Health Management Women's Health

Brothel VCT intervention yields positive results

Densely populated, crime ridden; filthy and full of brothels is how Hillbrow is usually described. Sex workers thrive. The rate of sexually transmitted infections is high in such areas. Yet an HIV Voluntary Counselling and Testing programme introduced a few years ago is showing positive results. And a number of women in this area celebrate Women’€™s Day with vigour ‘€“ knowing that they have a clean bill of health.

YOLISA: Fake leather bodysuits, fishnet stockings, and red high heeled shoes ‘€“ that is the picture one gets when you imagine a sex worker. Well at least that is the picture I had in mind ‘€“ when trekking to Hillbrow to meet one such worker.

Instead, I met a young, beautiful 24-year-old. She says that before she became a sex worker; 3 years ago she also had the same mental picture.  

Nolita [not her real name] is one of the women who I’m grateful for the intervention made by the Reproductive Health Research Unit [RHRU].

NOLITHA: Most of the sex workers are always’€¦all of them are always drinking; some of them are using drugs. It’€™s not something you can just take whenever, when you are sober. I don’€™t use drugs but I do drink ‘€“ a lot. Other people don’€™t know why. They’€™re like ‘€œoh she likes alcohol, but I know it’€™s not that’€.

YOLISA: Women like Nolitha are usually distrustful of public clinics. They’€™re also usually sleeping during the day, when the public health facilities are operating. In an attempt to reach women like these RHRU intervened.

TISETSO MOTLOUNG:  We make health services accessible to them. We take health to them.

YOLISA: Tisetso Motloung heads the RHRU’€™s sex worker outreach programme. She says the main objective of their programme is to reduce the rate of sexually transmitted infections particularly HIV. The programme started in 2002. At first it was an uphill.  

TISETSO MOTLOUNG: They used condoms with their clients and not with their boyfriends but now they come to us with their boyfriends.

YOLISA: Even the ones who subsequently test positive for HIV?

TISETSO MOTLOUNG: You know we thought that ‘€“ because of the suicidal rate; they would commit suicide but the response is quite good. It’€™s quite good. They actually come ‘€“ referring themselves and others for VCT.    

YOLISA: Motloung’€™s team also conducts workshops for the sex workers twice monthly.

I’€™m ushered into a dingy but neat hotel that is used as a brothel. Nolitha is one of those who has come to participate in the workshop.

Of the estimated 10, 000 commercial sex workers in Hillbrow; only about 20 congregate here.

Motloung asks about the others. The mumbled responses range from hangovers to business [sex work] and sleeping. Motloung is visibly disappointed.

TISETSO MOTLOUNG: Well, It is quite good and we are achieving a lot.  

YOLISA: Throughout the workshop there is not much interaction ‘€“ even though Motloung prompts it from time to time. Suddenly everyone jolts to life once police and the sex workers rights are mentioned. Seemingly, the police are the main health hazard as far as these women are concerned. Under the Sexual Offences Act, sex work is illegal. This plays a big part in discouraging these young women from seeking help from public institutions like clinics.

TISETSO MOTLOUNG: You saw the response as well. They’€™re not quite happy with the police because the police invade their privacy. They actually harass them. When they come in ‘€“ they just break everything and take their belongings.

YOLISA: But today that is beside the point. Today the focus is more on their health and well being.

TISETSO MOTLOUNG: They now can identify an STI condition and say ‘€œlook guy you need to go and be checked at the clinic’€ because of the workshops. Also because of the individualised attention that we give them.

YOLISA: For Nolitha, this is a good intervention. She ended up as a sex worker because of peer pressure. She says her friends were always wearing designer clothes and she couldn’€™t afford any. Also, her mother was always busy with all her boyfriends. Staying at a brothel seemed an easier way out.  

Nolitha has a clean bill of health after consulting with Motloung’€™s team. I ask her if she feels she can celebrate today [women’€™s day]; knowing that at least she’€™s healthy.

NOLITHA: mmmh – I don’€™t feel like a human being anyway. I hate myself and I get depressed a lot.  

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