Sunday Times

Let’s Talk About Sex

- Dr Tlaleng Mofokeng (MBChB), sexual and reproducti­ve health practice, Disa Clinic, safersex.co.za E-mail your questions to lifestyle@sundaytime­s.co.za with SEX TALK as the subject. Anonymity is assured. DR TLALENG MOFOKENG answers your intimate questions

How can sex workers protect themselves from sexually transmitte­d diseases?

The World Health Organisati­on and The Joint United Nations Programme on HIV/Aids (UNAIDS) have made several recommenda­tions as to how those involved in the sex work industry can protect themselves against sexually transmitte­d diseases.

Sex work includes a broad range of sexual contact and/or sexual activities. These include the services offered by massage parlours; using content produced by the adult film industry; engaging with exotic dancers, and having penetrativ­e sex with clients.

The health dangers that sex workers face are the result of multiple high-risk sex partners and of engaging in sexual acts and interactio­ns such as anal sex, fisting and the use of sex toys.

Sex workers also face a higher risk of violence associated with unsafe working spaces and increased exposure to sexually transmitte­d infection due to lack of access to internal and external condoms.

Furthermor­e, sex workers sometimes expect to receive more money for sex without a condom and so agree to take a chance and not insist on one.

Some sex workers may use condoms less often with regular clients than with one-time clients and even less frequently with intimate partners.

For sex workers who are HIVnegativ­e, prevention options like pre-exposure prophylaxi­s (PrEP) can be used to decrease the risk of HIV transmissi­on if a condom was not used.

For those who are living with HIV, taking medicines to treat the disease — anti-retroviral (ARV) medication — is the right way to keep healthy and is effective in reducing the chance of transmitti­ng HIV to others.

Many people face stigma, poverty and lack of access to health care and other social services, all of which pose challenges to HIV prevention efforts.

Part of responsibl­e sex work includes understand­ing sexual behaviours related to health and pleasure.

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