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Program Referral Network Connects Sex Workers and HIV Counselors

“I have them tell me everything as if they were speaking to their mother.”
– Sister Belaynesh Aberra, HIV Counselor in Mekele, Ethiopia

Sex workers in the city of Mekele often see HIV/AIDS counselor Sister Belaynesh as a mother figure. Many commercial sex workers—many without family of their own— go to the downtown Mekele Health Center where she works to get tested, and more often than not, to simply talk to someone who will listen.

“I have them tell me everything as if they were speaking to their mother, and they do,” she explains. With over ten years of experience in HIV/AIDS, Sister Belaynesh knows a thing or two about the psychology of at-risk populations for HIV/AIDS.

She is currently working in conjunction with EngenderHealth’s HIV prevention program known as most at-risk populations (MARPs) in high prevalence urban areas in Ethiopia. The goal of the program is to reduce the risk of HIV transmission among adult and young populations involved in transactional sex, and the program’s primary targets are commercial sex workers.

“Just last week a girl came in distraught and crying. Apparently, the condom came off with one of her customers, and she was scared she may have been infected with HIV,” according to Sister Belaynesh.

“After she tested negative for HIV, we talked about her getting tested every three months and finding another job with less risk of infection,” she said. “She was so happy to learn she was not infected, and it makes me proud to be a part of her life.”

Sister Belaynesh is also an important part of the referral system implemented by EngenderHealth’s MARPs program in Mekele, located in Northern Ethiopia.

First, commercial sex workers are encouraged to use the local drop-in center to rest and receive health information. At the drop-in center, they can prepare food and socialize in a supportive environment, a welcome change to bars and hotels.

Second, the drop-in center staff give the women health referrals for HIV testing, antiretroviral therapy, mother-to-child transmission prevention and family planning. Each service is offered free of charge by the municipality or paid for by the program.

“Many of the women do not have the money to pay for these services, but the main problem is that they don’t want to be seen in a public health center,” according to the Mekele city health facilitator, Gebremedhin Legesse.

MARP programs work in conjunction with the city’s health bureau, which funds certain services and assists in coordinating the health task force.

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