When unconfirmed reports alleged that Donald J. Trump had once paid sex workers in Russia to urinate on a hotel bed that had been slept on by the Obamas, Russian President Vladimir Putin responded himself, half joking about an event he said he doubted ever took place, and claiming that, after all, Russian sex workers are “of course the best in the world.”
Certainly the Russian women working in the sex trades whom I have met during my time coordinating the Global Network of Sex Work Projects, both in the United States where I live and at health meetings elsewhere, have been lovely, and I have no doubt that they are good at what they do.
But I am also certain that they do not receive health services that they desperately need.
Russia has one of the fastest growing HIV epidemics in the world, accounting for eight out of 10 new infections in Eastern Europe and Central Asia.
Russia’s regressive policies on sex work, LGBTQ people, and sex education are counter to good health. LGBTQ people are stigmatized and discriminated against and face grave violence, sex work is prohibited, the most effective HIV prevention strategies for people who use drugs are against the law, and comprehensive sexuality education is not offered in schools.
Putin’s glib remark, so widely quoted, is its own variation on fake news: a distraction from what are, in reality, life and death issues. Russia’s pernicious influence has gone well beyond its own borders. Last June in New York it worked to prevent comprehensive sexuality education and reproductive health services from being included in the Political Declaration (PDF) of the United Nations High-Level Meeting on Ending AIDS.
Russia spoke out to object to the use of accepted public health terms like “key populations” (those most affected by the HIV pandemic) and supported the use of “comprehensive education” instead of “comprehensive sexuality education,” successfully obscuring the topic of discussion.
The United States under the Obama administration created a $100 million Key Populations Investment Fund specifically to promote HIV programming among gay men and transgender people, sex workers, and people who use drugs, among others. Health wonks noted that this would be the most effective spending for HIV prevention.
That was part of PEPFAR, the President’s Emergency Fund for AIDS Relief, by which George W. Bush made HIV medications available in the most affected countries, saving lives and changing lives, and which Barack Obama transformed by investing in evidence-based, proven-effective strategies for HIV prevention, treatment, and care.
Will Trump follow these bold moves with continued strong public health measures, or will he emulate Russia’s less effective, punitive, and ignorance-based measures? Let’s hope he follows the model of his presidential predecessors, not the man he seems to admire so much in Russia.