Improving Prevention Education & Services For Sex Workers
This program is supported by USAID through APHIA II Nairobi and Central. Improving sex education for sex workers was a stretch for a faith based organization. It required a reorientation of the staff, most of whom were not familiar with the ‘Club’ scene whether it be by day or by night. It was difficult to think of launching an HIV prevention program targeting sex workers.
But one year down the line, HWWK can proudly (but humbly) boast of increasing expertise in reaching this at risk population with HIV prevention support and services. The faith based component has given the staff an increased level of compassion for those who are trying their best to make a living in strained economic times. It’s always important to seek first to understand the community we set out to serve and learn from them what they need and how we can serve them best.
With Kenya AIDS Indicator Survey reporting that most new HIV infections occur among the married population, the task has been to identify the drivers of the epidemic. Sex workers, both male and female, were identified as major contributors to the infection cycle. The IPESS staff are aware of the hot spots where transactional sex takes place, knows by name the sex workers and gate keepers, and have provided hope to them. In both Nairobi and Central Provinces programmatic zones have been created, hotspots identified, and peer support groups formed by sexworkers themselves. The peer support groups of Female Sex Workers (FSWs) elected their leaders who have been trained on HIV behaviour change communication using peer led approaches.
Some of the 450 FSWs trained as peer educators participate in conducting night outreaches where they share information on HIV prevention including correct condom use. They target other sex workers and their potential clients. They meet regularly and hold each other accountable on behaviour change. They provide information that is used to plan service delivery such as voluntary testing and counselling for HIV, STI treatment, and management of opportunistic infections.
Lucy, one of the HWWK volunteers who is living positively with HIV has been instrumental in helping sex workers address stigma among themselves. Her anti-stigma campaigns combined with a peer led approach has resulted in increased demand for HIV prevention services among sex workers including condom use, HCT, and initiation of alternative income generating activities. There is hope!
The IPESS program works under the following seven specific objectives:
- Providing HIV Counseling and Testing (CT) services to 18,000 (10,800 males and 7,200 females)
- Providing HIV Behavior Change Communication (BCC) and Other Prevention (OP) messages to 120,000 Female Sex Workers (FSWs) and their clients (60,000 males and 60,000 females)
- Training 500 sex workers as Peer Educators
- Providing treatment of Sexually Transmitted Infections (STI) to 600 sex workers and their clients
- Linking 300 sex workers to support groups
- Reaching at least 12,000 persons with anti-stigma messages
- Setting up functional 20 condom dispensers
“Sex workers are human beings and are entitled to good health” Agnes (not her real name) echoed the words of a HOPE worldwide Kenya TOT trainer. She had attended the training and was now extending the knowledge on prevention to her peers. She later gave her story:
When Agnes* heard about commercial sex work for the first time, she was only a small girl of 12 years. She had wondered why anyone in their right senses would choose to be a sex worker. “who is supposed to pay who?’ she always wondered. She would argue that both parties enjoyed the pleasure and if there was any reward involved, then it would be an equal share.
Agnes never imagined that fate would tailor her future to be in the same business, she so loathed. The 28yr old mother of two narrated her story to a HOPE worldwide Kenya interviewer during a Moonlight VCT at Southlands, Nairobi where she was mobilizing and educating sex workers to get tested for HIV. She said that no one knows how or when they get in the business.
Born in 1982 in Mombasa’s Mwembe Tayari Village, Agnes adapted to the slum life and confesses that she can never be comfortable even in the best estates elsewhere. From the day she was introduced to school, Agnes loathed the idea. “I hated teachers and books!” she confessed. Her parents however persisted and she managed to complete her KCPE. However, she did not pass very well but her parents were determined so they got her a place in Kagio Secondary School in Central province. She quit only in Form 2 and was employed as a house help in Nairobi shortly thereafter.
She met her first boyfriend at the age of 16 and was introduced to sex. He offered to marry her and they lived together for three years and got two children. After getting the children, the man turned beastly to her and blows and kicks became the order of her nights. She decided to quit the cohabitation and was employed in a local bar with a salary of Ksh.3, 500 (US$ 44). “I left my son with his father while I carried the daughter with me,” she recalled.
She declined when men offered her money for sex while still working in the bar. “My salary was however, not sufficient to meet my basic needs," she lamented. She says that she could not dress as smartly as her colleagues and soon she was the laughing stock. Her girlfriends also laughed at her when she borrowed money from them. It was inevitable to decline to the next offer. The offer brought her Ksh 800 (US$ 10) which to her was a kingly gift. But for fear of asking for payment men used her so much before she gained courage.
She gradually gained confidence and started bargaining with clients. However, life was not all smooth because there were times she would be roughed up by other women whose clients she had “stolen” and they would rob her of all the money she had been paid. She would also encounter clients who refused to use condoms and would beat her when she insisted. “My greatest worry was HIV infection as I had seen a person in their last stages of HIV” she said.
Her worst experience in the business is when she encountered rapists for the first time in her life. Two men followed her from a drinking spree and entered her house where they molested her in turns for four hours. They later drugged her before stealing from her house. Though she was treated, the bruises she had sustained during the ordeal kept her from business for two weeks.
Though Agnes* is still in the sex business, she is a trainer on prevention of HIV and other STIs. She was introduced to HOPE Worldwide Kenya by a friend. She attended Peer Education training sessions and ultimately became a trainer herself. “The best I got from the training was condom use”, she chuckles adding that no man can trick her into unprotected sex. “Though I cheat my parents that I work in a hair salon in Nairobi, I still believe I serve the community by imparting the knowledge I got from HWWK to my fellow sex workers.” she concludes.