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Siyayinqoba Beat It! 2005 Episode 8 –
Sex Workers and HIV
We all want to live in a world that is AIDS free and we cannot be judgemental about sex work. Sex workers are as much at risk from their clients as clients may be from sex workers. Our objective has to be to make sex work safe for both clients and sex workers. In this epsiode the support group spoke about the dangers faced by sex workers and what kinds of services are offered to help them protect themselves.
Jason Wessenaar: Kgotsong, re ya le amohela ho Siyayinqoba Beat It! Support Group {Sesotho} Hello and welcome to the Siyayinqoba Support Group. My name is Jason. In the Siyayinqoba Support Group we are all living positively with HIV. Each week we get together to talk about issues that affect our lives with HIV; from sex and the positive person to dental care. Siyayinqoba is your guide to better living with HIV. If you’re living with HIV or have a partner, a friend or a family member living with HIV, this programme is for you. Today we’re talking about sex work and HIV. We all want to live in a world that is AIDS free and we cannot be judgemental about sex work. Sex workers are as much at risk from their clients as clients may be from sex workers. Our objective has to be to make sex work safe for both clients and sex workers. The Siyayinqoba team went to Hillbrow where we spoke to some sex workers about how HIV/AIDS affects them.
Sex work and the risks of contracting HIV
Johannesburg, Gauteng
Voice of a sex worker: Ngiqale ukwenza lomsebenzi ngo-May 2004. Kuyenzeka ukuthi sithole abantu abangafuni. Bayasifundisa nge-HIV/AIDS nokuthi siziphathe kanjani, nokuthi singalali ngaphandle kwe-condom. {isiXhosa} [I started sex work in May 2004. Sometimes we meet clients who don’t want to use condoms. The clients teach us about HIV/AIDS and they tell us that we must not have sex without a condom.]
Martha: Last year ka January ka be ketla mona mo Hillbrow ka be ke qala span sena sa ho rekisa mmele.And then be ke etsa ntho eo secret hore ko gae ba seka ba tseba or motho o mong a seka a tseba.Di customer ha batla monna ka ba bolella ,ke sebedisa khondomo tse i two ke ba apesa khondomo tse i two hobane ka tseba sometimes di ya phatsha and ke be ke nna le problem ha di phantshile.Sometimes ba bangwe ha di pantshile ke ba le affection ya STD.Othele hore keya ko chemists kilo batla dipilisi hore ke tline.Se ke tshaba hore ke ye ko tliniking kilo nka madi because ka tseba hore {Sesotho} [I came to Hillbrow last year January to work as a commercial sex worker. I was doing it secretly so my family wouldn’t find out. I tell my customers that I use two condoms because sometimes they burst and I have a problem. Sometimes when the condoms burst I acquire an STD. I go to the clinic and buy pills to clean myself. I’m afraid to go to the clinic and do a HIV test because I have had unprotected sex three times for money.]
Jayne Arnott (Sex Workers Education & Advocacy Taskforce): Well, from SWEAT’s side, we would say that sex workers are a particularly vulnerable group in relation to the nature of the work they do. And that would place them in a vulnerable position in terms of HIV/AIDS. But then again the majority of sex workers being women, we would say women as a group are vulnerable. But it’s a bit more complex than that because it’s also issues of economics, often sex workers are offered more money and in terms of economic survival, some might do that.
Betty: I’m a sex worker and sisebenza khona la emahotela. I-most yama-customer i-condom ngiyayisebenzisa. Angiphazami kodwa umuntu engisho ngingayisebenzisi kuye yi-boyfriend yam. Ikhastama liyayisebenzisa i-condom {isiZulu} [we work here at the hotels. Most of the time I use condoms with my clients. I’m very careful but with my boyfriend I don’t use a condom. I only use them with my customers.]
Jayne Arnott: We would look more at peer education in terms of sex workers educating other sex workers on their health issues. And that would include stuff around negotiation skills, getting clients to use a condom. And there’s various ways of getting a client who doesn’t want to use a condom, to wear one.
