Sex workers lack food for taking HIV drugs during COVID-19

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Sex workers wait for clients in the red light district of Harare, Zimbabwe, Friday, June 12, 2020. As the coronavirus spreads in Africa, it increasingly threatens those who earn their living on the streets, including sex workers with HIV. (AP Photo/Tsvangirayi Mukwazhi)

KIGALI – As the coronavirus spreads in Africa, it threatens in multiple ways those who earn their living on the streets — people like Mignonne, a 25-year-old sex worker with HIV.

The lockdown in Rwanda has kept many of her customers away, she said, so she has less money to buy food. And when she doesn’t eat, the antiviral drugs she takes for HIV can bring on pain, weakness and nausea, or even make her pass out.

“Yet it’s equally dangerous when you don’t take the drug,” Mignonne said in an interview. “You will die.”

Similar challenges exist elsewhere in Africa, which has the world’s highest burden of HIV.

Studies have shown that food insecurity is a barrier to taking the drugs daily and can decrease their efficacy, affecting not only sex workers but anyone where food — or the money to buy it — is scarce.

Among sex workers in Zimbabwe’s capital, Harare, “most who are living hand-to-mouth have been lamenting that it’s making it difficult to adhere to treatment,” said Talent Jumo, director of the Katswe Sistahood, an organization for sexual and reproductive health.

That's a danger as many sex workers around the world are excluded from countries' social protection programs during the COVID-19 pandemic, researchers from the London School of Hygiene & Tropical Medicine and elsewhere wrote in a new commentary for The Lancet.

“Sex workers are among the most marginalized groups,” they wrote, adding that “it is crucial that disruption to health services does not further reduce access to HIV treatment.”