimates of persons in prostitution are based on those who have had contact with support services or placed advertisements, researchers maintain that these data are unreliable because not all prostitutes get counted and some might be counted twice. In addition, essential information about men selling sex is lacking. Knowledge on whether the ban has led to a reduction of the total sale of sex or if there are fewer clients, is not available. (pages 50-51)

It goes on to say, in relation to migrant sex workers,

Since the ban on purchase of sex was introduced there has been a significant reduction in registered sex workers from Nigeria and Central and Eastern Europe residing temporarily in Norway. It is not believed that these women have started in new professions in the Norwegian labour force. Reports from Denmark and Luxembourg indicated the e.g. many Nigerians have moved their business to this part of Europe. The number of registered Thai sex workers on the other hand, has increased. This can partly be explained by the fact that many Thai female, male and transpersons selling sex in Norway have permanent residence permit or Norwegian citizenship due to family reunification and are therefore less mobile.

I’m unclear as to why the number (as opposed to the proportion) of Thai sex workers should have increased since the ban, but this otherwise seems to validate a few points that I’ve made a couple times on this blog: first, that criminal laws are a poor method for getting people out of prostitution; second, that the effect of prostitution laws cannot be viewed in isolation from the effect of migration policies; and third, that what may seem to be a “reduction” in prostitution is all too often merely a diversion – which might look favourable to the jurisdiction that recorded the “decline” but does fuck all to actually protect anyone. If those Nigerians and CEE sex workers had been trafficked or otherwise exploited in Norway, and undoubtedly some of them were, they’re still being exploited in Denmark or Luxembourg or wherever. Norway’s law hasn’t done a thing to help them, it just made them someone else’s problem.

So, to summarise the report: Norwegian NGOs in the HIV/AIDS sector are very clear that the sex purchase ban poses an obstacle to effective HIV prevention. The Norwegian Directorate of Health is more circumspect on the issue – not surprising when its website states that “​The political frameworks to which the Directorate is subject are the political platform of the government in office at any time and resolutions of the government and of Parliament” – but it certainly seems to be a lot more skeptical about the claims for positive impacts of the law than it is about the claims for negative impacts.

All too often, the law’s supporters are portrayed as if their view was shared across Norwegian and Swedish society, with only irrelevant people like sex workers themselves dissenting. That isn’t true in Sweden, where criticism has come from such sources as the Discrimination Ombudsman, the National Board of Health and Welfare and the Federation for LGBT Rights (citations in this post), and clearly it isn’t true in Norway, either. It is essential that these opposing views be included in any honest and informed debate over the adoption of the law in other countries.