Strategies to overcome barriers of accessing Post Exposure Prophylaxis (PEP) by sex workers

Saturday, 16 November 2013

Malmsey Sengane, PhD
Department of Nursing Science, University of Limpopo (Medunsa), Pretoria, South Africa
Prince Nare, Honours in BSc Sociology
Tshwane Learning Centre, University of Pretoria / Tshwane Learning Centre, Pretoria, South Africa
Anna Mokwena, M.Cur
Jubilee Learning Centre, Jubilee Learning Centre, Hammanskraal, South Africa

Learning Objective 1: Identify barriers that sex workers face in accessing PEP.

Learning Objective 2: Describe strategies that nurses utilise to overcome the identified barriers in order to prevent unplanned pregnancies and sexually transmitted diseases.


Adult sex workers, irrespective of whether their work is considered criminal or not, should be afforded the same access to health, psycho-social and justice services guaranteed to all people in South Africa under national and international law. Across sub-Saharan Africa, sex workers are marginalised and face gross human rights violations, discrimination, harassment and numerous barriers to accessing healthcare such as a dearth of information, delays at police stations and hospitals, and uncertainty about legal duties, which obstruct rape survivors’ ability to access PEP.


To enhance sex workers access to preventative and promotive health services by developing nursing strategies to overcome the barriers they face in accessing PEP. 


A qualitative, explorative, descriptive and contextual research design was used.   Participants were sample purposively using snowballing until saturation of data was achieved.  Adult sex workers who had worked for a minimum of 12 months and working in specific areas in the South Africa were included.  Data were collected using semi-structured interviews and focus groups.   Audio recorded interviews were transcribed verbatim and analysed using Tesch’s method.  Ethical approval was obtained from the relevant International Review Board, and confidentiality was maintained throughout. Trustworthiness was enhanced through, prolonged engagement and persistent observation, method triangulation, member checking, audio-recording and keeping an audit trail. 


The barriers sex workers face when accessing PEP health services are illustrated and strategies nurses could use to address these barriers will be described.


Sex workers are a vulnerable population who have the right to access health services without discrimination and marginalisation.  Nurses should be mindful of the barriers that prevent sex workers from accessing vital preventative health services, in order to provide comprehensive quality care to this vulnerable population.