To appreciate and understand the emotionally charged response to sex work we need to confront a very deep rooted human fear -- few parents would like their child to be a sex worker or to be enticed into sex work. This overwhelming fear is intimately coupled with the existing dominant moral and social value system, in Ghana for instance it’s encouraged that one should not have sex outside marriage and especially not casual sex with strangers. Anyone who uses their body to provide sexual pleasures in exchange for money or favors is considered immoral. There are two questions which we all have to confront -- if this value system is such an overwhelming desire then how did we arrive at the current situation in which the sex trade is flourishing? Second, given that there exists a highly flourishing sex trade, should we try to stop it, can we stop it and if so how?
I would like to argue that there are four very important reasons why a large sex trade exists. First, moral and social constraints have not been applied uniformly to all people; second, a significant fraction of human beings stray from the straight and narrow path, thus creating demand; third, for people living in extreme poverty selling sex is a viable means of survival; and fourth, there exist enough ruthless people who are willing to exploit the poor and the unsuspecting. Given this environment, what policies will be most effective in reducing the trade is a very difficult and open question?

Conflicting Issues
So how does one resolve the many conflicting issues in our real world? "No" parent wants their child to end up as a sex worker or seek gratification through one, so how can society legitimize sex work? No child looks forward to, or plans for, a career as a sex worker, so how can sex work be desirable or voluntary? Why would any person willingly choose to be a sex worker if they could find alternate meaningful work? How does one deal with easy and anonymous access to sex workers eroding family values? How does one eliminate lust and the demand for easy sex? How does one confront the large scale trafficking of women that is occurring globally? On the other hand what avenue for survival does a person without work have when there are no social safety nets or worse still when there exists, open hostility towards victims of situations created by bad social practices and circumstances beyond one's control? Why should a fully cognitive adult not be allowed to use certain parts of his/her body to earn a living and to even prosper? Why does society not have the same emotional response to people working in highly hazardous and dangerous situations or debasing menial work which exposes them to extreme risk for physical and emotional harm?

What I wish to emphasize is that these are very emotional and difficult issues on which every individual has strong opinions and throughout history there has been no solution that has worked. What the rapid spread of HIV is forcing all societies and individuals to do is to confront this dilemma with urgency. We must have the debate, develop a consensus, make a decision on the course of action, implement the decision, monitor the programs for effectiveness, and if not successful in stopping the spread, have the courage to reassess and choose new solutions even if they go contrary to religious and cultural beliefs. Many people are very uncomfortable with being forced into this debate, but as with many things in life we cannot hide behind a veil of discomfort or ignore the issue or make decisions that prove harmful in the short and long term as lives of millions of people are at stake.

I rest my case.