The Big Issue: Stalking a virus among the shadows

Article by: Laura Lopez Gonzalez 24 March 2016 Sex workers may just be the start We may be creating a social construct that PrEP is for these ‘bad people’ who are disorganised and are thought to be having a lot of sex. What we should be doing is targeting anyone who is at high risk of HIV” In many countries, epidemiology is pushing governments to work with criminalised populations like sex workers and men who have sex with men to step HIV epidemics. For many politicians, it’s an uncomfortable partnership of necessity that in some African countries means that health departments are quietly undertaking small programmes to reach out to these groups without much public pomp and circumstance.South Africa’s high-level and very public commitment to addressing HIV among sex workers is a rarity. “It’s rare for a country to have such high-level leadership dealing with HIV among sex workers,” Abdullah said. “It’s a sign that government is taking this very seriously and working with non-governmental organisations and the community to make sure that the right thing is done and done properly. And PrEP for sex workers may be just the beginning. Prior to the announcement, both the Wits Reproductive Health and HIV Institute (WRHI) and the Anova Health Institute had started small demonstration projects aimed at learning how best PrEP might be rolled out. While WRHI focused on Hillbrow sex workers, Anova Health nurses have been providing PrEP to about 100 men who have sex with men (MSM) from its Woodstock clinic in Cape Town. Previous 2009 studies conducted in Johannesburg and Durban, as many as about 38 percent of MSM surveyed were living with HIV – a figure almost double the national adult HIV prevalence rate. With a growing body of data on the country’s MSM, as well as new lessons being learned in Woodstock, MSMs may be the next group to receive PrEP if South Africa continues rolling out the once-a-day pill for prevention. Read full article here … Continue reading →

UNIADS: Sally-Jean Shackleton: Getting Away From One-Size-Fits-All Health Policies

4 March 2016 What got you involved in the AIDS movement and particularly around PrEP advocacy? I work for an organisation called SWEAT — which stands for The Sex Workers Education and Advocacy Taskforce. Our interest is in the health and wellbeing of sex workers, which means we work in the intersection of rights and health. PrEP is an important tool for prevention, and since we are based in a country with one of the highest prevalence rates, it’s a key concern for us! What is an example of PrEP advocacy work you have engaged in recently? Is there a particular tactic or approach you have used in your advocacy that you can share? We have been partnering with a number of organisations making up the South African Sex Work Sector — and as such, participating in the development of a national Plan for sex work programming, which includes PrEP. In December last year, Truvada was approved for use as PrEP and so the country is developing guidelines for its use and plans for its distribution. We are campaigning for sex workers to be in the room in these discussions and ensuring sex workers are knowledgeable about PrEP. Aside from policy work, we work with peer educators, who are themselves sex workers, to deliver services on a range of issues, and advocate for the decriminalisation of sex work in South Africa. We provide a safe, supportive space for sex workers to lead groups on topics of concern — from motherhood to migrancy. From your perspective, what are the top priorities for PrEP advocacy to advance an accelerated, more equitable response to AIDS? Key is to ensure sex workers (trans and cis women, as well as men) are present in discussions on PrEP; especially sex workers from countries with the highest HIV burden. Secondly, we need to take a patient-centered approach. PrEP is only effective if it is used correctly — this means we have to invest in ensuring that there are adequate support structures, that sex workers are informed and that we address current disparities in health care settings for sex workers. Thirdly, we must continue to address sex work stigma and structural barriers, and change laws that prevent access to health and justice. PrEP is not a magic bullet — if we continue to apply new advances in the same, flawed and discriminatory health care settings, we will be wasting valuable … Continue reading →