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October 14, 2010
Anna Forbes: From Microbicides to Sex Workers—A Logical Development
by Lauren Tuck
Anna Forbes found her calling in 1992 when development of microbicides—usually in the form of topical gels or creams that block sexual transmission of HIV—began attracting notice. Since then she has become widely known for championing microbicides, which might offer women protection without a condom. For 10 years she represented the Global Campaign for Microbicides, working on behalf of disenfranchised women. Now she has moved onto consulting in order to discover new ways to fight HIV—and to broaden her horizons. On those new horizons: sex workers, whom Forbes views as an untapped resource of HIV prevention.
Why did you get interested in microbicides?
I have been working as a women’s health advocate all my life. In 1992 when I first heard about microbicides I thought, “Ah, that’s it! This is the place where the wires cross!” I became interested in them because I had women asking, “What do I do [to protect myself from HIV] if I can’t make my man use a condom?” There was no good answer for that, and there still is no really good answer for that except female condoms. It became clear to me that there was no way we were going to be able to successfully stop HIV from spreading if we didn’t find an answer.
Do you remember an incident that brought that to your attention?
I was working for an AIDS service organization in 1989, and this middle-age, middle-class, white, Italian-American woman in South Philly called me up late and yelled at me. She said, basically, “How can I be positive? I did everything that people said—condoms, monogamy, abstinence. I’ve been married for years and years. I’ve been monogamous. Obviously I wasn’t going to practice abstinence, and condoms weren’t needed because I was monogamous. Now I have HIV. How did that happen? You guys lied to me.” And it really blew me away because the message “condoms, monogamy, abstinence” is an either-or choice. [With that message we end up] lying to women who are relying on monogamy to protect them.
Why did you leave the Global Campaign for Microbicides?
I worked for the Global Campaign for 10 years, and it seemed like it was time for me to do something else. I wanted to have a chance to back up a bit, because I had been focused very closely on microbicides. I wanted to take a step back to look at women and HIV prevention a little more broadly, to look at HIV in a different context. I have become particularly interested in sex workers and why we haven’t engaged them more in HIV prevention policy. I think we very much need to do that. I’m trying to look at why it hasn’t happened, what it would take to make it happen, and what the issues are around that.
What sparked your interest in sex workers?
While I was still working in microbicides, I helped put together a training with sex worker organizations in Bangkok. They raised a lot of really critical issues and concerns that I’d never heard anybody talk about before. For example, how do you call a product safe for use if it’s safe for use once a day? What about a woman that needs to use it five times a day? How do you introduce microbicides in a way that doesn’t defeat the sex worker’s ability to insist that johns use condoms? Isn’t the client just going to say, “Why should I wear a condom when you can just use the gel?”
A sex worker once said to me, “If you’re working in a factory and you need steel-toed boots to be safe and someone gives you silk slippers, that’s not going to do it.” I thought that’s perfect, that is so friggin’ right! My goal is for AIDS activists to learn about sex work enough to be able to get the anti-prostitution language taken out of [the U.S. President’s Emergency Plan for AIDS Relief] and to get laws criminalizing sex workers lifted. Those laws are destructive to HIV prevention, whether they criminalize gay sex, drug use or selling sex. And we need to protect sex workers from [police abuse].
What are you planning to pursue in the future?
I’m still trying to educate myself, but I’m reminded of when I first got into AIDS work in ’85. All of a sudden I had to learn about the wonderful world of gay men because that was the culture we were predominantly working in at that point. I didn’t know much about it as a straight woman. Now I’m trying to learn all about the sex worker world and how it operates, functions, what their interests are and how [sex work] is different in different parts of the globe.
I see myself at the intersection between research and civil society advocacy. I define myself as an activist, advocate—I’ve never been quite sure as to what the difference is between the two, but I think it has to do with the willingness to get arrested—which makes me an activist because I’ve been arrested seven times! I think that what is difficult is that sex workers have been so heavily stigmatized—arguably one of the most stigmatized populations in the world. I really want to figure out a way to create a bridge to communicate with sex worker organizations about how they could be involved in HIV, prevention, policy planning and to try to make space for them to be involved. So I’ll give myself a year to figure out how to do that.
Along with being an activist, you are a woman, mother, aunt and wife—how do you juggle all that?
Well, as we like to say, it’s not a job it’s a lifestyle. I can’t imagine living any other way. I’m a Quaker—I was raised to believe that it was possible to create social change in the world and that in fact we have an obligation to do that. For me, sexual health has always been the area where I have felt as though I needed to do something to create change in the world. I am very fortunate my husband understands the urgency of what I’m doing and fully supports me in it. Somebody asked me once when I first started doing AIDS work—when virtually no straight people were doing AIDS work, in the ’80s in the U.S.—“What do your straight friends think of this?” And I said, “What straight friends?” My friends have become the people who share or at least understand the passion for what I’m doing.
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