The International Aids conference, held in the US for the first time in 22 years next week, is a chance for the country to celebrate its contribution to HIV and Aids prevention. Yet in Los Angeles, San Francisco, New York and Washington DC, state police forces are stopping, searching and arresting sex workers – and using condoms found on them as evidence to support prostitution charges, undermining decades of HIV and Aids harm reduction work in the process.
The four cities in question have significant histories of developing exemplary public health initiatives to deal with their HIV and Aids epidemics. In New York City, for example, where the Aids case rate is three times the national average, 40m condoms are distributed for free each year. Washington DC, meanwhile, which has the highest rate of Aids diagnosis of the four and the second highest rate of HIV diagnosis of any major metropolitan area in the US, has similarly embraced the so-called "rubber revolution" and, in the past decade, has increased HIV testing, decreased the rate of new cases and deaths from Aids, and appointed a mayor's commission on HIV and Aids to highlight the current administration's commitment to HIV prevention.
Law enforcement agencies have in the past had civil court orders brought against them where actions have compromised public health. In 2002, a federal judge ruled that New York City police could not arrest needle-exchange participants for carrying syringes, a directive echoed by LA chief of police William Bratton to his force in 2005. And in 1994, San Francisco's district attorney Arlo Smith signed an agreement advising that condoms should no longer be used as evidence for prostitution for the same reason – that police arrests were jeopardising public safety.
Alarmingly, this last resolution has since been abandoned, and the so-called "San Francisco model" – a positive, non-judgmental and harm-reductive approach to sex and sex work – is fast becoming the stuff of liberal legend. Instead, condoms are now being photographed by San Francisco's police as evidence of sex work, supposedly a way of law-enforcing without compromising public health. But the effect is still the same – to discourage the carrying of condoms, therefore increasing the risk of unprotected sex and exposure to HIV and Aids across the board.
Meanwhile, condom seizure prevails in New York, Washington DC and LA, creating a false belief among sex workers that there is a legal limit on the number of condoms they can carry at any given time. And as a consequence, outreach workers risk their own incrimination by carrying bundles of condoms for distribution instead.
Identifying condoms as evidence of sex work is just another way in which the US police endangers some of society's most vulnerable. In 2010, a city government transgender working group in Los Angeles recommended that local police stop confiscating condoms as a matter of safety. The force ignored them. Since then, Human Rights Watch has found alarming evidence of police abusing and "defacing" transgender sex workers. In all cities, police profiling gives them recourse to regularly stop and search any transgender individual, irrespective of profession, on the basis that he or she is "likely" to be soliciting.
Similarly, given that a conviction for prostitution is grounds for deportation from the US, immigrants without citizen status are also becoming too afraid to carry condoms. That the transgender and immigrant populations are at a higher-than-average risk of contracting HIV and Aids only compounds the deleterious consequences of current police strategy. As if harassing sex workers wasn't bad enough, the police are exacerbating the HIV and Aids health risks faced by every resident in these cities. In a final irony, county jails in San Francisco, Los Angeles, New York and Washington DC, some of the only detention centres across the US to do so, provide inmates with free condoms – the same inmates that have potentially been arrested for carrying condoms in the first place. In terms of HIV and Aids prevention, the message and method of public protection is about as clear as spilled blood.
As San Francisco's 1994 directive shows, the police have the power to balance their double duty to enforce the law and protect public safety. Sex work may be illegal in 49 of the 50 US states. But this damning policy of using condoms as evidence of prostitution is also making it illegal to be safe. With more than 30,000 delegates due at this year's International Aids Conference, the US should put its own domestic policy on the agenda.
