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COVID-19 (2022 Deadline)
Understanding the impact of COVID-19 and the national lockdown restrictions on sex worker uptake of health services in four sites in Gauteng, South Africa: A retrospective record review
PI: Khuthadzo Hlongwane, Perinatal HIV Research Unit (PHRU), a Division of the University of the Witwatersrand and co-PI Jenny Coetzee, African Potential Foundation
U.S. Partner: Glenda Gray, South African Medical Research Council (SAMRC) and PHRU
Project Dates: November 2022 - March 2024
Project Overview
 | | According to Jenny Coetzee, storytelling is her favorite way to connect donors and stakeholders with the work they do in communities. In May 2023 during USAID, NAS, and DSI representatives' visit at PHRU, Jenny took the delegation through Diepkloof Hostel in Soweto. Photo credit: Lina Stankute Alexander |
HIV prevalence amongst sex workers in South Africa is amongst the highest globally, with national estimates suggesting more than two-thirds of female sex workers were HIV-positive before the start of the COVID-19 pandemic. Pandemic restrictions implemented to curb the spread of the SARS-CoV-2 virus may have impacted access to antiretroviral treatment (ART) and pre-exposure prophylaxis (PrEP). HIV epidemic control, specifically amongst key populations such as sex workers, is vital to reducing its incidence and prevalence in the country. This PEER project sought to understand the impact that COVID-19 and the subsequent national lockdown restrictions had on the uptake of health services offered by sex work programs and how these restrictions have affected the UNAIDS 95-95-95 targets in Gauteng, South Africa.
In collaboration with their programmatic partner (Wits RHI), the project team conducted a retrospective record review from four sex work sites located across three districts in Gauteng, South Africa, covering two time periods: the year preceding the start of the national lockdown (March 1, 2019 – February 29, 2020), and two years after the start of the lockdown (March 1, 2020 – February 28, 2022).
Final Summary of Project Activities
In general, results from the researchers’ study showed that COVID-19 had a negative impact in healthcare services accessed by female sex workers. The strict lockdown levels such as Level 5 and 4 were significantly associated with negative impact, more especially in outreach visits. These outreach visits are important, as they provide an opportunity for female sex workers to test for HIV anywhere at any given time. Nevertheless, some services did improve during the COVID pandemic, including the number of viral loads measured and access to PrEP, but further data collection was necessary in order to come to a firm conclusion.
In May 2023, the PEER project team hosted representatives from USAID, the National Academies, and co-funder the Department of Science and Innovation of South Africa, who joined them on a community outreach visit to a district where female sex workers reside and work. The project researchers also participated in the South African AIDS conference in June 2023 in Durban and discussed the project with other researchers who are interested in key population projects. The PI also presented her findings at the Southern African HIV Clinicians Society Conference in Cape Town in late 2023. As of the time the final report was submitted in April 2024, further data analysis was under way, and the team expects to publish a paper on their findings.
Back to PEER COVID-19 Grant Recipients
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