by Ezra Abaga, PS Kenya Corporate Communications.
“In the four years I have been a female sex worker (FSW), I have seen colleagues lose lives to HIV&AIDS. It always makes me sad; I consder them family. In this industry we encounter all types of clients, those who insist on using protection and those who don’t; instead they offer more cash for the services. Such clients expose us to a greater risk of HIV infection but with PrEP (Pre- exposure prophylaxis) my protection from HIV is guaranteed and I don’t miss out on the good offers.” Aurelia (not her real name), a FSW, and peer educator.
We are in Kisii County to interact with PrEP users and hear their experiences using the drug. Our journey leads us to IRDO (Impact Research and Development organization), one of Jilinde project implementing partners. Jilinde is a Bill and Melinda Gates Foundation-funded project whose objective is to demonstrate that PrEP services can be offered at routine service delivery to prevent HIV infection. IRDO is located in Kisii town and deals with the health needs of vulnerable populations.
On arrival, we are directed to the clinical officer in charge of the health facility at the organization who updates us on the progress of the program, thereafter taking us around the facility to allow us to have a deeper understanding of what they do. It is impossible to miss the PrEP posters conspicuously displayed on the walls; a clear indication that the facility understands the benefits of using information, education, and communication (IEC) materials to create demand for services. After the facility tour, we are ushered into a room and waiting on us are three young beautiful ladies, perhaps in their mid-twenties. Chicly dressed, occasionally glancing at their smartphones. They look urbanized, well paid, and happy.
The ladies introduce themselves and engage us in banter.
“I am ready and will go first.” One of them says, “ I am more than willing to tell my story. It may motivate people like me when they read about how PrEP ‘saved’ me” she says. Thoughtfully.
Growing up, Aurelia faced many challenges; from lacking the very basic of needs to being too poor to afford an education. Her situation overwhelmed her and she opted to look for any means to survive. The need to ‘hustle’ and make money made her move from the rural area to Kisii town. On arrival in Kisii, she tried looking for a job to no avail, luckily she bumped into a childhood friend who took her in, the friend was living a good a life, this made Aurelia admire her only to later learn that she earned her living through sex work. Time passed and the friend started tagging her along to the ‘base’ (working station). Within no time, she too joined the business. Her first experience on the ‘job’ was ‘hell’ she says, she got inexplicable clients and being new on the job, it was all mental torture. However, the situation back home could not allow her to turn back.
“At first it wasn’t easy offering myself to a stranger, I found myself crying most of the time and at times I disappointed the clients by not offering the services to their expectation. I later got introduced to alcohol, which made it easier. It gave me the courage to approach clients and offer them good services depending on the money they could offer.” she says.
Still, the job came with its fair share of challenges that affected her psychologically.
“I witnessed friends lose their lives to HIV&AIDS. Others got incapacitated from drug abuse, rape, and others were murdered by being strangled or thrown out of moving vehicles. I also deeply feared being infected with HIV as I got clients who insisted on unprotected sex for a better pay. This continued for a while until I got a remedy; PrEP. PrEP, for me, is a ‘savior’ .”
Stumbling on PrEP information on Facebook stirred her curiosity and luckily, one day as she walked towards her ‘base’ (where they wait for potential customers), she came across people engaging a group about a drug that could be taken daily to prevent HIV infection. She joined in, asked questions and sought clarification about the drug. The peer educators also gave her brochures on PrEP and referred her to their health facility (IRDO). Later on, she decided to visit the facility where she was counseled and decided to take up the drug. She was directed to a clinical officer who after assessing her risk prescribed the drug and that is how her journey with PrEP began.
“It is now 2 years since I began taking PrEP. I usually go for HIV testing regularly to confirm my status and I am happy that I am still negative. With PrEP , I have assurance of safety from infection. I have also boosted my income! (she laughs when mentioning this), and yes, I know that if I can, I still need to insist on using a condom as PrEP doesn’t prevent me from STIs.”
I ask her how her body reacted to the drug,
“During my first week , I used to feel nauseated, tired and dizzy but with time that ended and we are now good friends (with PrEP). Actually, I have already taken my dose for the day, so I am ready for a client anytime!” She quips.
Promoted to a peer educator
Three months into using PrEP, Aurelia decided to start educating her peers about PrEP. She checked with IRDO to see how the facility could help her colleagues. An opportunity arose, and she was trained on PrEP. She is now a peer educator who acts as a link between the facility and her fellow sex workers. Her work entails teaching them about PrEP and linking them to IRDO for further discussion with health providers and counselors.