Female Sex workers continue to face disproportionate levels of violence and discrimination in a number of ways, including physical or sexual assault, or stigma attached to their identity based on their nature of work.
As a result of this many female sex workers are excluded from health systems consequently failing to access basic health needs which are a violation of core human rights and a clear driver of ill health.
However, Kenyan female sex workers no longer fear stigma and discrimination while accessing heath care thanks to the establishment of a sex worker friendly wellness center.
A tight spiral staircase leads you to the third floor of Hashi building located along the busy Jogoo road, few kilometers from Kenya’s capital Nairobi.
A smooth music decorates the corridor of the building and directs you to the reception of Bar Hostess Empowerment and Support Programme {BHESP} wellness center.
A 32 color inch television surrounded by a powerful sound system decorates one corner of the reception while the wall is decorated with male condoms cleverly arranged to form the word ‘BHESP’.
“I am prepared for a HIV free life. One tablet a day can protect you from HIV,” read one of the posters on the wall.
The reception desk is well arranged with condoms and lubricants clearly signifying the importance of HIV prevention among sex workers. The waiting bay is filled with a dozen of female sex workers waiting to be attended to by the clinician.
At the reception, I meet 41-year-old peer educator Carol*, a sex worker for the last 26 years, who tells me for the last four years the wellness center has been providing a friendly place where female sex workers receive medical care and behavior change counseling without stigma or discrimination.
“As a peer educator whenever a sex worker from my hotspot feels ills, I write for them referral letters and when they arrive at the wellness center they get free friendly health care. After treatment the sex worker also receives health education,” Carol explains.
Resonating Muthini sentiments, 21-year-old Jessie* says BHESP wellness center is a conducive place where her peers learn a lot about HIV prevention since female sex workers fall among the most at-risk population due to nature of their work.
“The staff from the wellness center are very friendly. They do follow up to know how one is fairing on. When one tests positive for HIV, there is a support group at the wellness center where HIV positive female sex workers meet and discuss issues affecting them,” says Jessie who is also BHESP’s outreach worker.
The wellness center nurse Mercy Wafula says the drop in center, which on average attracts 400 clients per month, was started to provide friendly services to key populations especially female sex workers because they were victims of stigma and discrimination in other health facilities.
“The nature of their job makes them face a lot of stigma and discrimination. Many people associate sex work with immorality and ungodly behaviors,” Wafula, who has been working with key populations for 3 years, points out.
Wafula further explains that they have identified and trained 62 sex workers from different hotspots, who are accepted in the sex worker community, as peer educators who refer clients to the wellness center.
“I wish we will have similar wellness centers all over Kenya so that sex workers can access friendly medical services because when you go to other health centers one is afraid to open up especially when you have sexually transmitted infections,” says Hellen*, a sex worker from Nairobi’s Eastleigh area.
For 21-year-old Mary* who was naïve and ignorant during her early days as a sex worker, the wellness center has positively bridged her knowledge gap on risk reduction.
“The wellness center has been an eye opener to me as a young sex worker. I was afraid to seek medical attention at our local hospital fearing the nurse will fail to treat me after finding out about my occupation. But now I have enough information on what to do when I encounter condom burst thanks to the wellness center,” says Mary.
The wellness center that was started back in 2013, offers STI screening, cervical cancer screening, HIV testing services, family planning and health education services to female sex workers from various hotspots in Nairobi.
“Being a clinic that implements wellness center and referral to GOK facilities and other NGOS facilities model. Clients are referred for ART treatment, cervical cancer management, and Pre-Exposure Prophylaxis {PrEP},” Wafula expounds.
She concludes that the clinic ensures follow-up and documentation of all referred case, to enhance retention of the clients adding that for all the cases they have referred they have followed up to ensure the client access the services.
*Names have been changed to protect the identity of the people.
