SCIENTIFIC studies have shown that pre-exposure prophylaxis
(PrEP) is effective in protecting people from HIV during both anal and vaginal
Sex workers should be more concerned about protecting
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
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
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 vaginal sex.
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 workers.
“We 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 school.”
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.