Health is a Right: Removing Barriers to Care for Sex Workers in Nyanza
For many sex workers in Kenya’s Nyanza Region, walking into a health facility is not a simple act. It can mean risking exposure, judgment, and outright refusal of care. Nurses who ask intrusive questions. Doctors who lecture instead of treat. A system built around assumptions — and none of those assumptions favour sex workers.
KISWA exists, in part, to change that reality.
What the Barriers Look Like
Stigma is not abstract. It shows up in waiting rooms where sex workers are made to feel unwelcome. It shows up in the reluctance to carry a health card that identifies your occupation. It shows up when someone delays seeking treatment for a wound, an infection, or a screening — because the last time they tried, they were shamed out of the door.
For sex workers living with HIV, the stakes are even higher. Inconsistent access to antiretroviral therapy, fear of disclosure, and the trauma of stigmatising encounters all contribute to gaps in treatment that can be life-threatening.
Add to this the economic pressure many sex workers face — choosing between transport to a clinic and food for the day — and the picture becomes clear: healthcare access is not just a medical issue. It is a justice issue.
What KISWA Does
Since 2014, KISWA has worked alongside sex workers in Kisumu, Siaya, Homa Bay, Migori, and Kisii to bridge the gap between community members and the health services they are entitled to.
Our work includes:
- Peer-led outreach — Trained peer educators who reach sex workers where they are, with accurate health information and referrals to friendly services.
- Harm reduction support — Facilitating access to condoms, HIV testing, and linkage to treatment without judgment.
- Capacity building — Training sex workers to understand their rights as patients, so they can advocate for themselves when they walk through that clinic door.
- Relationship building with health facilities — Working with providers to foster more respectful, competent care for sex workers.
The Bigger Picture
Kenya’s Constitution guarantees every person the right to the highest attainable standard of health. That guarantee does not exclude sex workers — even if the system has often treated it as though it does.
KISWA’s approach is not charity. It is rights-based. Sex workers are not passive recipients of services. They are agents of their own health, equipped with knowledge, networks, and collective power to demand what the law promises them.
When a sex worker in Kisumu can walk into a clinic and receive dignified, competent care — that is not a small thing. That is the vision in action.