Betty: Sine-clinic e-Johannesburg yethu, eyama-HIV. Ekliniki yethu sithole every treatment, sidla yonke iipilisi edliwa khona, sinama-support group. Bayasivakashela la emahotela, basibheke, bathathi-care for thina. {isiZulu} [We have a clinic in Johannesburg for HIV positive sex workers. We receive every treatment from the clinic. We have a support group and they also visit us at hotels, they take care of us.]
Tiisetso Motloung: Mina ngilana e-Esselen street, ngisebenza nama-commercial sex workers labo siba-classify [I’m based here in Esselen Street and I work with commercial sex workers whom we classify] as a high risk group and a highly mobile population. Si-provide i-VCT [We provide VCT (Voluntary Counselling and Testing)] so that they must know their status, they must be able to access ARVs. Yi-problem kakhulu kuma-sex workers [It’s a big problem with commercial sex workers] because they’ve got multiple sexual partners and are more exposed to HIV and sexually transmitted infections. If they are HIV positive, sithatha ama-CD4 counts wabo, senza [we do CD4 cell count tests]. We do all the yomuntu o-HIV positive [management for an HIV positive person]. Sitsheka i-CD4 count yabo ikuphi [After checking their CD4 cell counts], we may refer them for ARVs at any ARV site. {isiZulu}
Betty: Kuyenzeka sometimes ngiphuza ngilale ngo-12, ngizovuka ngo-10 angikalidli. Ngiyajampisa ngilidle ngo-12. manje inkinga yethu iyi-one masingawadli lamapilisi, yazi utywala nawo awahlangani. Lomsebenzi wam ungivumela ukuthi ngiphuze ngibheme ngoba ngekhe ngingene lapho ngifeyise indoda ngi-sober. {isiZulu} [Sometimes when I’m drunk and sleep late at about 12 in the evening and I wake up the following morning at ten,I’ll wait for midnight to take my treatment. I have a problem with adherence because alcohol and medication don’t mix. My line of work forces me to drink and smoke because I can’t face a man when I’m sober.]
Jayne Arnott: There are high rates of violence against sex workers generally and it does impact, in relation to unprotected sex, that there are many occasions where clients will use physical force or threat of physical force to have sex without a condom. If you can empower the sex worker and you’ve got the infrastructure, for example the brothel is also supportive of condom usage, then you have a situation where sex workers can educate their clients.
Support Group
Jason Wessenaar: What do you think is key in making sure that people do not judge sex workers?
Zack Smit (Former sex worker): It’s reality, you will always get those people who frown upon sex work and have a remark or a comment. The point that you reach when you become a sex worker, you are vulnerable and you open yourself up to anything and you believe what your client would tell you. You even allow them to befriend you after a while, with me, in my case, I had a regular client and it became a constant thing and eventually he never paid for it. So it wasn’t a case of I was working for him anymore. But that was the biggest mistake of my life.
Jason Wessenaar: What are other risks involved?
Zack Smit: I, for one, know from personal experience, physical violence is often where the client would force himself upon the girl or the guy or it would just get a bit out of hand.
Lihle Dlamini: Often clients provide more money and promise that if we don’t use a condom, I will give you more money. And they are tempted to do that because of the circumstances that led them to doing commercial sex working. I mean, not everyone who’s there as a sex worker, wants to be there.
Vuyani Jacobs: Uba i-client uzakuthi hayi ndizokunika i-R200 masiyenze ngaphandle kwe-condom [If a client perhaps offers you R200 for having sex without a condom], that one is the most risky client than a client who can say: “It’s fine, let’s do business, here’s my condom.”
Melinda van Wyngaard: Is, ons moet dan eintlik meer let op die klient as die seks werker self. Om rede as ons die, daar kan begin en vir hulle meer gelettered kan maak sal seksueele oordraagbare siektes en HIV soveel verminder onder die populasie. {Afrikaans}That means we have to focus more on clients than sex workers, because if we educate clients, the rate of sexually transmitted infections and HIV will decrease in the population.
