JOHANNESBURG, 17 November 2009 (PlusNews) - A plan by Malawi to offer prostitutes low-interest loans to start small businesses in return for abandoning sex work is generating controversy in a country where women are disproportionately affected by high rates of poverty and HIV.

"Most [sex workers] leave school at an early age, get pregnant, and then have to provide for a child, so they end up on the streets as a way to earn a bit of money," said Ayam Maeresa, special assistant to the Minister of Gender, Children and Community Development, Patricia Kaliati, who proposed the plan after discussions with sex workers, most of whom said they had been driven into prostitution by poverty.

The plan aims to economically empower female sex workers and reduce the spread of HIV, but critics question whether it can achieve either of these goals when there are so few opportunities for Malawian women to earn more than they do from prostitution.

"If we help them to get out of this trade, we'll also be helping to control the spread of HIV," Maeresa told IRIN/PlusNews. He was vague about what type of businesses the women would be encouraged to set up, saying only that several NGOs had indicated they would provide business management training.

Rehabilitation approach flawed

Many initiatives in Africa have made attempts to help sex workers find alternative sources of income without much long-term success. None of the sex workers in Botswana, Namibia and South Africa interviewed in a recent study by the Open Society Institute (OSI) had found jobs after completing what the authors called "rehabilitation" programmes.

"They offer women an alternative job in another part of the informal economy that is equally if not more unpredictable, and often leads to the women earning much less money," said Vivienne Mentor-Lalu of the Sex Worker Education and Advocacy Taskforce (SWEAT), a Cape Town-based NGO that lobbies for the rights of sex workers.

Research by SWEAT found that a South African woman with primary school education could earn up to four times more doing sex work than any other job she would be eligible for, if she could find a job in a country with around 25 percent unemployment.

"In South Africa we have this phenomenon where men stand on the side of the road selling their labour, and women stand on the side of the road selling sex," said Mentor-Lalu, who was worried that programmes steering women away from sex work were often less concerned with economic empowerment and reducing HIV risk than promoting a conservative moral agenda.

The OSI report suggested that the popularity of such interventions was linked to restrictions on foreign funding that undermined rights-based approaches favoured by the sex workers. Organisations that receive funding from the US President's Emergency Plan for AIDS Relief (PEPFAR), for example, are required to sign an "anti-prostitution pledge" that they will not support or promote sex work.

Marlise Richter, a South Africa-based researcher, said the requirement had "a chilling effect" on efforts to support sex workers' rights. "Sex workers don't need to be rehabilitated, they need to be given skills and a safe working environment. I can see there's a place for exit programmes and microloans, but you're not dealing with the underlying system."

Rights not rescue

In most of Africa, as in the rest of the world, the underlying system is one that criminalises sex work, making it difficult for sex workers to access health services or to report abuse at the hands of clients, pimps and even police.

As host of the 2010 FIFA World Cup, South Africa is ahead of much of the rest of continent in starting to debate the merits of decriminalising sex work, a move supported by the National AIDS Council. "Increasingly, there's recognition that you can't begin to look at sex work and HIV if you don't look at sex workers' rights," said Mentor-Lalu.

Explaining how the abuse of those rights could contribute to HIV infections, she cited the practice of police confiscating condoms from sex workers; of having to pay fines, when arrested, which made the women more likely to agree to unprotected sex for a higher fee; the marginalisation of prostitutes that prevented them from accessing health services.

Rather than addressing any of these issues, the Malawian plan would penalise women who returned to prostitution after accepting a loan from the government. "If it becomes a law, that will be one of the conditions," the gender ministry's Maeresa confirmed. "If you return to the streets, it [sex work] becomes a criminal offence."

The Reproductive Health & HIV Research Unit (RHRU) of the University of Witwatersrand, in Johannesburg, South Africa, have adopted a more flexible approach with their "Beauty Shack" project for sex workers from the inner-city neighbourhood of Hillbrow.

After completing training in beauty therapy at a local health spa, the women are encouraged to give up sex work and start businesses or seek jobs, but if they choose not to they can still participate in the programme as peer educators, earning a monthly stipend of US$134.

Nonhlanhla Motlokoa of RHRU, who coordinates the "Beauty Shack" project, is optimistic that it will be more successful than previous initiatives offering training in cooking and sewing. Although some of the women "are scared to take that leap", two have already secured full-time jobs at the spa where they were trained, while others are enthusiastic about the possibility of starting small businesses.

RHRU also operates a mobile clinic that provides condoms, HIV counselling and testing, and treatment of sexually transmitted infections at hotels where the women live and work.

Researcher Richter applauded RHRU's public-health approach, but insisted that "The bottom line is the criminalisation of sex work that results in stigma and abuse," and that only legal reform could address the gender-based violence and lack of legal recourse that put sex workers at most risk of HIV.