140908. Cape TOwn. "Ayanda" talking to the Cape Argus about the daily challenges they face as sex workers. Ayanda is 32 years old and has been in the sex worker industry for the last 17 years. He has worked in all the big cities in South Africa except for BLoemfontein. The money he earns he use to support his family. Picture Henk Kruger/Cape Argus

Cape Town - Whenever a Cape Town sex worker visited her local primary health care clinic in Gugulethu, not only did she have to spend hours queueing for health services, she was mocked by other patients and health workers - just because she was different.

Not only is Ayanda, 32, a sex worker, she is transgendered and is transitioning from male to female.

“People would call me all sorts of names... some called me a moffie, others referred to me as a drag queen.

Instead of getting attention for your health problems you end up being a centre of attention because of your sexual orientation.

You get mocked all day long... you are like a source of entertainment for them and you get judged for being immoral.”

But Ayanda won’t have to put up with these attitude anymore - thanks to a new TB/HIV Care Association Wellness Clinic, which opened in Observatory recently to cater for “key” populations, including sex workers, injecting drug users, men sleeping with men, and lesbian, gay, bisexual and transgender people.

Key populations are considered the most at risk for HIV infection and transmission, and are often discriminated against by communities and by health-care workers.

The new clinic - run by the NGO, TB/HIV Care Association in partnership with Sex Workers Education and Advocacy Taskforce (Sweat) - provides screening for diseases, HIV and Aids testing, sexually transmitted infections, and offers counselling and viral check-ups among other services.

According to Catherine Williams, a professional nurse and counsellor at the TB/HIV Care Association, the new clinic will provide a “judgement-free space” for people who are often stigmatised and face discrimination at mainstream government clinics.

Because of this discrimination, Williams said it was not always possible for these high-risk groups to discuss their health problems or sexual orientation that put them at risk.

“Most people are not comfortable because they either get judged by health workers as immoral or, in the case of injecting drug users, there’s often a great deal of fear that health workers will report their illegal drug use to law enforcement and get them into trouble.”

This judgmental attitude meant that many sex workers who were raped also failed to seek medical care to back up their claims of sexual assault, resulting in perpetrators walking scot-free.

Williams said the new clinic would provide a sex-positive space where people talked about their sexuality freely, and where health workers would deal with their problems as a public health matter rather than a moral judgment.

“The main problem with key populations is that they are already a hidden group. We want to create a space where they are encouraged to seek medical care and talk about their challenges that put them at high risk of HIV rather than to chase them away,” she said.

And Ayanda agrees that a more inviting space is more encouraging to seek healthcare. “I would rather go to a clinic where nobody judges me than go to a clinic where I will sit in the queue the whole day and still get mocked afterwards. For me it’s better to go to a clinic where I won’t be asked why am I taking so many condoms… where no one will question my sexual orientation or sense of dress. I want a health service that will take me for who I am,” she said.

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Cape Argus