Yesterday’s Supreme Court’s 6–2 deci­sion in US Agency for Inter­na­tional Devel­op­ment v. Alliance for Open Society Inter­na­tional inval­i­dated the “anti-​​prostitution pledge.” Advanced by reli­gious and other anti-​​human-​​trafficking groups, this pro­vi­sion was inte­grated in the Lead­er­ship Act–the law that autho­rized the Bush Era’s flag­ship PEPFAR ini­tia­tive to fight HIV/​AIDS. At issue in this case was the Act’s con­di­tion that any recip­ient of US funds to fight AIDS and related dis­eases must first adopt an organization-​​wide “policy explic­itly opposing pros­ti­tu­tion and sex traf­ficking.” With only Thomas and Scalia dis­senting, the Court’s con­ser­v­a­tive and lib­eral voices joined to find that the pledge pro­vi­sion runs afoul of the First Amend­ment. Going beyond merely dic­tating how the funds could be spent, this clause actu­ally man­dates pri­vate enti­ties to “espouse as their own the Government’s [policy] view.”

Although decided strictly on First Amend­ment grounds, this deci­sion also has impor­tant impli­ca­tions for the fight against HIV/​AIDS and other public health pro­gram­ming. Around the world, sex workers have an ele­vated risk for HIV and other infec­tious dis­ease; they can also transmit these infec­tions to clients and others. Public health evi­dence clearly demon­strates that suc­cessful efforts to curb dis­ease trans­mis­sion in this pop­u­la­tion require sex worker input, par­tic­i­pa­tion, and trust. State­ments about anni­hi­lating sex work cannot be squared with these basic tenets. This is espe­cially true when the req­ui­site policy posi­tion con­flates all sex work with human trafficking–a highly con­tro­ver­sial and inac­cu­ratechar­ac­ter­i­za­tion. Beyond merely stymying pro­gram­ming, the pledge require­ment alien­ates poten­tial recip­i­ents, including those best posi­tioned to imple­ment HIV pre­ven­tion and treat­ment. As public health orga­ni­za­tions and researchers argued in their amicus brief to the Supreme Court in the Alliance case, the pledge require­ment actu­ally hin­ders the public health goals of the Lead­er­ship Act.

Read the article at Huffington Post →