South Sudan: Sex Workers Use Emergency Drugs Instead of Condoms

South Sudan's AIDS Commission says at least 150,000 people in the country are living with HIV. Despite this, some sex workers are having unprotected sex - and taking antiretroviral drugs afterwards to cut the risk of infection.

"Let me tell you the truth about why many of us don't use condoms," says Jane who has been a sex worker in Yambio since the signing of the comprehensive peace agreement in 2005.

"We don't have money, so when we meet a client who offers more money than we usually get to have sex without protection, then we will do it - even when we don't know his HIV status."

Jane says she and other sex workers do this to earn a living since they have no other way to survive. She also says that sometimes they run to the clinic the next morning to get emergency antiretroviral drugs, which can suppress the virus if taken within 72 hours of infection and, in some cases, stop its progression.

Emergency antiretrovirals

"We use this medicine like condoms, in case of such emergencies," Jane says. "However, there are only a few clinics that have these drugs in town and they are extremely expensive."

The type of antiretroviral in question is known as post-exposure prophylaxis (PEP). It is intended to be used only in emergencies.

For example, it is given to victims of rape if their attacker is thought to be HIV-positive or to medics who have been pricked by a potentially infected needle.

There are no definitive figures to show how well PEP works. Experts say it is far better to prevent exposure to the virus in the first place, by using condoms.

According to Dr Medhin Tsehaiu, UNAIDS country coordinator for South Sudan, the worry is that if all sex workers know about the drugs, they will stop using condoms altogether.

Clinics sell drugs illegally

These drugs are sold illegally in clinics and no one knows where the owners of the clinics get them. This hasn't stopped 24-year-old sex worker Minisare from using PEP for more than ten times in the past two years.