STRATEGIC IMPACT INQUIRY ON THE EMPOWERMENT OF FEMALE
SEX WORKERS – PERÚ, WITH EMPHASIS ON THE PREVENTION OF
HIV/AIDS
RESEARCH PROTOCOL
INTRODUCTION
The focus on gender
Gender represents a general model of power that sustains the permanence of certain social structures (ideologies, rules, institutions) that reinforce and “normalize” behaviors and cause them to appear “normal” to eyes of the rest of the world. In this sense, gender is one of the elements that must be considered indispensable to social analysis. The integration of a look into gender in a social analysis requires looking into the lives of women and their relationships with men. The differences between women and men in terms of rights and responsibilities have originated from a biological distinction. This social construct has defined a gender-based distribution of power, which directly affects the possibilities of women to exercise their rights and capacities to break the circle of poverty.
As a result of a distribution of work based on social and sexual difference, women have been relegated to tasks considered of inferior status, separating them from economic and political life and confining them to a private sphere. This patriarchal position on the
"nature" of women has constrained them to a private space, denying them their status as citizens, while men have claimed the public space for themselves. It's in this way that behaviors associated with the maintenance of private and family life (child-rearing, cooking, household chores) have been considered intrinsically feminine in most societies, while those associated with production and public life are held to be typically masculine.
The concept of empowerment
The concept of empowerment is directly linked to the possibility of initiating a process of capability expansion. This concept, in turn, is supported by the concept of agency, understood as the possibility of active choice and has its basis in Giddens's theory of structuration (1984). This theory comprises four basic components:
1.
Agency. As the capacity of individuals to change a given situation, regardless of social identity.
2.
Structure. As the basis of routines, conventions, relations and behaviors existing in society that are assumed as normal, as "givens" and that comprise the social structure.
3.
Subjectivity. Understood as the manner in which the social structure incorporates itself into the lives of individuals through rules, norms, conventions, and is assimilated in two forms: a) “practical conscience,” unconscious and lived out in the daily world and b) “discursive conscience”, the explanations for one's own actions.
4.
Resources. Understood as the means by which power is consolidated in the lives of

people. Resources may be distributive, authoritative or symbolic.
The empowerment of women
The empowerment of women depends on the changes that occur at the level of social positions, material conditions and the broader structural environment within which these elements interact. The conceptual framework proposed for the empowerment of women also integrates the voices of women, encouraging them to express their strategic needs and to open new spaces of action and opportunity. Empowerment will differ according to the social context, as it is not correct to assume that the situation of women is the same everywhere or that all women face the same problems in the same way.
In short, an empowerment approach is concerned with the sum of resources and capabilities of a given social group that allows it to participate in, negotiate with, influence, control and demand accountability from the institutions that affect their lives.
(Narayan, 2001) Specifically, our approach is concerned with expanding the capabilities of women to make strategic decisions within a context that has denied them this capacity.
(Kabeer, 1999)
This empowerment approach comprises four fundamental dimensions:
1.
Agency, the aspirations, resources, actions, and achievements of women attained through their own effort.
2.
Structure, that which conditions the choices and opportunities of women. Routines, patterns of relationship and interaction, and conventions that lead to certain established behaviors; institutions: family, likeness, religion, social hierarchies, politics, ownership of resources, forms of organization.
3.
Relationships, through which women advocate for their needs and rights with other social agents, including men, in addition to the social capital they have at their disposal, which facilitates collective action.
Female Sex Work
In presenting an evolutionist history of prostitution, numerous articles in Peruvian literature accentuate its assumedly universal character, uniformizing it throughout the world and throughout history. The existence of prostitution is legitimized as a "necessary evil", supporting the idea of its inevitability with notions of masculine sexuality. On one hand, the regulationist discourse stems from the notions that prostitution must be controlled and that legislation constitutes an instrument of this control. On the other, abolitionists call for its complete elimination.
The first call for regulation was published by medical science. It asked that a solution to the spread of syphilis be sought through the regulation of prostitution, by keeping the populations exercising prostitution under "sanitary vigilance". This position underlines the importance of controlling prostitution as an inevitable activity which provided sexual initiation for adolescents of the time, as well as gratification of the non-reproductive male

