Programme
Health information, safe spaces, protection from violence, and advocacy for clinics where women can seek care without being judged.
Why this work
Women in sex work face a higher risk of HIV than almost any other group. The reason is not a lack of information about condoms.
It is pricing. Clients pay less for protected sex and more for unprotected sex. A woman supporting a family, or carrying dependants who rely entirely on her income, is being offered money to accept a risk she already understands.
Health messaging that ignores this does not work. Any response that takes the economics seriously has to offer something other than a warning.
Prevention advice that ignores why a woman accepts the risk is advice she has already heard and already priced.
What we did
Information without safety fails. Safety without income fails. We worked across all five because the women told us which ones mattered.
We mobilised women for sessions covering sexual and reproductive health, with HIV prevention and transmission risk running through them. The sessions were practical and specific rather than general awareness-raising.
Some women already knew their HIV status and were not on treatment. We held safe space sessions where women who are on antiretroviral therapy spoke to those who were not — about what treatment is actually like, and about reaching viral suppression.
Hearing it from someone in the same position works where a leaflet does not.
Women in sex work in this county face serious violence, including attacks on those known or believed to be living with HIV. This is part of the daily risk they carry, and it shapes whether they will seek health services at all.
Through community outreaches we brought women together with the County Health Management Team, who provided direct contact numbers for reporting threats and attacks. Knowing who to call, and having the number before it is needed, is a small thing that matters enormously.
Because the risk is driven by income, we supported women with small grants to start businesses — a route out of work that carries this level of danger.
This is the strand we would most like to expand. It addresses the reason women accept unprotected sex in the first place.
We connected women to health facilities where they could access sexual and reproductive health services without fear, and to service providers who would treat them decently.
We also advocated for friendly corners inside health facilities: places where a woman can collect condoms without being watched, describe a symptom without a reaction, and ask a question without being lectured. Judgment at the counter remains one of the biggest barriers to care for this group.
What comes next
New HIV prevention options are reaching Kenya. Whether they reach the women who need them most depends on what happens at the clinic door. These are the three things we want to carry forward.
Service points where women can seek sexual and reproductive health care without judgment. We are taking this to the county health team as a standing ask, not a one-off request.
New prevention options are only equitable if they actually arrive. We want to track whether they reach the facilities this community uses, and report back what we find.
The small business grants worked. Scaling them is the most direct way to reduce the risk women are being paid to accept.
We are looking for health partners, facilities and funders who want to make sexual and reproductive health services genuinely reachable for women who are currently turned away by how they are treated.
Get in touch About our work