Decriminalise sex to end HIV/Aids in Africa

Lazarus Sauti

Sex workers are among the highest risk groups for HIV, says the Joint United Nations Programme on HIV and Aids (UNAIDS) – the main advocate for accelerated, comprehensive and coordinated global action on the HIV/Aids epidemic.

UNAIDS, also a member of the United Nations Development Group, says in low- and middle-income countries, HIV prevalence among sex workers is an estimated 12 percent.

“One study of 16 countries, for instance, in sub-Saharan Africa found an average HIV prevalence of 37 percent among sex workers,” it adds. “In Nigeria and Ghana, HIV prevalence among sex workers is eight times higher than for the rest of the population.”

In Zimbabwe, notes the National AIDS Council of Zimbabwe (NAC), cases of HIV/Aids remain very high among sex workers and adolescents.

“While the country has made significant strides in meeting global targets of reducing new sexual infections by 2015 and reducing the HIV and AIDS prevalence rate to 13.7 percent, incidents of the disease are still high among sex workers,” says NAC monitoring and evaluation director, Amon Mpofu, during a Parliamentary Portfolio Committee on Health and Child Care workshop held in Beitbridge recently.

In South Africa, the Department of Health also asserts that between 6 percent and 20 percent of all HIV infections in the country can be linked to sex work.

In a 2013 study involving 2 180 sex workers in Johannesburg, Cape Town and Durban, 70 percent in Johannesburg tested HIV-positive.

Although the Aids response in the region has achieved numerous gains over the past decade, according to the AIDS and Right Alliance for Southern Africa (ARASA) – a regional partnership of non-governmental organisations working together to promote a human rights approach to HIV/AIDS and TB in Southern Africa through capacity building and advocacy, the epidemic is characterised by inequalities in access to services and the response is not matching up to the demand for HIV prevention services and commodities, particularly for key populations at higher risk of HIV such as sex workers and lesbian, gay, bisexual, transgender and intersex (LGBTI) people.

ARASA, the regional community partner for the 2016 International AIDS Conference in Durban recently, adds that sex workers in most countries in southern Africa are in a fix due to emerging and persistent human rights issues such as stigma and discrimination as well as harassment.

“Sex workers in Namibia and across the region report high rates of harassment, violence, rape and extortion at the hands of law enforcement agents and clients, which renders them more vulnerable to HIV infection,” says ARASA, adding: “In Namibia, as in most countries in the region, there is an inadequate implementation of protective laws and policies, contributing to the lack of access to justice when the rights of sex workers are violated.

“Sex workers also have a lack of knowledge about laws and how to go about enforcing rights and seek redress.”

As such, it (ARASA) recommends that laws related to sex work be reformed in an effort to decriminalise the selling and buying of sex by consenting adults.

Governments, adds ARASA, should improve access to justice for sex workers through the provision of legal services and holding perpetrators (including law enforcement officials) accountable for abuse, a fact supported by several delegates at the 21st International AIDS Conference in Durban.

“If we leave sex workers behind, HIV will spread further and further,” said celebrity Aids activist Sir Elton John. “If you give people love and compassionate and include them – like drug users, like sex workers – you leave no one behind.

He added that without health services as well as support for marginalised groups such as sex workers, the campaign to end Aids will be a disaster. 

Chris Beyrer, head of the International Aids Society – the world’s largest association of HIV professionals, with members from more than 180 countries working on all fronts of the global Aids response, says police needs to be engaged if countries are serious with beating HIV.


Sex Workers Education and Advocacy Taskforce (Sweat) – a non-governmental organisation that advocates decriminalisation of sex work in South Africa, sums up that involving sex workers directly in HIV prevention programmes can empower them to look after their health, a fact supported by research from the Lancet (a weekly peer-reviewed general medical journal) edition on sex work which shows that decriminalising sex work globally would have the greatest effect on the course of the HIV epidemic, averting between 33 percent and 46 percent of HIV infections in the next decade. 

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