A new briefing by Cheryl Overs calls for PrEP to complement rather than undermine existing prevention programmes and condom use, to protect the health of sex workers.
While many including UNAIDS are heralding the HIV prevention drug as the new first line of defense for HIV negative people, a new IDS briefing ‘Examining the implications of PrEP as HIV Prevention for Sex Workers’ highlights that sex workers and NGOs who work with them are worried that the medication could be pushed on them and drive demand for condomless sex.
Fears that testing could become mandatory
It says that PrEP needs to be used alongside condoms to protect sex workers against unwanted pregnancies and other sexually transmitted diseases. Unlike condoms that are fairly self-explanatory and easy to buy, PrEP has to be dispensed from a qualified professional, requires regular medical follow-up and a strict routine of regular HIV testing (as it is harmful to people who are HIV positive), which the briefing argues could be unworkable for sex workers in low-income settings. Others fear the testing will become mandatory and that they will lack the rights and power needed to make informed sexual health decisions.
Further evidence needed
The briefing by Cheryl Overs, a visiting research fellow at IDS also highlights that the lack of trials and evidence about the use of PrEP with sex workers raises urgent ethical questions and underlines the need for better insights into the potential impacts.
Cheryl Overs, visiting research fellow at IDS and founder of the Global Network of Sex Work Projects, said:
“There is much optimism around the introduction of PrEP and rightly so but sex workers have been placed in a wide bracket of people at risk of HIV, with a lack of trials or evidence of how PrEP will specifically impact them in the long-term.
“PrEP should not be seen as the magic bullet. Reconfiguring sex industries to make sex workplaces and sex workers’ lives safer remains the priority everywhere”.