Sub-Saharan Africa (SSA) has the highest number of people living with HIV/AIDS, with Nigeria, South Africa, and Uganda accounting for 48% of new infections. A systematic review of the HIV burden among women engaged in sex work (WESW) in 50 low- and middle-income countries found that they had increased odds of HIV infection relative to the general female population. Social structural factors, such as the sex work environment, violence, stigma, cultural issues, and criminalization of sex work are critical in shaping sexually transmitted infection (STI)/HIV risks among WESW and their clients in Uganda. Poverty is the most commonly cited reason for involvement in sex work in SSA. Against this backdrop, this study protocol describes a randomized controlled trial (RCT) that tests the impact of adding economic empowerment to traditional HIV risk reduction (HIVRR) to reduce new incidence of STIs and HIV among WESW in Rakai and the greater Masaka regions in Uganda.
At the 9th South African AIDS Conference (SA AIDS 2019), I can only reflect on the work we have done over the years in the fight against HIV. So many inspiring scientists, community representatives and activists in the room working to turn the tide on this virus. ‘Unprecedented innovation and technologies’ was a fitting theme for this year’s biennial conference: 19 years on from the first SA AIDS Conference, South Africa has become a world leader in the work to end AIDS.
Today’s judgement by the Gaborone High Court to decriminalize consensual same sex relations is a victory in the battle for equality and freedom to love whoever you choose, Amnesty International said as it called on other African countries to follow Botswana’s inspiring example.
Despite public health interventions targeting sex workers in an attempt to increase condom use, HIV still remains a significant health issue for those involved in the sex industry in many countries. In this paper, we analyse data collected as part of an ethnographic study of sex work in Soweto, South Africa.
Of no surprise to those in the HIV field, the epidemic continues to be fueled by stigma, none more evident than among key and mobile populations, such as people who inject drugs and sex workers. Speakers at the Southern African HIV Clinicians Society conference shared their experiences in working with these groups and challenged participants to view them as people – and not merely a public health problem.
Looking at where we have come from, and where we are in southern Africa’s fight against HIV, it is clear that we have had some monumental successes and some incredible failures along the way, both of which we can learn from to do better. One clear theme throughout the first day of the 2nd International Workshop on HIV Adolescence: Challenges and Solutions was that we have not consistently and adequately gained the insights of the very people who are enrolled in studies to generate evidence on how to address the needs of these populations. Further, we have not committed the resources required to conduct the research on the populations that are difficult to reach, whether due to challenging ethical enrolment or stigma and criminalization of key populations.
People infected and affected by HIV face multiple, far-reaching barriers every day – from structural barriers affecting their access to services and care, to societal and scientific barriers keeping them from enjoying healthy, safe, and full lives. We highlight some of these barriers, and what innovative approaches are being developed to bridge them.