Sex workers say it’s ravaged following US-funded clinic closure
We spoke to dozens of sex workers in Boslourus, Johannesburg and Springs about their struggles with access to medical services, particularly antiretroviral treatments. This is triggered by funding cuts for global aid in the US as he joined a clinic run by the WITS Reproductive Health and HIV Institute (WITS RHI). The clinic provided treatment for HIV, tuberculosis, and sexually transmitted diseases, and reproductive health services. Some sex workers said they had to go for weeks without HIV or prep treatment.
It’s an afternoon on Boundary Road in Vosloorus. Sex worker Simangele (not her real name) wants to secure her next client.
Earning enough money to pay the rent has always been a concern for Simangere. But now she has a new concern: how to keep up with her antiretroviral treatment.
Two months ago, the closure of a mobile clinic where other sex workers from Simangele and Vosloorus were about to go to a medical checkup and collect treatment left her without taking advantage of life-saving medication.
The mobile clinic was run by the Wits Reproductive Health and HIV Institute (Wits RHI) and relied heavily on US funding. The Institute has been providing significant sexual and reproductive health services since 2018. The program was one of many health facilities that were forced to halt services at the end of January following US funding cuts for US aid.
Simangele talks to Groundup and says he ran out of antiretroviral drugs (ARV) over a month ago and relies on borrowing a few tablets from a friend. “My friend has side effects on me, so I don’t know what to do,” she says. (Antiretroviruses treat HIV. They must take it every day for the rest of their lives.)
She says the clinic closed without warning or before they sent letters to public health facilities. She is now afraid that she will have to go to public facilities that she frequently discriminates against sex workers, especially those who have not been documented.
We spoke with Joburg and 12 other sex workers at Springs who are worried that the default for antiretroviral treatment will be the default after the Wits RHI clinic is closed. The clinic also provided pre-exposure prevention (PREP) (to prevent HIV-negative people from contracting HIV), sexually transmitted diseases, tuberculosis, sexually reproductive health services, and counseling treatment.
Another sex worker said, “The moment we go to a public clinic they need documents. Some of us have made time to listen to our issues as sex workers.
Sisi (not her real name) said she rents a room to help a sex worker at Vosloorus, defaults and knows some sex workers who have no access to condoms, lubricants and sexually transmitted disease treatments. “Wits Clinic doesn’t discriminate against people without documents and sometimes offers food, branded t-shirts, hats and even work,” she said.
“Many of us will die.”
We visited Zigzag Road in Springs. There, several sex workers said they were out of the ARV or mostly out. When asked why they didn’t go to the local clinic, they told Groundup about cases of stigma while trying to access treatment at a public clinic.
“Previously, I was prepared to prevent HIV (from Wits Clinic), and I also receive birth control services. Now I can’t go to a public clinic because I’m being a sex worker,” Sifhesihle said.
Ntombi, waiting for clients along End Street, attended one of Hillbrow’s Wits clinics, which had been closed. She said people in preparation were given a letter of forwarding before the clinic was closed.
Other workers nearby told Groundup that they could now pay R250 for PREP.
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Sisonke calls for an emergency response to the crisis
The Sisonke National movement, which defends sex workers’ rights, has been warnings since the closure of US-funded facilities. Before the closure, Sisonke had been in consultation with the National Health Ministry through the National AIDS Council of South Africa on the provision of services to sex workers and other vulnerable groups, said Yonela Sinqu, an organization’s spokesman.
She said when asked what would happen if donor funds were no longer available at these facilities, the department asked what would happen, they never answered the activists.
She said that pleas for assistance without referral letters have been made in all states, not just Gauteng. But Gauteng is the only state that has approached us with the crisis of people without referrals, she said.
Ministry of Health spokesman Foster Mohale did not respond to requests for comment.
