Lisa Isaacs

IN A milestone for the sex-worker industry, the at-risk population will now be able to receive oral antiretrovirals (ARVs) as pre-exposure prophylaxis (PrEP) at selected sex-worker programmes to prevent the spread of HIV/Aids.

From yesterday, sex-worker programmes around the country offered PrEP in addition to the other HIV-prevention interventions. They will also offer treatment upon diagnosis for those who are HIV- positive.

Combination prevention has been demonstrated to prevent new HIV infections and early initiation on ARVs contributes to better health, and decreases the possibility of HIV transmission to their clients and partners.

The national Health Department says an estimated 20% of the 350 000 people annually infected with HIV in South Africa are connected with sex work. HIV prevalence among female sex workers in South Africa is estimated to be 59.8%.

The department says these significantly high rates of infection, coupled with the possibility of onward transmission to their clients and partners, confirms the urgency of focused interventions for sex workers.

Sally Shackleton, of the Sex Worker Education and Advocacy Taskforce (SWEAT), said there were about 10 sites designated for the roll- out. “PrEP is an important preventative tool as part of a comprehensive programme which includes testing and counselling should someone test HIV-positive or HIV-negative.”

It was now pertinent that sex workers were informed about the benefits of PrEP. “We are, however, concerned that if it is offered in isolation, adherence could be a problem. Adherence makes PrEP work,” she said.

Wits Reproductive Health & HIV Institute project manager Wayne Helfrich said the safety of sex work needed to be ensured. “The news has spread and the idea that the department has acknowledged this group… is a step forward.”

The response had been immense, with sex workers wanting to know more about treatment and being willing to adhere to it.

He added it was still important that condom usage was encouraged.

[email protected]