Breaking HIV testing, treatment barriers in Qacha’s Nek
KEISO MOHLOBOLI
QACHA’S NEK – In Lesotho, an estimated number of 336 681 people are living with HIV, around 230 000 people were on treatment (2020), and, every year an estimated 10 663 new infections occur. Most of the newly infected people belong to key populations, including young women and girls and sex workers.
Lesotho retains the second highest HIV prevalence rate in the world and the National AIDS Commission’s Monitoring and Evaluation Officer Hlompho Motsoasele’s report discloses that more women in Lesotho are infected with HIV than men. “59 percent of people living with HIV by gender are females, while 41 percent are men.”
Qacha’s Nek: sex workers more vulnerable to HIV
Sex workers are more vulnerable to HIV/Aids in Qacha’s Nek and yet they face huge barriers to HIV prevention, testing and treatment services. Both male and female sex workers in the district face stigma and discrimination in the communities and in healthcare centres because in Lesotho prostitution is illegal.
This publication had interviews with both male and female sex workers and patrons in Qacha’s Nek on the sidelines of a conference on Gender Based Violence, the spread of HIV and non-observance of Human Rights held in Qacha’s Nek by the National Aids Commission.
NAC held a training workshop in Qacha’s Nek to engage community leaders; chiefs, community councillors, church leaders and traditional healers to provide a safe and supportive environment for people living with HIV and to advocate for modification of harmful cultural practices and norms that place communities in Qacha’s Nek at risk of HIV infection.
It is late afternoon at Ha Mpiti, a village one could label as a ‘prostitution hub’, about 6 km from Qacha’s Nek town and the area starts to be busy with tourists finding their way to Sehlabathebe National Park. Truck drivers stopping by the main road to get food and young women and men getting ready to go the taverns where their sex services would be bought.
Standing by the wall near a shack where local food is sold, there is a lady in a short dress, long hair, make-up and high heeled shoes. Although I was uncertain whether the lady was a sex worker or not, she was outstanding with the way she was dressed as compared to young girls around Ha Mpiti.
As the evening was approaching, NAC officers approached her to talk to her about issues of HIV/AIDS and consistent usage of condoms and lubricants.
Even though she denied being a sex worker she seemed to have full details of how prostitution works in Qacha’s Nek. Lisemolo (not her real name) said young women and girls are faced with unemployment and young women and girls face hunger more often than men.
This is due to disparities in income, limited access to opportunities or means of production and cultural practices and norms that put them last on the priority list.
A male sex worker who spoke to this publication on condition of anonymity to avoid discrimination for being gay and because sex work is illegal in Lesotho said discrimination against men who have sex with other men discourages early diagnosis of HIV.
He said discrimination from healthcare workers and society limits their access healthcare or treatment thereby increasing the risk of transmission of HIV/Aids.
“We are scared to go to clinics because of being discriminated against not only by our communities but also by healthcare workers. Men who have sex with men experience unnecessary suffering from untreated conditions because of psychological distress,” he said.
This reporter also spoke to two clients looking for sex workers. Liteboho Monaphathi and Motlalepula Ralekuku said they come from Quthing and Mafeteng respectively and left their families for work.
“I left my wife and children at home and in order to satisfy my sexual desires I buy sex from prostitutes. I know about the risks; I know the importance of consistent usage of condoms but access to sufficient supply of condoms is a problem around here. Even the ones which are sold are a problem,” Ralekuku said.
According to Monaphathi, sex work is criminalised, leaving sex workers and their clients unprotected by the law and exposed to human rights violations.
“There is a military camp not very far from here and soldiers from that camp assault civilians who afford to buy sex from sex workers claiming that it is illegal but surprisingly they violate the sex workers into having sex with them without paying them,” he said.
NAC making strides
The meeting, according to NAC Communications and Advocacy Officer, Miss Mozondase Tsepane is an initiative which seeks reduce new HIV infections among Basotho due to their practices and norms.
“Community leaders are intended group for intervention because they can play a major role in advocating and driving social mobilisation initiatives that address HIV/AIDS and Gender Based Violence,” Tsepane said.
Tsepane said community leaders have unparalleled authority and influence. Therefore, they can play a central role in addressing harmful practices in the context of HIV while also preserving core values and culture.
Miss Tsepane said Lesotho has achieved the first of the UNAIDS 90-90-90 targets and surpassed the second and third targets. “The LePHIA 2020 findings prove that Lesotho is on track to achieve UNAIDS targets by 2025,” Tsepane said.
She said she understands why HIV has become a tiring subject. “We have lived with it for more than three decades. It was once a mysterious new and fatal disease but now it is treatable chronic illness but Lesotho remains the second highest HIV prevalence in the world.”
According to Tsepane, NAC efforts are mainly to give effective coordination of HIV response in the quest to end AIDS in Lesotho by 2035.
Sex workers in Qacha’s Nek are more vulnerable to HIV/AIDS. Yet, in Ha Mpiti, a sex-work hub village face huge barriers to HIV prevention, testing and treatment services.
Sex work is illegal in Lesotho and sex workers face stigma and discrimination in their communities and healthcare settings. They are also at constant risk of having their human rights violated.
High risk groups
Sex work 79.1%
Factory workers 42.7%
Men who have sex with men 32.9%
Prison inmates 31%
Pregnant women 25.9%
General population 23%
Young women 10.2%
Young men 5.9%
Making strides
In spite of the challenges, the situation in Qacha’s Nek is steadily improving because of the joint efforts of National AIDS Commission, and the government of Lesotho through ministries of Health and of Gender, Youth, Sports and Recreation.
Overcoming the challenges
NAC initiates public gatherings not only to engage people living with HIV but also to engage community leaders, namely; chiefs, community councillors, church leaders, and traditional leaders for delivering services to at-risk groups.
The commission ensures that people living with HIV have access to quality HIV testing, treatment and care services in an environment free of stigma and discrimination.
NAC has also successfully advocated for government HIV programmes tailored to the needs of at-risk groups such as factory workers, sex workers, men who have sex with other men and prison inmates.
