Promise Nyakunhuwa/Caroline Hunzvi
Enhancing key population programming and addressing related institutional and capacity issues is a main issue faced by various institutions, universities, colleges, NGOs and the government in dealing with sex worker and sex for money situations. Stigma, discrimination and criminalization are among the factors that prevent sex workers from accessing health care. Certain groups face a disproportionate risk of HIV infection and transmission in all countries and settings. Even in countries with low HIV prevalence rates, men who have sex with men, sex workers, drug users, and transgender people, collectively known as key populations, are consistently at higher risk at contracting HIV.
Sex workers are a key population in the risk factor of getting HIV when compared to the general population as noted by UNAIDS Global AIDS update 2021. The Key Populations Research and Implementation Program in Zimbabwe focuses on the sexual and reproductive health, HIV prevention and care needs, and overall social welfare of female sex workers. On behalf of the Ministry of Health and Child Care and the National Aids Council, Center for Sexual Health and HIV/AIDS Research (CeSHHAR) manages the National ‘Sisters with a Voice’ program for female sex workers. Sisters with a Voice is one of Africa’s few nationally scaled programs for sex workers. However sex workers face discrimination when they seek reproductive health services.
Sex workers allege that they face abuse when it comes to their job for instance discrimination from health care workers when they seek medical attention; discrimination in societies were they live, abuse by authorities and clients, nonpayment of their services by clients, discriminations from authorities who should protect them and lack of proper counselling on their job on how to protect themselves.
There also have been allegations that in some instances police authorities have forced sexual intercourse with sex workers and do not use protection. When they go to seek medical attention nurses even with knowledge of their jobs knowingly ask them to bring their partners as a stance to humiliate them. Female police officers are being reported of dismissing accusations of sex workers who are abused by their clients and accusing them of spreading HIV. Extortion by police officers and family is an abuse male sex workers face, on top of intimidation and hate speech.
CeSHHAR Zimbabwe noted that fifty-four percent of sex workers in Zimbabwe have HIV with a 10 percent increase every year due to lack of preventive measures. According to the findings of a study conducted by CeSHHAR, the stigmatization and discrimination of commercial sex workers in some Zimbabwean hospitals and clinics is impeding their access to increased HIV/AIDS treatment and care. They are now afraid and embarrassed of going to clinics or hospitals to seek medical attention due to public humiliation they face from health workers who at times accuse them of being ‘prostitutes’ and spreading HIV.
Young girls in communities are facing abuse with girls as young as nine years having started working as sex workers. For instance in Epworth Harare Zimbabwe there are reports of young girls being pimped out by their ‘boyfriends’ who makes them have sexual intercourse for money despite their young age. They even have definition of types of services they offer, in which they do not have enough knowledge to protect themselves, face unwanted pregnancies, get sick and stay without treatment.
Due to the nature of their jobs, sex workers go through a lot of psychological trauma. In most instances due to the fact that they are usually bashed and attacked by society, they hardly share their problems and end up slipping into depression which pushes them into drugs that are harmful to their health to try and numb the pain they go through. In worst case scenarios they end up committing suicide. This has also contributed to high rates of suicide cases in the country.
Due to the fact that societies have not been fully educated fully about sex work, they usually treat them as second class citizens. In some cases they are not allowed to participate fully in society for instance in churches. Their children and family members also face discrimination. Without even listening to their side the story on what led them to become sex workers, society rushes to judge them.
Early responses given in Zimbabwe when it comes to sex workers as key populations were in regard to High School and Tertiary Education students and ordinary sex workers. Institutions must tailor services to the specific needs of populations affected by sex workers, as well as invest in programs that address the root causes of discrimination. The best way to accomplish this is to include the key populations in the design, implementation, and monitoring of those health services, as well as in policy decisions that affect them. They empathize more on their counterpart than people of populations not affected by these issues and do not discriminate them.
To assist sex workers in Zimbabwe clinics provide a full range of sexual and reproductive health services, including HIV testing and counseling, referral to ART, start of pre-exposure prophylaxis (PrEP), family planning, condom promotion and distribution, and STI diagnosis and treatment. This was achieved by services in different provinces of Zimbabwe which include static clinics, highway mobile clinics and local mobile clinic sites. These offer first hand assistance to sex workers, which is a step in the right direction.
