Sex Work

Skinner Clinic: KP Friendly Public Health Services Arrive in Tshwane!

Skinner Clinic: KP Friendly Public Health Services Arrive in Tshwane!

TB HIV Care’s PWID Programme celebrated the launch of the Centre of Excellence, a key population-friendly health services centre at Skinner Clinic, Tshwane District Hospital, on Tuesday, 30 May 2023.

The new centre will ensure vulnerable populations, including PWID/PWUD, MSM and female sex workers have easy access to friendly, inclusive and non-judgemental healthcare services. These key populations face heightened risk of HIV transmission and STIs compared to the general population, largely due to various structural, socio-cultural and behavioural factors.

The launch allowed for candid dialogue between Gauteng Health MEC Nomantu Nkomo-Ralehoko, valued partners and service users (representing various key populations), which not only shed light on the challenges faced by key populations – but also explored potential solutions.

TB HIV Care’s Site Manager, Phumzile Mngomezulu, delivered a comprehensive speech highlighting the PWID Programme’s intricacies and the tailor-made harm reduction strategies employed to prevent and manage HIV among people who inject drugs. The programme’s profound impact in Tshwane and the collaborative relationship with the district were also emphasised. In attendance were members of the TB HIV Care team, including peer educators, a peer coordinator and three service users. Importantly, the service users were given a platform to address the MEC directly, sharing their challenges in accessing services at public health facilities.

The MEC attentively responded to the challenges raised by each key population and reiterated the support that Skinner Clinic, as the Centre of Excellence, will provide. The event marked the successful commencement of key population-friendly services at Skinner Clinic, thanks to our partners’ continuous support and commitment. Through training, mentoring, sensitisation efforts, and the implementation of effective service referral systems, the clinic is fully dedicated to meeting the unique needs of vulnerable groups.

Launching the Key Populations Friendly Service Centre at Skinner Clinic was a significant milestone, promising a brighter future for key populations who can now access the care and support they deserve.

Sharing Global Perspectives on Sex Work and Harm Reduction

Sharing Global Perspectives on Sex Work and Harm Reduction

On Wednesday, 13 March, a group of people from around the world gathered at the Cape Town Sex Worker Drop-in Centre. Delegates from Mexico, India, Morocco, Nepal, Macedonia, South Africa and Kosovo were invited to learn about TB HIV Care’s Sex Worker and People Who Use Drugs Programmes in Cape Town by hearing from staff and service beneficiaries alike.

As members of the Global Fund’s Developing Country NGO Delegation, many of the international delegates had very comparable experiences implementing similar programmes in other countries. This was evident from the many nodding heads in the audience when our staff explained our processes and challenges. This delegation is responsible for representing the interests and viewpoints of NGOs from developing countries on the board of the Global Fund, and has one seat on the board. The delegation is currently holding a retreat in Cape Town to plan its year ahead and the purpose of the visit to the Drop-in Centre was to get insight into South African experiences.

Lesley Odendaal, Communications Focal Point for the delegation, commented that the site visit had far exceeded her expectations. 

Rudolph Basson, Cape Metro Key Populations Project Coordinator, and Yolaan Andrews, Cape Metro Sex Work Site Manager, both gave excellent presentations describing the work of their teams. This was followed by emotional presentations by Natleen Jordaan, representing peers in the Sex Worker Programme and Angelo Langenhoven, representing peers in the PWUD Programme. Three service beneficiaries also shared their experiences with TB HIV Care, explaining how much they had learnt and how appreciative they were of the welcoming nature of TB HIV Care’s staff.

Thank you to all involved!
Minister of Health visits TB HIV Care’s Drop-in Centre in eThekwini

Minister of Health visits TB HIV Care’s Drop-in Centre in eThekwini

Submitted by: Mfezi Mcingana (Key Populations Programme Manager)

TB HIV Care’s Drop-in Centre in eThekwini provides support, healthcare services and treatment to sex workers within our community.

Over the years we have worked hard to ensure that the centre is a safe space for sex workers, where their needs are met and their voices are heard. On the 10th of January 2019, we were able to allow sex workers the chance to voice their fears and daily challenges to a delegation of government representatives.

In attendance were the Minister of Health, Dr Aaron Motsoaledi, Deputy Minister of the South African Police Services (SAPS), Bongani Mkongi, KZN Health MEC, Dr Sibongiseni Dhlomo, CEO of SANAC, Dr Sandile Buthelezi, police and Department of Health representatives, civil society and the sex worker community. Aiming to eliminate violence against women in general and sex workers in particular, this dialogue had our centre filled to capacity with sex workers who had come to engage with the government and SAPS about their grievances.

The pain and suffering of the community was visible as they took full advantage of the opportunity provided to voice their fears and discuss the hardships that they face on a daily basis (at times as a result of police brutality).

In his address, Dr Motsoaledi highlighted that in eThekwini, the Department of Health is working closely with TB HIV Care, Global Fund and PEPFAR to provide services to the sex worker community, noting that “they are not only providing additional services through mobiles, but are also assisting the department to improve the services that we provide in public clinics.”

He told the audience that “we are testing a fair number of sex workers, but are still not reaching everyone”. He also reiterated that those individuals that are testing negative and are being offered PrEP, are not accepting the service even though they know it will prevent the transmission of HIV.

He highlighted the fact that of all those individuals that test positive, only 55% are on ARVs.  He went on to say that ARVs are “good for the health of people living with HIV and one can enjoy a long healthy life if one continues the medication. However, we also know that those that take their medication are virally suppressed and will not transmit the virus to others.” Dr Motsoaledi went on to say that “it means that we have to work harder to test for HIV and STIs and screening for TB.  Everyone gets access to contraceptives and when one tests positive they are placed on treatment immediately. Secondly, it means consistent use of condoms and if offered, use of PrEP for the duration of the practice of risky sexual behaviour.” The Minister of Health therefore humbly requested that sex workers encourage their colleagues in eThekwini and elsewhere to get tested regularly.

The Minister of Health (MOH) acknowledged that sex workers experience much stigma and discrimination, both at the hands of health workers and some members of SAPS. The Deputy Minister of SAPS and the MEC are working together to ensure that sex workers are not abused by the system.  He encouraged sex workers to report any form of abuse.

In his conclusion, the MOH spoke about drug use. He stated that he understands that many sex workers use drugs to cope with their work and working conditions. However, this increases the chances of violence as well as HIV transmission and forgetting to take medication like ARVs and PrEP. In addition, some sex workers also inject drugs and we know that sharing of needles is the cause of transmission of both HIV and hepatitis. He asked that    “you don’t share needles if you are injecting drugs – rather come to TB HIV Care and request needles and ensure that used needles are disposed of safely, as this can be another major challenge if they are left lying around on the ground. I am sure that colleagues from TB HIV Care will say more about how to deal with these issues safely.”

Massive congratulations to everyone involved!