Zack Smit: I never became HIV positive from any other way but because of doing sex work. If I never allowed the guy to befriend me, it would have never happened. If I had remained a person that was supposed to be professional sex working, it wouldn’t have happened either. But because of the way he approached me and because of the way he made me feel and at that point in my life, I was rejected by my family and I was vulnerable. So you are open to anything, if a person welcomes you and makes you feel good in a way, then obviously you’re going to jump for that. That is where it all started, that is where I landed up.
Jason Wessenaar: How did you get out of it? What motivated you to get out of sex work?
Zack Smit: I don’t have an addictive personality and that’s one thing I’m thankful for. I met a man when I was 17 turning 18 and he took me away from it, otherwise I don’t think I would have because it became a way of life.
Lihle Dlamini: Sex workers kumele bafundiswe ukuthi ama-condoma asetyenziswa kanjani {isiZulu} [need to be taught how to use condoms because in the insert we saw earlier] there was a lady who talked about putting two condoms. I mean she’s even in a bigger risk of contracting HIV because if there’s friction, both of them can break. So I think abantu kumele bafundiswe ukuthi asetyenziswa kanjani ama-condom, ukuthi ufaka two or three {isiZulu} [people need to be taught how to use condoms because putting two or three doesn’t mean you are more protected.]
Jason Wessenaar: We need to target men as well in terms of providing education because it’s a two-way street, it’s not just men that are at risk of getting infected, the sex workers themselves are at risk. But I think the other issue is that it’s much more difficult to target men because most of them do not want to be known they are utilising the services because some of them are married or they are MPs or they have businesses and they do not want to be known. So we do need to look into how we can educate the men themselves. We talk more about sex workers and their clients after the break.
Jason Wessenaar: We’re talking about sex work in the age of AIDS. The key thing is to improve services to this vulnerable group, to make sex work safer for both clients and sex workers. Let’s see two very different projects extending services to sex workers and their clients.
Roadside prevention of HIV and STIs
Atlantis, Tshwane and Beaufort West
Mary Smith (Atlantis, Western Cape): I have a wonderful marriage of 28 years. My husband became very ill, so the doctor said: “I’m sad to say but your husband has got AIDS and you also have to be tested”. My late husband was a long distance truck driver. It’s been five years since I heard I’m HIV positive. The doctor told me at that time that I have two years to live. You know I go into the community to try and help other people. There is life after knowing you are HIV positive.
Lodewyk Hollander (Imperial Logistics): It was decided that something has to be done about HIV/AIDS within our industry because our truckers run across boarders and are running throughout South Africa. We are accused of spreading the disease within Africa. Hotspots mean where a group of truckers sleep over every night, for instance, a truck stops at toll gates, there are specific areas where they park off and that is obviously where the ladies at risk get involved with our truckers. And we thought of taking the programme to the drivers in our industry than just having peer educating. And we started establishing roadside clinics and training centres in those hotspots, those areas where drivers are parked off over weekends or over night.
