Despite being offered a daily pill to
protect them from HIV, almost three-quarters of women sex workers had stopped
taking the pills after a year.
This is according to a study published in
the PLoS journal last week, conducted by the TAPS Demonstration Study.
Only one pill
The study tested almost 700 women, and says
that the average woman was “married or had a steady partner, worked in brothels,
and were born in Zimbabwe”.
Almost half of the women tested were HIV
positive (341). Of these, 139 decided to go on ARVs. Around 60% of them
were still on the medication after a year.
The sex workers who tested HIV negative (351) were offered one pill, Truvada, to take every day to protect them from
the virus. 219 women accepted the offer.
But a year later, only 49 women were still
taking Truvada – although none of those still on the pills had contracted HIV.
“The final retention rate was lower than we
would like. However, there were no seroconversions among those women who stayed
on the PrEP arm,” said Robyn Eakle, a senior researcher from the Wits
Reproductive Health and HIV Institute (WRHI), which was part of the study.
Infections occur in three groups
Using ARVs to protect people from HIV is
called pre-exposure prophylaxis (PrEP). Scientific studies have already shown
that Truvada is effective in protecting people from HIV during both anal and
The Department of Health decided to offer
PrEP at certain clinics that serve sex workers, despite being under pressure to
provide ARVs as prevention more widely available.
Around half of the world’s new HIV
infections occur in three groups – sex workers, men who have sex with men and
injecting drug users. In South Africa, HIV rates are very high among sex
found that many of the women cycled in and out of care as they felt more or
less at risk, as reported by them,” said Eackle. “Some reported difficulties
getting to the clinic at times due to work, family or other conflicts such as
Eakle said this and other studies “suggest
that PrEP use is likely to be cyclical for many women, which is fine as they
develop new habits for remaining negative. Perhaps the act of engagement in
care in the larger picture is what will keep them negative.”
Sex work still a crime
Sex work is illegal in South Africa, which
makes it hard for health workers to reach and treat them.
But Health Minister Aaron Motsoaledi told
Health-e that “South Africa does not need to wait for laws to decriminalise sex
workers before protecting this sector from HIV”.
The country’s National Strategic Plan on
HIV and TB recommends decriminalising sex work, but last year the SA Law
Commission recommended that sex work remain illegal.
“The issue of sex workers is not just for
the Minister of Health but involves other Ministers,” said Motsoaledi.
“India has not decriminalised sex workers,
but health workers in Bangalore are working very openly with sex workers and
police are not arresting them.” – Health-e News.
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