MSF Offers Targeted Health Services for Sex Workers in Malawi
Isabella*, a shy young woman, arrived near the end of a community outreach day organized specifically for commercial sex workers in Nsanje, Malawi.
She and two of her friends were tested for HIV; her test result was positive. During counseling and encouragement to start antiretroviral (ARV) treatment, Isabella admitted to the counselor that she already knew she was positive. She had missed two appointments at the hospital's HIV clinic and, after that, had been too embarrassed to go back. Instead, she had been taking pills from friends—sometimes without their knowledge—in order to continue her medication. Scared, she came to our clinic looking for help.
The community outreach clinic is part of MSF’s new model of care for sex workers in Nsanje, the southernmost district in Malawi. According to official estimates, the prevalence of HIV among this group in Nsanje is an alarming 82 percent, even higher than the reported national prevalence of 71 percent. With no local response targeting sex workers and a continuously low supply of condoms in the district, sex workers are drivers of new HIV infections in Malawi and in the district.
“Not only is there no special response to the needs of this highly vulnerable group, but also the women feel stigmatized and disrespected when they go to the clinics, especially for treatment of sexually transmitted infections, or STIs,” says Risa Turetsky, outreach nurse for MSF in Nsanje. “They feel stigmatized by the other patients and sometimes even the clinic staff treat them badly. This discourages most women from coming in for services, which is unacceptable and quite tragic considering the health needs of this group.”
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