This represented the first time that any PrEP product was made available outside of a research study or demonstration project in an African country. In the first six months, hundreds of women have started taking PrEP from a network of 11 sites across five provinces in South Africa. Sex workers are able to access these facilities anytime. The second approach is outreach. We go out with a package of servicesβdrugs, equipment, and HIV test kitsβand reach out to the sex workers in brothels.
When we get to the brothels we request a room and set up a clinic to provide services in the brothel itself. The third approach is a mobile van. We are targeting those that are street-based, whether they are operating at the bush, on the highway, under the bridge, wherever, to reach those sex workers using a mobile van where we provide a comprehensive package of services. The fourth approach is using the peer educators , who form a link between the clinic and the sex workers because they do lots of referrals, they go out there, they mobilize, they also provide HIV testing services including finger pricking, give health talks, they talk about PrEP quite a lot, but also they make sure that they link the sex workers to our services so that they are able to access PrEP.
Raising awareness among potential PrEP users about their own risk is a strategy to generate demand for PrEP and ensure higher levels of adherence. Those who see themselves being at risk know PrEP will help them. People know their lifestyle and who they engage with, they know the factors that are pushing them to request it. From peer educators to friends, having a community to create accountability can make all the difference.
We look at a buddy system - who are they bringing or identifying as their support person or support structure that will ensure that they take treatment on time and they come in for their check-ups. We also keep a register to ensure that those that do not honor their appointment are traced , telephonically and physically. We have peer educators who do the physical tracking.
They go to the brothels to find the sex workers, even though they are mobile, the peer educators have been in the area and have a relationship with the community, and they will have feedback and information about where they are.
