19 July 2016

South Africa: Aids Conference - Spotlight On HIV and Sex Work

Photo: Abhi Indrarajan/AIDS Society
Activists for sex workers protesting outside the Durban ICC on the morning of the International AIDS Conference.

Durban — As scores of delegates gather in Durban this week for the 21st International AIDS Conference, the debate around decriminalising sex work to combat HIV infections has once again turned the spotlight on sex trade, a subject many are not comfortable to talk about.

Although sex workers are among the highest risk group for contracting HIV, many feel that this is the group that has largely been marginalised in the debate on HIV. Sex workers have comparatively high numbers of sexual partners compared with the general population but this does not necessarily increase their likelihood of becoming infected with HIV if they use condoms consistently and practice their trade without fear of being arrested, said Sisonke Sex Workers Movement Director Kholi Buthelezi.

"Until we agree on the decriminalisation of sex work, we don't think we are being listen to. Sex work is like any other work. Many of us are in the sex work industry because we want to be and want to be protected and at the moment we feel everyone is against us," said Buthelezi.

She is among a group of sex workers who are demanding to have their voice heard at the five-day conference being held at Inkosi Albert Luthuli International Convention Centre.

"It's not nice to be mistreated by nurses when you go to the clinic for help just because you are a sex worker. It is also not nice to be turned away from the police station when you go to report a rapist. It's all these things that we want this conference to recognise," said Buthelezi.

The sex workers are complaining that the stigma associated with their work can make it hard for them to access healthcare, legal and social services. This puts them in a vulnerable position. However, this may slowly start to change as the Deputy Minister of Social Development, Hendrietta Bogopane-Zulu, has given her unwavering support to the fight of sex workers to be put at the front of the battle against HIV/AIDS.

On the first day of the conference on Monday, Deputy Minister Bogopane-Zulu led a robust session which focused on debating the South African National Sex Workers HIV Plan, which sets to focus on sex work and HIV prevention over the next five years.

In an interview with SAnews on Tuesday, the Deputy Minister acknowledged that there were still challenges in the sex industry mainly due to its legal status but said government has moved to improve the condition of sex workers by putting in place several programmes aimed at assisting those in the business.

"The question that has been asked is whether we have overlooked sex workers in this debate on HIV and the answer would be yes and no. Yes, we have not done enough but as the government of South Africa, we have taken several bold steps to address this issue. One of our interventions is the National Sex Worker HIV Plan, which we are championing," she said.

The Deputy Minister says the implementation of the plan was an indication that government was serious about combatting new infections in this population. The plan, she said, provides for a standardised minimum package of services to be implemented by all sectors, both within and outside of government.

The plan has been supported by Cabinet and includes the provision of Pre-Exposure Prophylaxis (PrEP). According to the South African National AIDS Council (SANAC), PrEP affords sex workers a greater chance to stay negative. The plan also endorses the provision of Universal Test and Treat (UTT) for sex workers. Deputy Minister Bogopane-Zulu said both initiatives have received the blessing of the National Department of Health, as part of government's commitment to the UNAIDS-led campaign to reach the targets of "90-90-90" by 2020, and in line with the World Health Organization (WHO) treatment guidelines.

90-90-90 is a set of goals that supports the idea that by 2020, 90% of people who are HIV infected will be diagnosed, 90% of people who are diagnosed will be on antiretroviral treatment and 90% of those who receive ARVs will be virally suppressed.

The plan will also focus on three areas which are prevention, treatment, psychological support as well as legal support to all sex workers. It is an initiative that sex worker representatives like Buthelezi have welcomed as a move in the right direction.

"We believe that dehumanisation of sex workers has the potential to harm the efforts to fight HIV, so we welcome any initiative that will put sex workers at the forefront of fighting the HIV pandemic," said Buthelezi.

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