Vuyelwa Mandindi: Le kliniki ivulelwe ama-truck drivers kuba bona abanama-kliniki kwenye indawo futhi they are always on the road. Ikakhulu thina sidilishana ne-sexually transmitted diseases, angithi bahlangana nalamantombazana ngoba bahlala kude namakhosikazi abo for weeks and months. Uma befika la siyabenza ukuthi they should feel at home, sibaxoxise nje siba-counselishe sibatshele ukuthi uyabona ke kukhona isifo ezinje lesi samagama amathathu so in order that siyehlise fanele nina niziphathe kahle, i-sexual partner yakho ibe yodwa. Noma iyodwa in order that you must be 100% safe usebenzise i-condom. Before bahambe onke ama-patients afika la sibanikeza i-packet yalokhu. Phakathi kukhona ama-pamphlets azobafundisa nge-HIV. La ngama-condoms, siyabafundisa futhi i-counselling. Sibatshele ukuthi uma Ufuna ukuphuila mfethu, ilizwe lijikile manje, fanele ubene-one sexual partner, nalo-sexual partner ufanele usebenzise i-condom. {isiZulu} [This clinic was opened for truck drivers because they don’t have their own clinic and they are always on the road. We deal mostly with sexually transmitted diseases because they meet with these girls since they are away from their wives for weeks and months. When they get here, we make them feel at home. We have a chat with them, counsel them and make them aware of the three letter disease. In order to reduce HIV infection, they must behave and have one sexual partner. Even if they have one sexual partner, in order to be 100% safe, use condoms. Before each patient leaves, we give them a packet of this, inside there are pamphlets that will inform them about HIV/AIDS. These are condoms. We teach and counsel them. We tell them if they want to live they must have one sexual partner, and even if you have one sexual partner, you must always use a condom.]
Support group
Jason Wessenaar: A part of me is a bit excited because I was part of that clinic that started in Beaufort West for truck drivers. And we saw also that in Hillbrow, Esselen Street is providing services but where else do you guys think this service can be provided or where else do we need to take these services for sex workers?
Primrose Mathabatha: The more we can recognise them, the easier it will be for healthcare workers, communities and their clients to know that this business does exist, we cannot shy away from that. Let’s make it our mission to go to our communities and let’s educate our own communities, let’s educate our own siblings, let’s educate our own parents, to say that this does exist.
Jason Wessenaar: We do not have prevention messages that are directed at sex workers, we have messages that are quite general. Do you think decriminalising sex work would make education or prevention programmes more effective?
Lihle Dlamini: If we decriminalise sex work and our government is conducive enough to take the rights of sex workers into consideration, the sex workers would know their rights and they would know how to stand for their rights as well. I don’t think people would take a chance to manipulate them.
Zack Smit: Decriminalise it or not, the women or men are still vulnerable and they are going to give in to things to please their clients regardless of anything else.
Jason Wessenaar: But Zack, I think what we’re saying here is that there will be a number of things that will be limited. I’m saying that there is education for sex workers and in that sense sex worker will then be able to make informed decisions about how they have sex. So that’s one problem solved. But I think problems such them being beaten up, being abused, I mean women have been thrown out of a moving car, some women have been killed. And usually when they are abused, they can’t go and report this because it’s illegal. So I think in a sense the industry will be regulated, they will know their rights, they will know that if I’m abused for whatever reason, I can go and report it, but at the moment they can’t do that.
Vuyani Jacobs: Thethwa directly kwi-sex workers ngohlobo lokuthi njeng’ba sisebenza nabantwana kusetyenziswa nabantu abaphila ne-HIV. Lonto ithethe ukuthi ke makubekho nee-messages ezi-directed kwabantu abasebenza estratweni nabantu abangasebenzi estratweni bawazi amalungelo abo. Kusokwazi ukunceda kakhulu ukuba decriminalised, ibesemthethweni ukuthi abantu mabasebenze phantsi kwemeko ethile ukuze amapolisa bangabasebenzisi kakubi. Ukuze bakwa uku-organise nabo because xa besaziwa ukuthi ngabantu abakhoyo uzawukwazi uba-mobilise. {isiXhosa} [We need to have direct communication with sex workers. For example, we have messages directed at children and people living with HIV. That means we need messages for commercial sex workers and private sex workers so that they can know their rights. This will help the industry to be decriminalised and therefore sex workers can work under authorised laws. In that way nobody will be able to abuse them. They will be accessible and therefore mobilised] as a group.
Jason Wessenaar: The sex workers have also said that sometimes they get clients who do not want to use condoms because they’ve never been taught how to use condoms. A lot of men do not go to clinics because they do not want to go to clinics, so I think we need to advocate for provision so that women are empowered also in that sense. I mean, if you empower a woman on how to use a male condom, you’re just only doing half the job, so you need to empower them to use female condoms.
