Mother, HIV-positive, sex worker: Phelister Abdalla on her fight against stigmatisation and discrimination

Abdalla reports on how and why the view of sex work urgently needs to change - also for health reasons.

Medical and political equality still a long way off

Phelister Abdalla is HIV-positive, a mother of three children and has chosen to become a sex worker. She is also the national coordinator of the Kenya Sex Workers Alliance (KESWA). At IAS 2021, Abdalla reports on how and why the view of sex work urgently needs to change - also for health reasons.

Under the title "Decriminalisation of sex work and providing good health outcomes for sex workers", the national coordinator of the Kenya Sex Workers Alliance (KESWA) talks about prejudices, health and legal restrictions on sex workers and the need to stand united against stigmatisation and discrimination. Abdalla emphasises that problems such as prostitution out of necessity or forced prostitution exist, but that forced labour is a global problem that does not only affect the field of sex work. Abdalla herself and the KESWA specifically work against human trafficking and child labour in sex work, among other things. However, many people choose sex work voluntarily and consciously. Accordingly, these people should be treated politically and medically in exactly the same way as in all other professional fields.

Factors such as the criminalisation of sex work, legal restrictions or limited access to contraceptives for reasons of poverty mean that many sex workers are at increased risk of HIV infection. The COVID-19 pandemic has added to the vulnerability and exclusion of vulnerable populations. However, professional restrictions due to corona rules are only one of many aspects of risk in sex work, as Phelister Abdalla reports.

KESWA is an umbrella organisation of sex worker-led organisations in Kenya that aims to make sex workers' voices heard and connect their organisations in their diversity - whether female, male or transgender. In Kenya, sex work is still considered a criminal offence in many places; however, legal foundations in particular are crucial for the well-being of sex workers, Abdalla emphasises. State sanctions provide a particularly strong basis for stigmatisation, discrimination, exploitation and extortion. The KESWA coordinator gives an example: In one part of Kenya, several prostitutes were arrested and compulsively tested on the mere suspicion of spreading sexually transmitted diseases.

Health risks: not only HIV and STDs

According to Abdalla, the dangers sex workers face in the course of their work are multifaceted. Especially during the COVID-19 lockdown, she and many of her colleagues were forced to do their work "in the neighbourhood", which puts this group of workers in a different, public perspective - especially by people who disapprove of sex work. This encourages stigmatisation, discrimination and exclusion. The need to work in clients' homes has also increased the risk of becoming a victim of violence. Abdalla reports that 30 KESWA sex workers have been killed since the beginning of the pandemic in major cities and towns in Kenya. In addition, due to the 7 p.m. curfew and the occupational necessity of exceeding this time, some sex workers have become victims of police brutality or harassment.

Most of the risks come from the clients

According to Abdalla, many of these risks also pose concrete health risks for sex workers. There are many clients who do not want to wear condoms for socio-cultural reasons, such as lack of education or religious motives. Biological factors, such as male circumcision and a high incidence of sexually transmitted diseases in general, also pose a high health risk. Especially since alcohol and drug abuse are also widespread among both sex workers and clients in Kenya. In addition, Abdalla says, there are also many sex workers who shy away from seeking medical care for fear of stigmatisation and discrimination in the health system. However, she also points out: Health risks in sex work do not only extend to HIV and other sexually transmitted diseases. Many female prostitutes also worry about their reproductive health, for example. Another major health issue that is not talked about enough is the mental health of sex workers.

Ensuring access to medical care and prevention

So how can health risks among sex workers be counteracted? For this, Abdalla emphasises, it is urgently necessary that the public and legal perception of sex work fundamentally changes and that prostitution is decriminalised. If stigmatisation and discrimination were removed, access to medical and health care would also change immediately. The risk of HIV transmission in sex work can be minimised if regular education on contraceptives and prevention takes place and access to them is guaranteed. At KESWA, it has long been common practice to regularly inform oneself about contraception and prevention and to exchange ideas with other colleagues.

International AIDS Society Conferences (IAS) 2021, Prime Session "Decriminalisation of sex work and providing good health outcomes for sex workers", 20 July 2021