Sexual and Reproductive Health Needs and Rights for Sex Workers: Message Brief

As part of an initiative to address the sexual and reproductive health (SRH) needs of sex workers at selected borders between Malawi, Zambia, Zimbabwe, and Namibia, the Soul City Institute for Health and Development Communication (SCI) and regional partners (see contact details below) conducted formative research to help develop communication materials designed specifically for this population. This programme message brief highlights key insights gained from consultations with stakeholders and sex workers, and offers key messages for the development of advocacy and awareness raising materials intended for sex workers (See Related Summaries below for the individual formative research reports). This activity forms part of the Soul City Regional Programme on Sexual and Reproductive Health and Rights.

Consultations with stakeholders identified some common issues for consideration across the four border areas. These included addressing safe sex issues such as condom use, ensuring that programming is relevant to all groups of sex workers (female, male and transgender), and improving access to health services, such as SRH, family planning, routine check-ups, and HIV treatment and care. Additional needs identified were the need for legal information, protection from abuse, and addressing alcohol abuse and unsafe abortions. The brief outlines a number of challenges that are to be considered, including sex workers fear of discrimination, poor attitudes of clinic health workers, and lack of knowledge and information about their rights.

Consultations with sex workers demonstrated similar issues and concerns raised. Sex workers lack knowledge about their rights, which can lead to exploitation and lack of care. They face social stigma, especially at clinics, and while they are aware of HIV treatments, lack of supplies at these clinics results in problems with treatment adherence. Consultations with sex works show that while they are aware of condom use as preventing HIV and STIs, unprotected sex is common because clients are willing to pay more, and alcohol sometimes impairs judgement. There are also misconceptions about condoms, which include comdoms having holes, lubricants causing stomach pains, and female condoms as unsafe.

Communication activities and materials have female sexworkers as its primary audience as female sex workers in borders are often left out in SRH advocacy programmes and there is a need to create more awareness on the importance of access to SRH and the interlink with HIV prevention. But the campaign will engage men as a secondary audience because of their positions at the border.

The general objective is to improve the sexual and reproductive health and rights of sex workers. The specific objectives are to:

• Create awareness on rights, policies and national laws that protect sex workers from abuse.
• Promote safe sex behavior including correct and consistent condom use (both male and female) and HIV testing among sex workers.
• Provide comprehensive knowledge and information on SRHR and HIV Prevention to sex workers
• Provide sex workers with referral information on SRHR services such as where they can get legal assistance and health care.
• Create awareness on and promote safe drinking practices

To achieve these objectives, the brief outlines a number of regional messages, to be adapted at country level, which cover aspects such as rights and legal recourse, safe sex, heath services, and alcohol and HIV.

To see the resulting materials developed by regional partners, see Related Summaries below.