The effects of COVID-19 on the health and socio-economic security of sex workers in Nairobi, Kenya: Emerging intersections with HIV

Abstract

The COVID-19 pandemic, and its attendant responses, has led to massive health, social, and economic challenges on a global scale. While, so far, having a relatively low burden of COVID-19 infection, it is the response in lower-and middle-income countries that has had particularly dire consequences for impoverished populations such as sex workers, many of whom rely on regular income in the informal economic sector to survive. This commentary captures the challenges in Kenya posed by daily curfews and lost economic income, coupled with further changes to sex work that increase potential exposure to infection, stigmatisation, violence, and various health concerns. It also highlights the ways in which communities and programmes have demonstrated resourcefulness in responding to this unprecedented disruption in order to emerge healthy when COVID-19, and the measures to contain it, subside.

Access to Healthcare in a time of COVID-19: Sex Workers in Crisis in Nairobi, Kenya

“…For example, in the UK context, Howard (2020) highlights reports from sex worker rights organisations indicating sex workers were missing crucial sexual and reproductive health services products during the lockdown (also see Sanders, 2020). Kimani et al (2020) highlights some of the effects of COVID-19 on the health and socioeconomic status of sex workers in Nairobi, based on observations of healthcare providers and programme implementers of sexual health programmes for sex workers in Nairobi, to which this paper adds empirical evidence.…”

“…Reports by the International Planned Parenthood Federation (IPPF) suggest that COVID-19 impacts including closure of their 5633 static and mobile clinics and community-based care outlets in 64 countries has disrupted access to sexual and reproductive healthcare for millions of women and girls (IPPF, 2020). Kimani et al, (2020) observe that COVID-19 was deepening existing stigmatisation of sex workers as new forms of stigma were emerging whereby sex workers were being viewed as potential spreaders of the coronavirus in their communities. They further observe that this heightened stigma at a time of COVID-19 may further hinder sex workers' access to healthcare services.…”

Sex Workers Should not Be Forgotten in Africa’s COVID-19 Response

“…8,9 Because of relative collapse of their industry, some sex workers are unable to afford rent or alternative forms of shelter, making them further vulnerable to harassment and exploitation. 10 Sex workers do not also have access to employment insurance or many of the recent governments' emergency support and rent assistance for citizens, 11 and because of the cultural criminalization of sex work in Africa, they are not entitled to various COVID-19 social services and safety net. They are also often denied help, further reiterating poverty, inequality, and marginalization among this group.…”

“…17 They are becoming increasingly worried about their health, 18 and those living with HIV are greatly concerned that their prior condition, with its negative effects on their immune system, will make them especially vulnerable to contracting COVID-19 and may worsen their health. 10 With the adoption of the 2030 Agenda for the UN Development Program, UN member states all pledged to ensure "no one will be left behind" and to "endeavor to reach the furthest behind first." 19 This could not be more important than now as sex workers as a part of the population are left behind in COVID-19 response in Africa.…”

Strategic use of patent opposition safeguard to improve equitable access to innovative health technologies: A case study of CAR T-cell therapy Kymriah

“…Yet the procedure is managed essentially by hospitals and could therefore be considered a medical procedure. These two modifications could have important consequences with regard to the reach of intellectual property rights' (Kimani et al, 2020). Similarly, Abinader and Contreras noted in their 2019 paper that CAR-T and other recent gene and cell therapies, which operate based on the extraction of genetic or cellular material from a patient, the alteration of such material, and the reintroduction of such material to the patient's body, should … be considered medical treatments.…”