"instincts," under the pretext of helping to preserve "the family's honor". Conversely, since the beginning of the debate, the underprivileged position of women has been used as an argument to condone the entry of more women into this occupation, without effort to help change the negative opinion that society has about prostitution and the women that exercise it.
In 1910, regulation is instated through a set of decrees, resolutions and ordinances that originated at different levels of the State (national, local and law enforcement) and referred directly to sanitary statutes, registration and licensing. This regulation includes establishments such as tolerance houses, brothels, dating houses, and makes reference to dancing and the consumption of alcohol, license taxes, fines, sanitary requirements, location of the establishments, and the distribution of health identification for prostitutes.
Only adult women were allowed to operate in these establishments. The regulation of prostitution gave way to the institution of a new category of prostitution: clandestine prostitution. The abolitionist position is constructed around the concern for the spread of sexually-transmitted diseases, though it did not have significant impact and regulation was not modified.
With the existence of a regulationist policy, prostitution in Peru is not a crime, although
"pimping" is, considered as a promoter of prostitution. It's necessary to add that prostitution not only involves the prostitute, but also other protagonists such as clients and pimps.
Sex Work and Vulnerability to HIV
The theoretical concept of social vulnerability is an extremely useful tool to understand the persistence of the risk in certain populations to contract HIV/AIDS. Such is the case with the population of sex workers due to the vicious circle that causes this vulnerability, which in turn produces poverty, lack of opportunity, stigmatization and discrimination.
Female sex workers suffer from the difficulties affecting all women due to the hegemonic ordering of gender. However, in not abiding by the norms conventionally expected of women, they suffer not only from the burdens of a double role of being a worker, and generally a provider, but also from stigmatization and the discrimination for being transgressors of social norms in the public sphere.
The processes of empowerment need a framework for the exercise of viable rights and responsibilities outside of a context of poverty and symbolic violence, the latter defined as the process by which symbolic systems (images and practices) promote hegemonic norms and dominant ideas that legitimize domination and hierarchies accepted by those who live this violence on a daily basis.
Moser (1997) postulates that the concept of vulnerability must be understood as a dynamic concept that captures multiple dimensions of the life of specific social groups.
Vulnerability is not only present at the individual level, but also at the levels of family and community, and implies the existing disadvantages in facing different social

problems, exposing the affected groups to situations that impede wellbeing and the exercise of their rights, as is the case with all processes that cause the decomposition of the social fabric. Moser (1996) has identified five variables that measure the degree of social vulnerability: employment, human capital, production of goods, family relations and social capital.
Toro-Alfonso (1997) suggests that social vulnerability results from the experience of social isolation, lack of support, reduced political organization and empowerment.
Consequently, it produces an incapacity in the vulnerable populations to confront their health problems. There is strong evidence that conditions of social exclusion and vulnerability limit the agency of individuals. (UNAIDS 1999) In this sense, sexual risk is an important aspect to take into account in analyses of social vulnerability. (Toro Alfonso
1997)
Populations that suffer from social exclusion like sex workers, frequently express vulnerability to HIV/AIDS, among other problems. The complexity of determining the roots of vulnerability associated with sexual risk among sex workers implies that potential solutions may be found in connection with economic, educational, empowerment-related and political themes that favor this population.
From this point the following questions of the proposed study emerge:
1. What are some of the perceptions, meanings, aspirations and frustrations that sex workers participating in the projects (organized and non-organized) have about themselves and about their lives as sex workers, emphasizing HIV/AIDS?
2. From the perspective of the sex workers involved in the projects, how has the project contributed to their own empowerment?
3. What are some of the evidences that demonstrate that sex workers participating in the projects have been empowered to protect themselves from HIV/AIDS in accordance with these perceptions?
1.
OBJECTIVES
1. To know what the concept of empowerment represents for female sex workers that have participated in the projects associated with CARE-PERU.
2. To analyze the consequences of the reduction of vulnerability, especially to
HIV/AIDS
3. To find evidence of empowerment that helps them to protect themselves from
HIV/AIDS

