PrEP protects sex workers

Sex workers in certain areas in the country are now receiving oral antiretroviral medication as pre-exposure prophylaxis (PrEP) in addition to other HIV prevention efforts.

This is according to Department of Health spokesperson Joe Maile. “Combination prevention has been demonstrated to prevent new HIV infections and given the very high level of HIV infections in sex workers, this community needs additional protection.”

PrEP is a programme for people who don’t have HIV but who are at very high risk of getting it. To prevent HIV infection, people at risk take a pill each day. It contains two medicines that are also used to treat HIV. According to Maile, the latest World Health Organization HIV guidelines issued in December 2015 provide evidence for the use of PrEP in high-risk populations as well as universal test-and-treat efforts regardless of CD4 count.

“An estimated 20 percent of the 350 000 people annually infected with HIV in South Africa are connected with sex work. HIV prevalence amongst female sex workers in South Africa is estimated to be 59.8 percent.” He said the SA Health Monitoring Survey of Female Sex Workers estimated that the prevalence of HIV among female sex workers was 71.8 percent in Johannesburg, 39.7 percent in Cape Town, and 53.5 percent in Durban.

“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.” To ensure that PrEP is offered in programmes that already provide comprehensive services to sex workers, which include general health screening, STI screening and treatment, provision of condoms, contraceptives, HIV counselling and testing, ARV treatment, post-exposure prophylaxis and circumcision for male sex workers, the Department of Health has assessed and approved the following sites for the initial rollout of PrEP:

Esselen Street Clinic in Hillbrow in the City of Johannesburg, SSWP Wellness Centre in Soweto, Sediba Hope Medical Centre in Tshwane, TB/HIV Care Clinic in eThekwini, and the North Star Alliance Trucker Wellness Centres in Musina (Limpopo), Pomona (Gauteng), Ngodwana (Mpumalanga), Pongola (KZN), Upington (Northern Cape), and Hoedspruit (Limpopo). Additional sites will be prepared to provide these services in the coming months.