Friday, 16 May 2025

HOOKERS IN CRISIS AFTER USAID FUNDING CUTS

Sex workers in Mutare are facing a crisis following the withdrawal of USAID-funded organisations that previously provided them with crucial medication and support.

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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