South Africa’s 55,910,000 population comprises the world’s biggest HIV epidemic: an unusually high 18.9% adult people living with HIV (PLHIV)—varying by region—and 270,000 new infections in 2016. Nationwide 320,000 children are infected.
Men who have sex with men (MSM), transgender women, sex workers and people who inject drugs (PWID) experience even higher rates: sex workers nationally 57.7%, in Johannesburg an astonishing 71.8%., yet not many are getting Antiretroviral therapy (ART). The rate of infection among young women is 4 times greater than among same-age men.
High levels of stigma, homophobia and ignorance prevent many people living with HIV (PLHIV) from getting the health care they need.
Yet there is ground for hope. South Africa has the largest Antiretroviral therapy (ART) program in the world, a huge investment. It was the first country in sub-Saharan Africa to approve PrEP. It now has a progressive national HIV policy for sex workers, although on the ground, the program meets resistance from local authorities.
(Figures from AVERT, 2016)
FLORENCE AND BRILLIANCE
Johannesburg, South Africa
Florence (42) and Brilliance (26) are half-sisters from Zimbabwe who are sex workers in a Johannesburg club. Both women are infected with HIV. For their checkups and medication they visit a North Star Alliance container clinic at a truck stop, a few kilometers outside the city.
We went out one day along with the women. We spoke with them, ate with them and visited some important places in their Johannesburg lives. During the photo shoot at the park, we unexpectedly witnessed the danger and violence, which the women face almost daily: suddenly an angry man was standing before us, his pistol aimed at Brilliance. We escaped in our car and managed to get away unharmed. Brilliance and Florence were as upset as we were, but recovered a lot faster from the incident. They said they especially enjoyed this free day.
Florence (L) Brilliance (R)
My name is Brilliance. I’m 26. I have two children, two girls. My firstborn is 8 and my second is 3. Yes, I miss them. My firstborn is staying in Zimbabwe with my mother. My second is staying with her father.
I came to South Africa in 2014. First I worked as a housemaid, but there was not enough money. So now I work in this business. I’m my family’s eldest, so I am responsible to support my family. I support my children, my mother and my brother.
I’ll go back to Zimbabwe in December to see my girls.
And my name is Florence. I’m 42. I live in South Africa for the past 2 years. I have five children, three boys and two girls. They live in Zimbabwe with my housemaid, because my mother passed away 6 years ago. I support them for everything. I pay for food and help and a salary. There are a lot of people I support in Zimbabwe.
In Zimbabwe I was working as a bank clerk, but there was no work anymore. Then I moved to South Africa and now I work in a club. I have a room there. During the week I work from 11 o’clock in the morning to 7 or 8 at night. Friday and Saturday we start at 10 and work till midnight or 1 or 2 o’clock at night. Sometimes I don’t work, because I want my body to relax. I pay a fifth of the money I make to the place for rent, and the rest is mine. I make 1000 or 1500 rand daily, but weekends I make 3 or 4000 rand. (about 200 US dollar) I don’t live in the club. I have my own place.
No, I don’t live with Florence. I have my own house. I only stay with Florence on weekends, because it’s not safe on the street. I work in the same club. It’s a safe place. There is security. If there is a problem, then they want to protect me.
It’s a hard job, but you don’t have a choice. I need the money because I want to keep my family happy.
I’m not scared. I’m happy. I’m always happy. No one is going to make you happy. You must make yourself happy. Today is a happy day. Today is a good day. We don’t work. We just talk.
Florence: When Brilliance and I go out, we go shopping. Brilliance gives me advice. Always advice. She says: you have to buy this and do this, and this and this… We support each other. We’re sisters. We always support each other.
Brilliance: Yes, I always support her. I support my sister because I became positive in 2012…
Florence; I am positive 4 months. Only 4 months.
Brilliance: I was pregnant with my youngest, seven months pregnant. That’s when they told me. My CD-4 count was 400 and going down, and I had a headache every day. A white doctor gave me the tablets. I still take them every day. Now I feel healthy.
Florence: I got it from my husband. He did not tell me. He was drinking ‘kotch’ [antibiotics] all the time. I asked him: why are you drinking ‘kotch’? And then he told me that he was positive. Yes, I was angry with my husband. Why didn’t he tell me? But now, not so much…
Brilliance: Yes, my youngest is negative. She is healthy. And my firstborn is healthy too.
Florence: All my kids are healthy. But my youngest has to go to the doctor for another test. The first test was negative. His second one was negative. Now he has to go for the third test.
Brilliance: I want to go back to Zimbabwe. I’ll work three years more. Then I’ll go back and start a business. I want to sell clothes or something. And I want to have a house for myself. Just for my own family and myself.
I know how to protect myself. If you protect yourself you survive for a long time. I want to survive. But men don’t like protection. They want to fuck without a condom. They say they know their status. But you have to be careful, because you don’t know.
I’m not worried. I give my life to God. I take care of myself and I pray every time. When it’s time then God will decide. But it’s not time. God is not taking me. He is not punishing me. And I want to survive…
I have to tell my husband and my brothers and my sister that I’m HIV positive. When I am back in Zimbabwe for Christmas, then I will tell them. I’m not afraid to tell them, because I know they will support me.
I’ll work for two years more in the club. Then I’ll be 46. That is too old to work in this profession. Then I’ll go back to Zimbabwe. I want to built a hotel and a house. And I want to stay with my children.