Fear HIV cases may rise as sex workers adopt new strategies

Health officials are concerned that the countrywide curfew and lockdowns could lead to a spike in HIV infections.

Health Ministry’s National Aids and STI Control Programme (NASCOP) has said the restrictions have pushed thousands of sex workers in Nairobi into risky coping strategies.

The strategies include working from home, shifting from night to daylight hours and catching clients in the early evening, just before the curfew hours.  

A joint report by NASCOP, the University of Manitoba in Canada, University of Washington (United States), and the University of Nairobi, says condom distribution networks have been disrupted, exposing sex workers to a higher risk of HIV infection.

Similar sentiments have been expressed by the Global Fund to Fight Aids, Tuberculosis and Malaria which has said in a post that sex workers are disproportionately affected by the Covid-19 crisis.

In the post, Peninah Mwangi of the Bar Hostess Empowerment and Support Programme, said sex workers’ incomes have declined by 75 per cent due to Covid-19 restrictions.

“Many sex workers have been forced to return to their villages where they are facing stigma and family condemnation,” says Ms Mwangi.

The report says since they generally work around the schedule of the client, they often miss curfew timelines and, therefore, become susceptible to police violence and harassment while in transit. 

“Some sex workers have reported being forced to offer favours to law enforcers to secure their freedom from curfew-related persecution,” says the report.

Sex workers who live in brothels, it says, have been arrested and taken into quarantine centres.

The report, published in the Global Public Health journal on May 27, is funded by the US President’s Emergency Plan for AIDS Relief (PEPFAR).

Greater risk

It says sex workers, especially those who are HIV-positive, are at a greater risk in case of Covid-19 infection.

“Sex workers living with HIV are greatly concerned that their prior condition ...will make them especially vulnerable to contracting Covid-19 and, as a result, will suffer more progressive illness,” says the report.

The authors say travel restrictions and the curfew have made it difficult for sex workers to access healthcare services.

“Currently, sex worker clinics are being run primarily by appointment, placing limits on the number of people being attended to at any given time so as to comply with social distancing requirements,” it said.

The “work at home strategy” advocated by the government for formal workers, the report says, is a disadvantage to sex workers. 

The report says sex workers operating at home are being hounded out by neighbours for bringing strangers to the “plots” who might spread Covid-19.

“When neighbours notice strangers entering and exiting, sex workers have been openly chastised for breaking physical distancing rules and placing their communities at further risk for Covid-19,” says the report.

But the bigger problem the authors have raised is the economic impact the curfew and restrictions are having on this population.

“The curfew hours, closure of hot spots, and restriction of movement and assembly, coupled with general physical distancing, dealt a devastating blow to the sex industry,” it says.

Sex workers, like other daily wage earners, the report says, have suffered major losses in income.

“But because of the nature of their work, they face severe difficulties in accessing financial support offered through government social protection schemes,” it says.