December 7, 2016
This post originally appeared on FHI 360’s website here. Reposted with permission.
FHI 360 is marking World AIDS Day 2016 by telling the story of a woman in Africa who is tackling HIV prevention head-on through her use of oral pre-exposure prophylaxis (PrEP). In this Q&A, Scotchy, an HIV-negative woman from Zimbabwe, talks about some of the pressing issues affecting women who are taking daily antiretroviral medication, one of several proven options for preventing HIV.
The interviewee’s name has been changed for privacy.
Scotchy is a 24-year-old oral PrEP user and mother to a 9-year old daughter. She is a sex worker who also works with the Centre for Sexual Health & HIV/AIDS Research (CeSHHAR) in Zimbabwe. At this clinic, sex workers can obtain treatment and other clinical services in a safe, nonjudgmental setting. Scotchy mobilizes young sex workers to visit the center and get the services they need.
How has HIV affected your community or you personally?
HIV and AIDS completely destroyed my life. I didn’t know my father, my mother died of AIDS, my uncle died of AIDS, and some of my nieces also died of AIDS in front of me. In terms of the community, it really affected me a lot, because [the community] looked upon us as people who were cursed. People discriminated [against] me; they stigmatized me.
How did you find out about PrEP?
I found out about PrEP in 2014 through the CeSHHAR clinic. They gave us a lot of information about PrEP and educated us on how it works, the side effects and how is it going to change our lives if we were willing to take it.
[When I was learning about PrEP,] one thing that came into my mind was, “Ah! You know, here in Zimbabwe, people hate sex workers, our communities hate us, and now this PrEP pill is coming to us, which means people are trying to kill us or do something,” so I know that fear.
What made you decide that PrEP was safe to trust and worthwhile to use?
The conversations with the [clinic workers helped me understand that,] at the end of the day, this could make me take control of my body for once in my lifetime. I started sex work at the age of 14. Since then, my body was in the control of my client because I had no power over myself. I sometimes tried to negotiate for condoms, but they would beat me up. I still remember with some of the clients, I would talk inside me like, “Please, please, please use condoms, use condoms,” but I was afraid to say it out loud.
After [I understood PrEP,] I just thought, “Thank God. This is going to make me feel safe for my job for once.” It’s a form of empowerment and makes my job easier and more flexible.
How do you think we can reach more women with information about PrEP?
Trust and sensitizing their communities. Advocacy and peer-to-peer support are some of the strongest tools. I’ve been in front of sex workers, talking about PrEP and telling them I’m taking PrEP. It makes them understand more easily than an implementer explaining about PrEP. I think [sensitizing] the government and policymakers is also important.
If you look at most of us, we came into sex work HIV-negative, but after six months, we’re really in danger of getting infected. It was my goal that I target [them] to get PrEP, and I’m doing that still today.
What would you like practitioners and the public to know about your experience with prevention?
From a personal perspective, I think definitely, as young women, we’re at risk. I’m not talking about sex workers now, I’m talking as a young woman, because as much as I’m a sex worker, I’m a mother. As much as I’m a sex worker, I’m a woman. As much as I’m a sex worker, I’ve got my health drive. As young women and adolescent girls, we definitely need PrEP. We’re not saying that if we get PrEP, we ignore condoms. Prevention is two[-fold]. We really need PrEP now if we want to end AIDS by 2030, because as I speak to you now, maybe one of my friends, one of my sisters, one of my young girls is getting infected now.
HIV and AIDs really destroyed my life, but I thank God that I’ve got PrEP. I can stand and fight for other women to also take PrEP so that we end this HIV epidemic.
For more information on PrEP, visit PrEPWatch, a clearinghouse of information on PrEP science, research, cost, access, advocacy and implementation efforts.