Mchinja District Sex Worker Intervention

In order to reduce HIV and sexually transmitted infections (STIs) among female sex workers (FSWs) and their clients, as well as promote sex worker's health and human rights in Malawi, several organisations implementing FSW Interventions with funding from United Nations Population Fund (UNFPA) convened a number of meetings that led to the formation of an Alliance for Female Sex Workers in Malawi. As part of their sex worker intervention programme, the Pakachere Institute has helped to form a district level group in Mchinja. The main goal of this structure is to make FSW more organised for easy and effective addressing of the issues. The district level alliance will work hand in hand with national alliance to address bottlenecks.

In addition, the project is working towards a minimum package of interventions, which will guide organisations to be able to implement activities that will make significant impact with limited resources, while not restricting those that have the financial and technical capacity to go beyond the minimum agreed interventions. Prevention interventions will include distribution or promotion of condoms; provision of health services, especially to treat STIs; discussion groups or classroom-based HIV and sexual health education; networking to promote better laws, working conditions and health services for sex workers; dissemination of information through printed materials and street theatre; and economic development programmes for sex workers seeking other types of employment.

The projects is also working improve access to health care services and addressing issues of abuse of rights. This includes simplifying and translating laws that deal with FSW, as well as organising meetings with the Malawi Police Service to sensitise them on the alliance.

Rights, Health, Sex Work

In Malawi, FSWs are one of the key populations with the highest HIV prevalence rate (70%) of HIV and yet their access to information and health care services is limited. The national HIV prevention strategy singles out most at risk populations as one of vulnerable groups that require targeted interventions to address factors that put them at risk of infection and infecting their clients.

According to UNAIDS (2012) guidelines on prevention and treatment of HIV and other sexually transmitted infections for sex workers in low- and middle-income countries, the lifetime probability of a sex worker becoming infected with HIV is higher than among people in the general population, due to multiple risk factors, including multiple sexual partners, unsafe working conditions, barriers to negotiating consistent condom use, lack of access to appropriate lubricants, high prevalence of sexually transmitted infections (STIs) and sharing of injecting equipment. The report further says that studies show that female sex workers are 13.5 times more likely to acquire HIV than all other women aged 15–49 years, including in high HIV-prevalence countries. In addition, sex workers are often not in a position to control these risk factors, because of the environment and context in which they live and work. For these reasons, sex workers have been considered a key population with whom it is essential to work if the epidemic is to be stopped.