Sex-work activists at the SANAC consultation on HIV prevention among sex workers
Two years ago, the Global Fund, an initiative that supports community efforts to combat HIV, tuberculosis and malaria, began funding interventions in the sex-work industry with a grant of 8.5 million USD. Tasked with spearheading the interventions, SANAC commissioned the Sex Worker Education and Advocacy Task Force (SWEAT) to produce a report that estimates the size of the industry in South Africa. SWEAT visited sex-work hotspots across the country and extrapolated the number of sex workers in specific regions to the overall population figures.
The report estimated that there were 153 000 sex workers, including 7 000 male and 6 000 transgender workers, with the highest number of sex workers in Gauteng province. Almost 60 percent of female sex workers were HIV-positive.
On 12 January this year, 140 sex workers met with NGOs and high-level government officials, including Deputy Minister of Justice and Constitutional Development, John Jeffery, and Deputy Minister of Social Development, Hendrietta Bogopane-Zulu, to discuss details of the Global Fund interventions. “I think we’re failing sex workers,” said Dianne Massawe, who works for SWEAT in Gauteng. She said that much more could be done.
SANAC CEO Dr Fareed Abdullah provided feedback on the national sex worker HIV programme to be launched later this year. He said consensus still had to be reached on some of the more controversial issues. “It is not only a question of having a large number of sex partners, many of whom demand unprotected sex. Sex work is often dangerous and lonely. It is illegal in this country and carries a heavy social stigma. An exceptional programme is needed to provide effective HIV services to sex workers and fulfil their right to receive healthcare.”
Some initiatives are already underway. SANAC raised R100 million from the Global Fund to finance 20 NGOs to implement a peer-outreach programme for sex workers (see box below). The programme, launched at the beginning 2014, reaches 30 000 sex workers each quarter with information, education, risk-reduction workshops and a meeting venue with a site coordinator. There are now 56 sites throughout the nine provinces each with 10 peer educators from amongst the sex workers themselves.
Decriminalisation
Massawe said sex work has to be decriminalised. “I think the key thing we need to change across South Africa is to look at the laws. Criminalisation clearly doesn’t eliminate the industry, but only serves to increase stigma and discrimination.” As an example of the problems with illegality, Massawe said she had heard of police officers arresting suspected sex workers if they had condoms in their bags. “It doesn’t stop them from working, only from carrying condoms. Such structural barriers inhibit workers from accessing services and realising their rights.”
A version of this article was first published in the Daily Maverick on 15 January 2015.
| MORE ABOUT the peer-outreach programme
Each peer educator is trained to reach 60 sex workers per quarter. They also supply condoms and lubrication. Further work is being done to ensure that the sex workers reached by the programme have effective referral plans to local (or mobile) clinics so that antiretroviral treatment, STI treatment and contraception can be accessed regularly. The programme also aims to improve referrals to social workers for alcohol and substance abuse, places of safety, women and child abuse and other psychosocial support such as rape care and counselling. The peer educators are also being trained in paralegal support so that they can assist sex workers in their area when they need to lay a charge for violence or rape with the police, or if there is abuse from police themselves. |