Sex workers' access to treatment stymied by Covid-19 lockdown
Lockdown may have undone the strides made to assist sex workers with health care, said members of the Soweto Sex Worker Project at Chris Hani Baragwanath Hospital.
The organisation’s Dr Jenny Coetzee said there was a significant decline in clinic attendance since the start of lockdown, with many people still not attending their regular clinic visits.
The project offers sex workers access to health care, social workers and legal aid. It ropes in former and current sex workers and offers help for reproductive health management, HIV and other sexually transmitted infections and diseases, as well as counselling and other support services.
Much of the project's work was halted during the Covid-19 pandemic, and the team is now working in the area to help track and trace potential Covid-19 cases.
Dr Maya Jaffer, who manages the project team, said they now make house calls, where possible, to ensure antiretroviral drugs (ARVs) are delivered if patients cannot come to the clinic.
“There are two components: the clinic and the outreach programmes. The clinic remained open during lockdown to deliver HIV care, contraceptives and treatments,” she said.
She said a lot of the clinic's activity was generated by the outreach programmes, which went into the sex work community to encourage them to access the health services.
During lockdown, however, the outreach activities were targeted at getting medicines to many of the workers who could no longer afford the taxi fares to travel to and from the clinic.
Jaffer said sex workers are a very vulnerable group because they were not high earners and had no legal protection.
“The bigger problem we face is that many sex workers in the area work between Gauteng and the North West. Some of these workers are stuck in the neighbouring province and we can’t chase up on their medication.
“Sex workers are still struggling and taxi fares have become a lot more expensive.”
Coetzee said many of the strides they had made in terms of HIV prevention and management had suffered a huge setback.
“Covid-19 created chaos about access to health care. Patients have been afraid to access care.”
She is concerned about the risk of new HIV infections.
“SA has continued to haemorrhage new infections, with roughly 250,000 infections recorded annually. The question is, what will this landscape look like when the Covid-19 dust settles?
“I believe an initial form of lockdown was appropriate in the early stage as the country needed time to prepare hospitals and buy personal protective equipment (PPE), but this should have been more carefully balanced against factors such as the inability to access food.”
Their published research showed that sex workers earned less than R150 a day, but with lockdown their ability to support themselves and their families has dried up.
Their findings also showed sex workers often support between seven and 12 people.
Sex worker Amanda Booi, who shares a home with four other sex workers in Soweto, said the women in the home were all breadwinners and used to send money to their parents, children and siblings. The five women said they were not able to send money home since March.