Vuyani Jacobs: I still think sex workers are in more position to enforce condoms. If any female puts a condom on a man in a very seductive way, a very good way, like sex workers do according to the job, it becomes such a nice thing for men.
Jason Wessenaar: I understand the whole thing about being sensuous and finding other ways to put on a condom but what I’m saying is that we need to empower women and provide female condoms. When we come back we’ll talk to Vivienne Lalu. Vivienne is an education officer at SWEAT, the Sex Worker Education & Advocacy Task Force. Don’t go away.
Jason Wessenaar: Welcome back to Siyayinqoba Beat It! Support Group, the programme for everyone infected and affected by HIV. We also welcome Vivienne Lalu from SWEAT. Vivienne, we’ve talked about sex workers and services provided to sex workers, we’ve spoken about issues around providing condoms, female condoms and male condoms, we’ve spoken about the safety of sex workers and the fact that they are vulnerable. But what other issues are there that need to be addressed in order to make sure that sex workers are protected from being infected with HIV as well as their clients are protected in terms of getting HIV/AIDS plus other STIs?
Vivienne Lalu (Sex Workers Education & Advocacy Taskforce): For us at SWEAT, the very important point is around connecting, getting those safer sex messages out there and encouraging behaviour change with sex workers accessing their human rights. And I think you can get messages out there as much as you like and try and educate people about using condoms as much as you like, but if you don’t deal with the aspect that sex workers cannot actually apply that knowledge then there’s going to be limited success with getting behaviours changed. So for us that’s really key, it’s really critical.
Ricardo Moses: Vivienne tell me, did you ever come to a situation whereby a sex worker came to you and disclosed her status and is there any follow-up after that, whether the person went for treatment. Are there any follow-ups from your side?
Vivienne Lalu: You’ve been speaking about messages, specific messages that reach specific audiences and we develop those messages. So one of the pamphlets we developed was a VCT pamphlet and we went and looked at if a sex worker was trying to access a testing service, for example, how difficult would it be? We tried making phone calls, we tried how easily accessible some of these testing sites were and so we do that, we go out and we don’t just do safer sex and condom demos; we speak about VCT, we speak rights, human rights and law reform.
Jason Wessenaar: And how far are we from decriminalising sex work?
Vivienne Lalu: I think we’re still quite far away but there has been some moves that encourage us quite a lot. For starters the Sexual Offences Act is under review at the moment so the South African Law Reform Commission are actually considering it at the moment. And so we are waiting for the next paper and I’m not sure if you’re familiar with the law reform process but it’s a lengthy process with many steps. So we have been staying on top of this, where as soon as the paper comes out, we translate it, summarise it and we get booklets out there and we try and engage as many sex workers as we can to be involved with this law reform process because we want law makers to hear their voices and so when a decision gets made around law reform, they are actually considering what sex workers are saying, what they are needing.
Vuyani Jacobs: So, does your advocacy actually also involve engaging other organisations like human rights movements, like organisations that fight against HIV like TAC, organisations of people living with HIV, do you engage such organisations?
Vivienne Lalu: That’s quite critical because when sex workers meet, they often compare their struggle with the people living with HIV, struggles around that. because there are quite a lot of similarities especially around the stigma and also how hard it is for sex workers to come out and say I am a sex worker and what that could result for a sex worker doing that, the kind of stigma, isolation, the discrimination that she would face or he for that matter. So there are a lot similarities and we are trying to build relationships with other organisations and other movements and that is going to be Sisonke, the Sex Workers’ Movements’ key task to build some of those relationships so that there can be sharing and communication.
Jason Wessenaar: You’ve been watching Siyayinqoba Beat It! the programme for everyone infected and affected by HIV/AIDS. Join us again next week in the Siyayinqoba Beat It! Support Group, right here on Ya Mampela. We value your questions opinions and views, so please contact us on the numbers below. Till then stay healthy and stay positive.
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