By Risto Mushongo
It is one thing to have desire of keeping one’s HIV viral load low and another to adhere to treatment. This is especially difficult for sex workers who, due to different circumstances, have a likelihood of defaulting from treatment and missing clinic appointments. However, innovation has made it easier for Key Populations to keep track of their follow-up dates and adhere to treatment. The USAID Key Population – Strengthening Technical Assistance and Response for sustainable HIV prevention and treatment (KP-STAR) project implemented under the leadership of IntraHealth Namibia is making use of an online platform called QuickRes to help clients assess their sexual health needs and book for HIV services in Namibia. The platform also reminds clients of pending appointments and medicine pick-up dates through text messaging or SMS.
Testimony to how brilliantly this application aids in adherence to treatment is the story of a 29-year-old sex worker from Rundu, Lucia*. Lucia started sex work seven years ago after completing grade 12 at a secondary school in Kavango West.
Lucia who resides in Kaisosi, a location in Rundu, with her three children aged twelve, six and a one, says peer pressure forced her into sex work after grade 12
“Life after school was not easy for me. After grade 12 my mother, who sold fat cakes to pay for my school fees, told me that she could no longer support me, thus I had to find ways of making money to take care of myself, Lucia said, adding that while in school she saw sex work as something done by people with low or no income. This was until I met friends who are teachers and they told me that they do sex work as a profession. I started hanging out with them and this is how I started sex work,” she says.
Lucia further says that making money as a sex worker is hard given that one must go look for clients in bars. “If you are lucky, you will make N$500 a night. This is how I make a living to support my three children,” Lucia says. In December 2015, Lucia tested positive for HIV and was subsequently initiated on Antiretroviral Therapy (ART). She, however, admits that being a sex worker while on medication is hard, especially, because some clients take them out of town, causing them to default on medication. “You forget that you are on medication, just, because you are offered money. Imagine having to think of follow ups and at the same time thinking of how to make money. Some potential customers do not even want to see you taking medication. Therefore, we do not carry our health passports when travelling out of town with clients, because we fear that they will notice,” she says, adding that this causes them to forget their follow-up dates at health facilities for drug refill and viral load check. “We are going through hardship and people without treatment supporters suffer a lot,” an emotional Lucia says with tears rolling down her face.
Defaulting on treatment and forgetting follow-up dates is no longer Lucia’s problem. She was introduced to the KP-STAR project by a friend who was recently enrolled on ART with the help of a Peer Educator from the Society for Women Empowerment Trust (SWET), an implementing partner under the KP-STAR project. “My friend informed me about SWET and what they do with clients on their case management. She also told me that she will be receiving an SMS that reminds her of her appointments which I think is a good thing. I then asked her to link me up with the Peer Educator, who assisted her, for the same services,” Lucia narrates.
According to Lucia, she has been receiving medication for one month only, ever since she was initiated on ART, because of missing appointments. “I used to miss out on my appointments and focus on men who will give me money. However, QuickRes has made my life easier. I don’t need to carry or check my health passport for my next appointment, because QuickRes sends me a reminder. And the good thing is that I do not need to have a smartphone to receive these reminders, any phone can receive the SMS. With QuickRes I never miss my appointments at the clinic. Even as we speak, I just received an SMS that my next appointment is on 14th of May 2022,” she said with a smiling face while showing the text message from QuickRes.
SWET Founder and Director, Isabel Somp emphasis that the online platform has potential of changing many Key Populations’ lives and encourages them to make use of the platform.
“QuickRes is a great platform that has helped us reach a lot of clients in our program. The number of clients who had interruption in treatment has also reduced because our clients are reminded by the App about their follow-up dates. This is a great success, and we want more people to make use of the platform,” Somp says.