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From: PlusNews <[email protected]>
Date: Wed, Nov 14, 2012 at 6:09 PM
Subject: UGANDA: Sex workers missing out on HIV care
To: Elisabeth Janaina <[email protected]>


UGANDA: Sex workers missing out on HIV care

KAMPALA, 14 November 2012 (PLUSNEWS) - Sex workers in Uganda's
capital, Kampala, are reluctant to seek HIV testing and treatment
services, putting their health in jeopardy, preliminary results of a
new study reveal.

The multi-site research study, named The Early Capture HIV Cohort
(ECHO) RV217, is being conducted among high risk uninfected female sex
workers in Uganda, Kenya, Tanzania and Thailand. It is monitoring a
group of high-risk sex workers to gather information on acute HIV
infections.

Preliminary results [ http://www.retrovirology.com/content/9/S2/O28 ]
from the Uganda arm of the study, launched by Makerere University
Walter Reed Project, MUWRP, in 2009, showed 221 participants out of
631 tested HIV-positive, but a large number did not return for
confirmatory tests.

"Out of the 105 participants who got their confirmatory results, 96
were referred for care and treatment at the centres of their own
choice. Currently there are some 56 on [treatment], 13 didn't report
and 27 couldn't be traced," Lillian Mutengu Kasirye, the community
outreach coordinator for MUWRP, told IRIN/PlusNews.

Sex workers, Kasirye said, needed more counselling on the benefits of
HIV testing and getting their test results.

"Failure to return to get confirmatory results and access to care is a
lost opportunity for HIV prevention and a potential source for new
infections among sexual partners," she said.

Sex workers in Kampala told IRIN/PlusNews that HIV was just one of the
occupational risks of their profession.

"It doesn't matter whether it's live [unprotected] or protected sex,
all I want is money - I have a child to take care of," Sophie*, a sex
worker in Kabalagala, one of the city's red light districts, told
IRIN/PlusNews. "The clients who want unprotected sex pay more money. I
get about 40,000 shillings [US$16] a round."

Stella, another sex worker in Kampala, says the decision to use
protection lies with the customer. "The truth is I am HIV-positive,"
she said. "If a man comes and asks for unprotected sex, it means he
too is HIV-positive. I do it provided he gives 50,000 shillings."

Activists say the criminalization of sex work, discrimination and
stigma is a major factor in sex workers remaining underground and
failing to seek crucial health services.

Criminalized and at risk

"Because sex work is criminalized in Uganda, sex workers face
discrimination, stigmatization and assaults from the hospitals and
community members such as landlords and taxi drivers," Macklean
Kyomya, the director of local NGO Women's Organization Network for
Human Rights Advocacy (WONETHA), told IRIN/PlusNews. "They [health
workers] are afraid to associate with them [sex workers] and sometimes
openly attack some of the sex workers who are positive, blaming them
for spreading the HIV virus."

According to the 2009 Uganda HIV/AIDS Modes of Transmission Analysis [
http://siteresources.worldbank.org/INTHIVAIDS/Resources/375798-1103037153392/UgandaMoTCountrySynthesisReport7April09.pdf
], sex workers, their clients and their clients' partners account for
10 percent of all new HIV infections annually.

A 2011 study [ 
http://journals.lww.com/stdjournal/Abstract/2011/04000/HIV_and_Other_Sexually_Transmitted_Infections_in_a.13.aspx
] published in the Journal of American Sexually Transmitted Diseases
Association found that 37 percent 1,027 female sex workers surveyed in
Kampala's red-light districts were HIV-positive; the country's
national HIV prevalence is 7.3 percent.

Civil society organizations say the exclusion of marginalized
vulnerable groups like sex workers and men who have sex with men was
rolling back the fight against HIV in the country.

"The government should stop neglecting the most vulnerable
populations. We need to design programmes that target high risk groups
like commercial sex workers and homosexuals if we are to bring the
epidemic down," said Stella Alamo Talisuna, executive director of NGO
Reach Out Mbuya Parish HIV/AIDS Initiative.

Health workers and some service providers, especially those supported
by the US President's Emergency Plan for AIDS Relief (PEPFAR), have
been accused of discriminating against sex workers, a charge senior
government and US mission officials in Uganda have denied.

"All Most at Risk Persons, including commercial sex workers, are
included in PEPFAR services across the board, including testing,
counselling, prevention services, treatment, etc," Dan Travi, the
public affairs officer at the US Mission in Uganda, told IRIN/PlusNews
in an email.

Minister for Health Christine Ondoa said: "Our health workers don't
discriminate against patients. When patients come for treatment, we
don't ask whether you are sex worker. We take care of everybody."

Some organizations like WONETHA have begun sex worker friendly
programmes, including training them as peer educators and providing
psychosocial support. The group also distributes condoms, and
lubricant and provides information to sex workers on where to get HIV
services.

"We are engaging with sex workers, health practitioners and clinics in
dialogue to provide friendly, non-discriminatory services to sex
workers," WONETHA's Kyomya said. "We are organizing seminars and
workshops to sensitize public health care practitioners on human and
health rights of sex workers," she added.

so/ko/kr/cb

[END]

This report online: http://www.plusnews.org/report.aspx?reportID=96779



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