South Africa, Aids and the World Cup

Too much of the mainstream media's coverage of sex work predicted to take place during the World Cup in South Africa has unfairly placed an emphasis on sex workers, rather than their clients.

The sensationalist tabloid press would have us believe that sex workers are "vectors of the virus" who pose a public health threat by potentially infecting visiting football fans with HIV. But what about the responsibility of those who pay for sex? South Africa has one of the highest rates of HIV in the world, with more than one in 10 people living with the virus. Stigmatising assumptions about sex workers could make the problem worse. It can often be the clients who pose the bigger HIV risk by pressuring sex workers to engage in unprotected sex for more money, at times turning violent if they refuse.

Because sex work remains illegal in South Africa, it is driven underground, and the women involved are unable to access health services and HIV prevention programmes. Even simple measures such as promoting and providing condoms are a risk when sex work is illegal. Evidence from Aids organisations on the ground suggest that sex workers are increasingly choosing not to carry condoms for fear of being arrested by police.

Criminalisation of prostitution also means that sex workers are jostled off the main streets and are forced to operate in desolate, unsafe areas where they are more vulnerable to attack. If and when they face violence or rape, women are unable to report it to police for fear of being arrested and treated as the offender, rather than the victim.

It is widely acknowledged that in countries where sex work is illegal, police authorities coerce sex workers into providing sex in exchange for freedom. A number of these women are mothers and sex work is their only form of livelihood, so arrest can lead to their children being left at home alone, forced to fend for themselves for days on end.

Freely accessible HIV prevention programmes that empower sex workers and engage their clients – such as those supported by the International HIV/Aids Alliance's partners around the world – mean that sex workers have higher levels of HIV awareness, risk perception and condom negotiation skills. In fact those countries that have prioritised public health over sexual moralism have witnessed far greater success in reducing HIV.

In lieu of such prevention programmes being rolled out across South Africa in time for the World Cup, there at least a need to be clear public health messages on safer sex. Most importantly, access to health services and information – including a supply of condoms and lubricants – must be provided to both sex workers and visiting football fans. That way both sides can make informed decisions that will minimise the HIV risk to themselves and their other sexual partners.

Alice Klein, a former newspaper journalist and coordinates a global citizen journalism programme for the International HIV/AIDS Alliance.