Unavailability
of key HIV prevention medication, such as pre-exposure prophylaxis (PrEP), has
left these workers vulnerable to infection and jeopardised their livelihoods.
PrEP stands for
Pre-Exposure Prophylaxis – a medication regimen designed to prevent Human
Immunodeficiency Virus infection in individuals who are at high risk of
contracting the virus.
PrEP typically
involves taking a daily antiretroviral medication, usually a combination of two
drugs – tenofovir and emtricitabine (TDF/FTC).
When taken
consistently, PrEP has proved to be highly effective (up to 92-99 percent) in
preventing HIV infection.
PrEP is
intended for individuals who are HIV-negative, but at increased risk of
contracting the virus – sex workers, people with multiple sexual partners,
injection drug users and those in relationships with HIV-positive partners.
By taking PrEP,
these individuals can significantly reduce their risk of acquiring HIV, adding
an extra layer of protection to their prevention strategies.
Operating near
Forbes Border Post, the sex workers cater for truck drivers and other clients,
but lack of PrEP has made their work increasingly precarious.
In response to
these challenges, the Senate Thematic Committee on HIV and AIDS is conducting
nationwide consultations to investigate access to HIV and AIDS and sexual
reproductive health services for sex workers.
The sex workers
highlighted a range of challenges beyond medication shortages, including
harassment and sextortion by authorities, declining business, coerced
unprotected sex, and exposure to substance abuse, particularly at the hands of
foreign truck drivers.
Stigma and
discrimination further compound the difficulties they face in their profession.
With their
safety and well-being hanging in the balance, the sex workers are calling for
urgent intervention to address these pressing issues.
During a recent
visit by Senators to their Forbes Border hideout, a sex worker named Rophina
made a heartfelt plea for the immediate restoration of PrEP in health centres,
citing the crucial need for the medication to ensure their safety while
working.
Rophina
expressed concern that some young women are being lured into drug abuse,
leading to defaulted medication and exposure to sexually transmitted diseases
for themselves and their clients.
“We are facing
a growing number of clients who refuse to use protection. Some truck drivers
will pick you up, only to drop you off along the way without payment. Business
is slow, and competition is fierce, especially with new, younger entrants in
the industry,” she decried.
Rophina fears
that if they cannot earn enough to send their children to school, they will be
forced to do anything for survival.
“That is why we
are appealing for PrEP to always be available. Even with protection, there is
still a risk of bursting. The issue of drugs is also taking a toll on many
girls, who use them to cope with stress. These drugs are mostly provided by
foreign truckers, and they are exacerbating our problems, as some girls stop
taking their medication,” she added.
A middle-aged
sex worker, who used the pseudo name Margarine, made a heartfelt appeal to
authorities, seeking scholarships for tertiary and vocational education.
This, she
hopes, will enable her and her colleagues to transition out of the sex
industry, and into more decent job opportunities, ultimately improving their
livelihoods and those of their families.
“We urge
Government to initiate projects that will help us exit this industry. Our
earnings are meagre, making it difficult for us to survive. Many of us have
impressive Ordinary and Advanced Level passes, and are eager to pursue tertiary
education, but we need scholarships to make this possible,” she said,
emphasising that accessing vocational and technical skills training will also
be incredibly empowering.
“These skills
will allow us to explore alternative means of survival, unrelated to sex work,”
she said.
Senator
Angeline Tongogara, chairperson of the thematic committee, explained that the
visits aim to assess the accessibility and utilisation of HIV and AIDS and
sexual reproductive health services by sex workers.
The committee
seeks to identify challenges faced by sex workers in accessing these services
and evaluate measures to reduce HIV prevalence and incidents among this group.
“We will
provide recommendations to enhance access to HIV and AIDS and sexual
reproductive health services for sex workers,” said Senator Tongogara.
National AIDS
Council director of monitoring and evaluation, Mr Amen Mpofu revealed that
currently, PrEP is only available to pregnant women and breastfeeding mothers.
However, he
assured the committee that the country has a sufficient supply of
antiretroviral (ARV) medication.
“We have enough
ARVs at NatPharm. The Global Fund has pledged to support 710 000 patients, and
the US Government had ordered ARVs that will last until the end of September
2025. The Global Fund will continue funding a similar number of patients next
year,” he said.
Mr Mpofu added
that the US government has pledged to continue its support in 2026, ensuring a
sufficient supply of antiretroviral (ARV) medication.
“However, we
need to develop a long-term plan, as we are uncertain about what will happen
after 2026. If we do not receive support from the Global Fund, Government need
to find alternative sources for ARVs,” he said.
Mr Mpofu said
the programmes most affected by the funding changes are PrEP and male
circumcision.
“The US
Government has restricted PrEP to only pregnant and breastfeeding mothers. This
means that other populations previously receiving PrEP can no longer access
it,” said Mr Mpofu.
To address this
gap, the NAC will procure PrEP for the current programme.
Mr Mpofu
highlighted the importance of the AIDS Levy – a home grown solution that needs
to be protected.
“We must target
the levy to fill the gaps in our programmes,” he said. Manica Post
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