Run by the UK consultancy Mott MacDonald Group in partnership with the departments of health and social development, the Amaqhawe project seeks to help sex workers in Mpumalanga’s Gert Sibande District outside of Ermelo access HIV prevention and health services.

Growing from just 20 sex workers in Embalenhle township five years ago, the project now caters for more than 900 workers from communities including Kinross, Standerton and Bethal.

A Bethal municipal hall was recently the site of a Amaqhawe road show that offered sex workers access to male and femal condoms, as well as screening services for HIV, tuberculosis and sexually transmitted infections (STIs). Presenters also outlined career and educational opportunities and presented information on sexual and reproductive health, substance abuse and HIV prevention.

Alongside 65 peer educators, about 450 workers have also graduated from Amaqhawe’s HIV risk reduction training programme.

Buyisile Cele* is one of the project’s sex workers.

“Before I joined the Amaqhawe project, my life was a nightmare,” said Cele, who asked to remain anonymous as did other workers. “I didn’t care about my safety and health, and used a condom (only) sometimes because my clients were paying more money if I didn’t use condoms.”

“Now? No condom, no service,” added Cele, who said that fear of stigma and discrimination continue to keep sex workers out of clinics and prevent them from reporting gender-based violence. “We are constantly blamed because we sell our body for money.”

[quote float= right]“I didn’t care about my safety and health…Now? No condom, no service”

Bongiwe Buthelezi* said she always makes sure to come to events like these to access health services after a lay counsellor at a local clinic refused to test her for HIV because her files was allegedly too full from frequent visits.

Sex worker Silindile Masinga* discovered that she was HIV positive after testing with the project. She said Amaqhawe peer educators helped her come to terms with her status and adhere to her antiretroviral (ARV) medication.

According to Bethal Hospital’s Lebo Makoe, conducting outreach among vulnerable groups like sex workers is key to enabling South Africa to reach ambitious new United National targets adopted by Motsoaledi last year. These targets call for 90 percent of HIV-positive people know their status, access treatment and adhere well enough to treatment to achieve undectable HIV viral loads by 2020.

HIV viral load testing measures the amount of virus in a person’s blood. When these levels are very low, they are said to be undectable. While this does not mean a person is cured, it reduces the risk a person will transmit the virus.

Makoe also urged pregnant women to come early for antental care so that those who were living with HIV could begin taking ARVs to prevent passing the virus onto their babies.

“All pregnant women should start antenatal care early at 14 weeks,” she told OurHealth.

Although there are no national estimates for the HIV prevalance rate among sex workers, a 2012 study published in The Lancet medical journal estimated that prevalence rates could be as high as almost 60 percent based on a previous 775-woman study.

*Names withheld upon request

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