Abstract 摘要

The conception that commercial sex is a high risky behavior and prostituting women are one of major high risky group has been prevalent in mainland of China and formed one of the conceptual basis on which public policy of HIV prevention was shaped. But it should be challenged as it is not sound and fair.

There are safe protective measures that can reduce HIV infection and control HIV transmission. HIV was transmitted between prostitutes and clients due to the shortage of protective measures. Surveys that there are many cases ranging from 65.6% to 98.4% in which condom is never used in commercial sex. The reason is mainly that male clients refused to use condom when prostitutes asked them to wear. Prostituting women are powerless in the bargain with clients on the use of condom. So it is clients who should be mainly responsible for HIV infection and transmission in commercial sex. There are some cases in which clients are infected with HIV by their prostitutes, but more cases show that prostitutes are infected with HIV by their clients. Clients constitute more risky group than prostitutes and should be main target in HIV prevention.

In mainland of China AIDS/HIV is taken as associated with immoral and illegal behaviour first, and then as disease. And persons living with AIDS/HIV are taken as sex wrongdoers, and then as patients. So they have to get access to medical advocacy only after they are morally blamed. And prostitutes are morally condemned much more than they clients are. But AIDS is first a disease, and it cannot form a premise on which a moral judgement is made. Secondly, persons living with AIDS/HIV are patients, victims of a disease, not moral defendants. As prostitutes and their male clients both take risk to be infected with HIV, but the right to health care of prostituting women as well as women in general are ignored, neglected or even rejected.

The unjust treatment of prostituting women highlights vulnerable powerless status of women in general. It is the gender inequality that made women in a disadvantaged position in employment and education, and thus pushed them enter into prostitution. The society should be accountable for that. But instead the society condemned them, treated them as criminals. Policy and law involving HIV prevention should be reformed on the basis of conceptual change.