Specific objectives
1.1. To know the perceptions, meanings, aspirations and frustrations that organized and non-organized sex workers have with regards to themselves and their lives as sex workers, emphasizing HIV/AIDS
1.2. To analyze the perceptions, meanings, aspirations and frustrations that organized and non-organized sex workers have about the rights that assist them and their expectations in this regard, emphasizing HIV/AIDS
1.3. To know the perceptions, meanings, aspirations and frustrations that organized and non-organized sex workers have about their relationships with their partners and men in general, emphasizing HIV/AIDS
1.4. To know the perceptions, meanings, aspirations and frustrations that organized and non-organized sex workers have about the opportunities that life afforded them: at the family and public levels, emphasizing HIV/AIDS
1.5. To analyze the perceptions, meanings, aspirations and frustrations that organized and non-organized sex workers have about their formal and informal social networks, emphasizing HIV/AIDS.
1.6. To analyze the activities that have involved the population of sex workers and have contributed to their empowerment to protect themselves from HIV/AIDS
1.7. To determine the perspective of the sex workers involved in these projects on which activities could have helped them and were not carried out
1.8. To explore the perspective of the leaders of the organizations of sex workers regarding the impact of their own empowerment and that of the other sex workers, emphasizing HIV/AIDS
1.9. To collect evidence through a survey, compare it with previously acquired data and determine whether the analyzed projects have contributed to the empowerment of sex workers.
2.
SETTINGS
Lima and Callao for being the capital city where the majority of cases of HIV are concentrated, and Iquitos and Chimbote.
3.
METHODS AND TECHNIQUES
The methodology selected to carry out this study will be a combination of qualitative and quantitative methodology.
Qualitative Methodology: searches for information in the depths of the subjective lives of the populations. It is directed towards the perceptions and meanings of the protagonists with regards to their own reality. Its main characteristics are: close involvement of the researchers, holism, and a demand for great contextual sensitivity. Qualitative methodology is applied from the perspective of the people and is more oriented towards knowing the meaning of the phenomena, rather than quantify them. Its inductive quality allows for the elaboration of local theories that may be adapted for similar local uses, as

well as for more general contexts.
The approach will be participatory: this approach is characterized by the active role assumed by the research participants, both researchers and research subjects. A distinctive trait of participatory research is that it is a group activity. Within this approach, research is conceived from an alternative perspective, in which the researcher and the research subjects are united by a flexible and holistic method. It is considered fundamental that decision-making be oriented towards the creation of critical communities with the purpose of transforming the social environment.
Quantitative methodology: this approach will allow us to establish comparisons with the baseline and follow-up surveys that have been carried out within the framework for the monitoring and evaluating the activities of the World Fund, specifically the activities involving sex workers. This way concrete evidence of the empowerment of sex workers can be generated. The two methodologies combined will allow us to have a more clearly defined panorama for the research questions.
Proposed techniques
1 Document analysis
It will consist of the revision of official, legal and institutional documents on each project, in addition to a revision of the public policies concerning sex work.
Moreover, the normative instruments that guarantee and protect the rights of sex workers will also be revised, as well as the plans and programs that are developed in favor of this specific population in order to contextualize the subject of study.
2 Life histories
This technique will allow us to focus on the experiences, values and perceptions of the population of sex workers in a detailed manner. This technique will allow us to access a plane of information that is both individual and intimate, in addition to explanations that could be suppressed or cut short in a group setting.
3 Participatory activities
Participatory activities are used in numerous development programs and projects, as in case of programs of sexual and reproductive health. It consists of a group technique to identify problems and obstacles with the aid of motivating questions to later analyze the causes and possible consequences of these problems in order to collectively propose future solutions.
4 Surveys on empowerment

