Body as a site of contestation and reconciliation: Learning from an “STI management program” in India

This paper draws from research on a global health initiative to prevent HIV/AIDS among female sex workers [FSWs] in Rajahmundry, Andhra Pradesh, India. Treating and preventing STIs among FSWs was a critical goal of the initiative to protect the health of the women and their communities. It was also a cost-effective way to slow the spread of HIV, especially in rural areas where laboratory facilities are unavailable. In this context, the STI program was implemented in a two-pronged strategy. The first involved setting up a clinic and providing STI services that included condom promotion, regular check-ups, asymptomatic treatment, syndromic case management and counseling. The second included the formation of a Health Committee, consisting of FSWs, PEs [Peer Educators] from the FSW community, and medical doctors to monitor the program, ensure quality treatment and so on. While the latter strategy emphasized “community ownership” and had as a goal that FSWs would eventually own the program and take decisions, the former strategy gravitated towards close surveillance and regulation of sex workers’ bodies. On the other hand, sex workers’ reactions to these strategies varied over time: from contestation or resistance in the initial period to negotiation and reconciliation later on. Following the arguments of embodiment theorists, we argue that FSWs’ response to the STI management program cannot be reduced to “body governance” which over-emphasizes “docile bodies”, making bodies subservient to discourses, technological advancement and structures of society. Rather, we illuminate how the body also exercises agency in the world and therefore, is also an instrument of refusal and rejection. Indeed, FSWs reconciled with the STI management program only when the intervention restructured the program in ways compatible with FSWs’ convenience.