Antiretrovirals for all sex workers

We are “affirming the right of all South Africans to life, to dignity, to health” - Deputy President Cyril Ramaphosa

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Photo of Cyril Ramaphosa
Deputy President Cyril Ramaphosa in Cape Town earlier this year. Photo: South African Government

The state will provide a once-daily pill to sex workers that will reduce their risk of contracting HIV. The intervention, known as Pre-exposure Prophylaxis (PrEP), was announced last week at the launch of a South African National Sex Worker HIV Plan in Johannesburg. The pill is an antiretroviral consisting of the drugs tenofovir and emtricitabine.

PrEP will be delivered in combination with other HIV prevention methods.

The plan also provides for antiretrovirals to be made available to all sex workers who test positive for HIV regardless of CD4 count. This is a step ahead of the current national guidelines on the treatment of HIV. Currently HIV-positive people are only treated when their CD4 count, a measure of immune system strength, falls to below 350 cells per cubic millimetre. HIV-negative people and HIV-positive people in the early stages of infection typically have a CD4 count above 500 cells per cubic millimetre.

Deputy President Cyril Ramaphosa addressed the audience, telling them that the plan was “about human rights” and “it is affirming the right of all South Africans to life, to dignity, to health - regardless of their occupation and regardless of their circumstances”.

Sex workers “too have mothers, fathers, families and children who love and appreciate them,” he said.

He said that the plan is “informed by the principle that sex workers can no longer be denied their constitutional rights, be beaten up with no recourse to justice, or that they can be subjected to unlawful arrest”.

Despite Ramaphosa’s affirmation of sex workers’ rights, sex work is still illegal in South Africa, which has led to questions of whether the plan will be able to be fully realised. Ramaphosa admitted that as the plan unfolds we “will need to deal with the legal status of sex work”.

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