Sex Worker Programme (SWP)

Overview

The Centre for Community Impact (CCI), through Sub-Recipients, implements the Sex Worker Programme (SWP). This is part of South Africa’s national response to HIV, TB, STIs, Gender-Based Violence (GBV) and Human Rights violations affecting Sex Workers (SWs), their families and clients. Funded by the Global Fund (GF), the programme delivers a comprehensive, rights-based and peer-led package of services across 18 priority districts in 8 Provinces. The programme reaches all typologies of sex workers and specific high-vulnerability sub-populations. The aim is to reduce HIV, TB, STI and GBV among sex workers through comprehensive implementation of biomedical, structural and behavioural interventions. This work is closely aligned with the goal of the recently finalised National Sex Worker HIV, TB and STI Plan 2023-2026.

The programme targets female, male and transgender sex workers. It also includes the following High-Vulnerability Sub-Populations: sex workers who are parents, Young People Who Sell Sex, Children of Sex Workers, Sex Workers Who Inject Drugs (SWID) and Clients of Sex Workers.

Where & How We Work

The Sex Worker Programme reaches 18 high-burden districts nationally,across the 8 provinces, delivering services through a network of Sub-Recipients, operating at district level as follows:

The programme aims to achieve district saturation, maximising the reach of sex worker population over the grant period (October 2025- March 2028) through intensive outreach and cohort management.

What We Do

By integrating biomedical, behavioural and structural interventions, the programme aims to improve health outcomes, protect human rights and strengthen systems of support for sex workers and their families.

Biomedical Interventions

Our services are designed to complement public health systems. Our focus is on provision of lubricants and condoms, HIV Testing Services, risk assessments as well as TB screening and STI screening. The layered services include: HIV self-screening, pregnancy testing, annual pap smear, emergency contraception, Pre-Exposure Prophylaxis (PrEP), Antiretroviral Therapy (ART), periodic presumptive treatment for STIs, TB treatment, Post-Exposure Prophylaxis (PEP), hepatitis B screening, mental health services, rectal care cervical cancer and HPV awareness, screening and referrals and Noncommunicable Diseases (NCD) screening and referral. Strong referral and navigation systems ensure continuity of care through Department of Health facilities.

Behavioural Interventions

The activities include the following core and layered services:

Core activities include small groups activities (PSS, counselling, parenting skills, PrEP./ART, TB adherence, Youth support groups, substance use programmes and support), Harm reduction for sex workers who inject drugs, parenting programmes for SWs who have children.

Layered services focus on providing ssupport for effective PrEP use, emotional & psychosocial support and parenting programmes for sex workers who have children. Teen parenting programme for young women who sell sex and Substance use programmes and support. This supports treatment initiation, adherence and retention in care.

Structural Interventions

Gender Based Violence awareness and screening services are central to the programme. The layers include: Dignity packs / menstrual health, Family health days, Gender, power and condom negotiation, and a Mechanism to report and record human right violations. Legal services to enhance access to justice, post-violence care, Interventions for young people who sell sex, Prenatal and Postnatal Support are also at the heart of our work. In GC7, the SWP seeks to integrate human rights and gender in the routine provision of comprehensive services. The SWP provides a structured package of rights-based, gender-responsive interventions to ensure equitable access to services including psychosocial and legal services for sex workers in their diversity. The Human Rights and Gender component is integrated within the Sex Worker Programme to champion the following:

  • Removal of human rights–related barriers to services
  • Community-led monitoring
  • Gender equality and GBV prevention
  • Legal literacy and paralegal support
  • Stigma and discrimination reduction
  • Community systems strengthening

The goal for this integration is to reduce HIV incidence, improve health outcomes and protect the human rights of sex workers through comprehensive, rights-affirming and gender-responsive services.