Sex Workers

Communicating Social Behaviour Change using TV and Radio

TB HIV Care was invited to partner with the National Department of Health (NDOH) on a Social and Behaviour Change Communication (SBCC) grant.  Asanda Ngoasheng (Project Manager) and Chanelle Munick (Project Administrator) joined the team to manage the three-month campaign. 

The campaign is aimed at three target markets, namely adolescent girls and young women (15-24), men who have sex with men (MSM) and sex workers. This project is about empowering women, men who have sex with men and sex workers to make the right choices as each action has consequences. The campaign will focus on TV and radio public service announcements (PSAs), community dialogues and health calendar day-focused events organised around the key campaign messages of:

  • Encouraging clinic visits for all target populations, especially to youth zones and youth clubs.
  • Promoting the prevention of STIs, teen pregnancy and HIV through combination prevention, i.e. condom and contraception use.
  • Calling for an end to gender-based violence – creating messages about the positive consequences of using your power or strength for good instead of physically abusing women.
  • Encouraging the initiation of and adherence to treatment for TB and HIV.
  • Testing – know your status, know your power and whether positive or negative, play your part! 

An important component of the SBCC project is community dialogue,  and TB HIV Care joined Sisonke/SWEAT’s ‘Creative Spaces’ initiative to host a conversation with sex workers. 

Asanda Ngoasheng led the conversation and shared SBCC Project messages with the twenty-nine sex workers present. They, in turn,  shared their stories of facing discrimination and stigma in clinics, both as sex workers and as people living with HIV. They also shared tried and tested condom negotiation tactics that they use on clients.

Although the topic was serious, there was a jovial mood and happiness at being able to tell their stories and hopefully inspire others to live healthy lives while working in a high-risk industry. 

This week the project reached a major milestone when the TV and radio campaign kicked off on the SABC. 

The messages portrayed on TV (and then translated into radio skits) focus on the following themes:

  1. We call for an end to gender-based violence and want men to use their power or strength for good. We call on communities (the power of collective action) to stand up and take action against gender-based violence.
  2. We call on young girls and young women to overcome their fear of clinics and visit clinics (especially Youth Zones and Youth Clubs) in order to receive combination prevention services (including condoms, contraceptives and/or PrEP) to prevent STIs, teen pregnancy and HIV infection.
  3. We call on young people to test and know their status.
  4. We call on young people to adhere to their medication if they receive a positive status – and to keep using condoms if they receive a positive (or negative) status.
  5. We call on young people to use condoms and see people who carry condoms as sexy and desirable, because they care about protecting the future health of their partners.
  6. We call on young people to choose a condom in all their sexual interactions in order to reduce the risk of infection with STIs and HIV or the risk of unwanted pregnancies.

The response to the messages so far has been phenomenal, with many people using our dedicated WhatsApp line to ask further questions and seek help for their health concerns.

If you are interested in finding out more about the campaign please click on the following links below:

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!