South Africa

Sex and HIV in a time of criminalisation

By Greg Nicolson 15 January 2015

A plan on HIV in the sex work industry is due for release, and as stakeholders met this week to discuss issues affecting workers, the issue of legalisation was brought back on the agenda. For one Johannesburg sex worker, it's a crucial discussion, “because it's work, because we support families.” By GREG NICOLSON.

“Sometimes, criminals come and rob us, our money. Sometimes you go inside and the client doesn’t want to pay you. Sometimes the condom can break, can burst,” says Precious Ngcobo. “All clients use condoms.”

“Sometimes they say no condoms,” says another sex worker standing outside a dilapidated building in Nugget Street, Johannesburg.

“She lies. Sometimes they say no, but strictly condoms,” Ngcobo cuts her off. From Durban, Ngcobo came to the city eight years ago and has been a sex worker for six, first in Hillbrow’s Little Rose club then here on the streets.

“Why Jo’burg,” she laughs, “because there’s money in Jo’burg.”

After a meeting this week to discuss HIV in the industry, the issue of sex workers, and legalisation, is back on the agenda. On Monday, 140 sex workers, NGOs and government met to discuss details of the Global Fund, an initiative supporting community efforts to combat HIV, tuberculosis and malaria, which two years ago started funding interventions against the illnesses in the industry with an $8.5 million grant.

That intervention is led by the South African National Aids Council (Sanac). In 2013 it commissioned a study to estimate the size of the industry in South Africa. The study was carried out by the Sex Worker Education and Advocacy Task Force (Sweat). After visiting hot spots across the country and extrapolating the number of sex workers in a specific region to the population figures, the report estimated there were 153,000 sex workers in the country, including 7,000 male and 6,000 transgender workers.

The highest number of sex workers are in Gauteng, and according to the report almost 60 percent of female sex workers have HIV.

Initially, Ngcobo says she has a nice job. Wearing floral tights, a stretched top with orange, brown and camel stripes, and red lipstick, she says she gets money every day and can buy whatever she wants. Later, she says she wants a new job. She’s ageing and has to sleep with clients inside the building. It’s dirty, with no electricity, and the mattresses lie on the floor. Then there are the cops. “Sometimes they beat us. They want to sleep with us for free… Yeah, we sleep with them.”

“I think we’re failing sex workers,” says Dianne Massawe, who works for Sweat in Gauteng and was at Monday’s meeting, attended by Deputy Minister of Justice and Constitutional Development John Jeffrey and Deputy Minister of Social Development Henrietta Bogopane-Zulu. While heartened by their attendance, Massawe says there’s much that can be done.

Sanac is finalising the national sex worker HIV programme, to be launched later in the year by Deputy President Cyril Ramaphosa, “once there is consensus on some of the more controversial issues”, says Sanac CEO Dr Fareed Abdullah.

On Monday he told the meeting, “It is not only a question of having a large number of sex partners, many of whom demand unprotected sex. Sex work is often dangerous and lonely. It is illegal in this country and carries a heavy social stigma. An exceptional programme is needed to provide effective HIV services to sex workers and fulfil their right – along with all South Africans – to receive healthcare.”

While the plan is being finalised, Abdullah says some initiatives are underway. “Sanac has raised R100 million from the Global Fund to finance 20 NGOs to implement a peer outreach programme for sex workers. This programme started at the beginning of 2014 and now reaches 30,000 sex workers each quarter with information, education, risk reduction workshops and a meeting venue with a site coordinator. There are now 56 sites throughout the nine provinces and each site has 10 peer educators from amongst the sex workers themselves.”

He continues: “Each peer educator is trained to reach 60 sex workers per quarter. The peer educators also supply condoms and lubrication. Further work is being done to ensure that sex workers reached have a good referral plan to the local clinic (or a mobile clinic) for antiretroviral treatment, STI treatment and contraception on a regular basis. The programme will also aim to improve referrals to social workers for alcohol and substance abuse, places of safety, women and child abuse and other psychosocial support such as rape care and counselling. Lastly, the peer educators are being trained in paralegal support so that they can support sex workers in their area when it comes to laying a charge for violence or rape with the police or if there is abuse from police themselves.”

While Abdullah says more information is needed on the HIV prevalence rate amongst sex workers and a new study by the US Centres for Disease Control should be released in a few months, Ngcobo says not many of her fellow workers have HIV or STDs. They sit listening to her against the wall waiting for clients. The sex workers get free boxes of condoms from Sisonke, a national movement of sex workers, and a mobile clinic visits every fortnight.

Despite these services and the efforts from NGOs and Sanac, Massawe says sex work needs to be legalised. “I think the key thing we need to change across South Africa is to look at the laws,” she says. Criminalisation clearly doesn’t eliminate the industry, but only serves to increase stigma and discrimination. Symbolising the problems of illegality, Massawe says she has heard of police officers arresting suspected sex workers if they have condoms in their bags. It doesn’t stop them from working, only from carrying condoms. Such structural barriers inhibit workers from accessing services and realising their rights.

“We believe it is the only viable approach to promoting and protecting the dignity and rights of sex workers,” said Commissioner for Gender Equality Janine Hicks on legalisation in 2013.

That option looks unlikely, despite its reported benefits. Deputy Minister Jeffrey told Monday’s meeting, “We are, on the one hand, a very conservative country […] If decriminalisation is to go through, it’s important that it has the majority of support from the people of South Africa.”

For Ngcobo, it’s crucial. She looks at another sex worker holding two school bags she just bought for her children, and Ngcobo remembers her daughter in KwaZulu-Natal. She wants a better place to take clients and for her job to be deemed legal.

“Because it’s work, because we support families with this work.” DM

Photo by Greg Nicolson.

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