Leaving no one behind; the realities of access to health services by sex workers in Kaiso

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In Songalendu village in Kaiso sub county, Hoima, Western Uganda, a teenager recounts her unfortunate tale. After conceiving while still an adolescent, Amanda (not real name) was thrown out of her father’s home. The quest for survival landed her in Songalendu, her new home, where she gave birth from. To fiend for herself and the baby, she got a job as a waitress at a local bar but it was not enough. Amanda ventured into sex work.

From interactions with most of these young  women, many of them turn to sex work because of poverty and lack of opportunities but as they narrated, they do so without the needed knowledge about sexual reproductive health especially how to practice safe sex and family planning.

Another teenager, a sex worker,  said that many times, they are raped because people do not attach value to their bodies or sexuality and think of them as sex objects. She added that even with clients, some of them will only wear a condom in the start and pull it off during sex, risking infecting her with STDs or leaving her pregnant.

With no government  health facilities in Songalendu, it’s next to impossible for them to receive medical care, the other option is to opt for privately owned clinics which are relatively expensive.

According to a report by Global Network of Sex Work Projects, access to comprehensive sexual and reproductive health services – from STI prevention to post-natal care – is an essential component of a human rights-based health approach. However, public health programmes and policymakers have seldom addressed the comprehensive sexual and reproductive health (SRH) needs of sex workers. Due to abolitionist approaches and popular conflations of sex work with human trafficking, SRH services for sex workers may even be excluded from national and international HIV and health funding.

The report also highlights that the common view of sex workers as ‘vectors of disease’ within public health systems (indicated by their emphasis on HIV and STI interventions) has reinforced stigma and impeded the development of comprehensive SRH programmes.

Sex work in Uganda is illegal according to Section 136, 138 and 139 of Uganda’s  Penal Code (Amendment) Act 2007 but despite this, its widespreas and a source of income for many women and men.

The IKnow HIV/AIDS awareness campaign that happened in Hoima with a weeklong of free SRH service and information delivery extended to Songalendu village. The campaign increases awareness that translates into HIV testing, positive behaviour change that inspires people to make informed sexual reproductive health choices. The sex workers being some of the target groups to benefit from the campaign, the team set out to places they frequent such as bars, brothels and lodging facilities.