It will consist of a survey of perceptions and behaviors implemented by interviewers with a representative sample of the target population of sex workers.
Variables corresponding to empowerment will be incorporated along three dimensions: relations, structure and agency; in addition to self-esteem and variables related to sexuality, safe sex, alcohol and drug consumption, relations with clients, and socio-demographic data of the sex workers. The survey will be complemented by the qualitative results. For the sampling, we will use an institutional source, depending on the amount of sex workers that there are in each project.
Projects to be researched
1 Objective 2, World Fund (Sex Workers)
2 The project to strengthen the organization Miluska Vida y Dignidad (Miluska Life and Dignity)
3 The project for sex workers of Callao
INDICATORS AND TECHNIQUES FOR THE COLLECTION OF
INFORMATION
Dimensions of empowerment
AGENCY
Questions Categories
Self-image
Relationships with men
Relationships with partners
Definition
The perception of oneself and of one’s capacities to act, to decide, to overcome problems and move forward.
Techniques of information recollection
Life histories
The capacity to negotiate in sex work. The attitude towards clients. Negotiating protection. Strategies to protect against violence. The capacity to negotiate with pimps.
Life histories
Capacity to negotiate with one’s partner. The attitude with one’s partner.
Negotiating for protection.
Strategies for protection against domestic violence.
The distribution of economic resources.
Life histories

Awareness of rights
Utilizing services
Negotiation
Control
The perception of being subjects of rights. The agency to advocate for one’s rights.
The capacity to protest against discrimination in public institutions.
General health,
ITS/HIV/AIDS.
Assistance in having access to periodical medical attention.
The forms of negotiating resources and safe sex
Resources
Participatory activities
Survey
Survey
Participatory activities
Survey
Survey
Decision-making With partner, client, pimps, etc.
Participatory activities
Survey
Migration
Organization
Forms of migration, reasons for migration, migration for work
Survey
Organizational membership.
The perceptions of the organization. Types of organization, reasons for getting organized. The sense of belonging in the organization
Participatory activity
Survey
STRUCTURE
Condom use
What are the perceptions, meanings, aspirations and frustrations that organized and nonorganized sex workers participating in the project have about themselves as sex workers, emphasizing
HIV/AIDS?
Forms of family coexistence
Condom use during the last sexual encounter with the client.
Condom use during last sexual encounter with steady partner.
Survey
Systems of coexistence with partner, family, children, and extended family.
Life histories

RELATIONS
Access to health services
Access to social justice services
Representation/ organization
Orientation in
Human Rights
Existing health services, quality of service,
Existing social justice services, quality of services.
Existing organizations
Survey
Survey
Survey
Relationships in the work space
Negotiation
Informal social networks
Formal social networks
Organizations for sex workers
Having received an orientation in human rights.
Relations established in sex work. Relations of subordination or of solidarity
Strategies of negotiation with the significant figures in the family and work
Relations established for the achievement of daily goals.
(neighborhood, family, child care, immediate neighbors)
Relations established for the achievement of strategic goals such as improvements in work, healthcare, justice, rights.
Relations within the organization, tensions, pacts, mutual problems.
Survey
Life histories
Life histories
Life histories
Life histories
Life histories
Knowledge Regarding healthcare services and rights concerning
ITS/HIV
Survey
BIBLIOGRAPHY
Giddens, A. (1995). La constitución de la sociedad: bases para la teoría de la estructuración. Cap.1. Elementos de la teoría de la estructuración.
Buenos Aires:
Amorrortu, 1995
Kabeer, N. (1999). The conditions and Consequences of Choice: Reflections on the
Measurement of Women´s Empowerment
. UNRISD Discussion Paper 108. United
Nations Research Institute for Social Development, Geneva.

Moser, C. (1997). Household responses to poverty and vulnerability. Volume 1.
Confronting crisis in Cisne Dos, Guayaquil, Ecuador . Urban Management Programme
Washington, DC: World Bank.
Narayan, D. (2001). Empowerment and Poverty Reduction: A Sourcebook . Washington,
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Toro-Alfonso, J. (1997) Vulnerabilidad de hombres gays y hombres que tienen sexo con hombres (HSH) frente a la epidemia del VIH/SIDA en América Latina: La otra historia de la masculinidad . In C. E. Cáceres; M. Pecheny and V. Terto Júnior (eds.) Sida y sexo entre hombres en América Latina: Vulnerabilidades, fortalezas y propuestas para la acción (Perú: Universidad Peruana Cayetano Heredia/ONUSIDA/Red de investigación en sexualidades y vih/sida en américa Latina), pp. 57–81.
UNAIDS (1999). Contextual factors affecting risk for HIV/AIDS . A complex comparative analysis of multi-site studies.