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on a positive impact

Stories Worth Sharing: HIV Peer Educators on Combatting Stigma, Creating Hope, and Inspiring Change

ByDimitri Bois, 2018 J&J Secondee

In Mlolongo, Kenya, it’s hard to miss the wine and spirit stores, miraa dens, brothels and strip clubs that line Madharau street, or “malicious” street. Mlolongo is a city located along the Nairobi-Mombasa Highway, about 20 kilometres from Nairobi. It is an area well-known for sex work and North Star Alliance, a Flagship Partner of the J&J Global Community Impact team in Europe, the Middle East and Africa, alone cares for more than 2,800 sex workers in the area.

As a Johnson & Johnson employee, I have had the opportunity to analyse healthcare systems and address their challenges every day. However, I rediscovered it in a bright new light when I joined the North Star team this past March through the Johnson & Johnson Secondment Program and began collaborating closely with the people at the front lines of care. Walking through Madharau street was not something I envisioned doing when I thought about “being on the front lines of care,” but my Secondment experience has taught me that going the extra mile to reach vulnerable and mobile populations who need care the most is indeed a major component of successful healthcare delivery.

Collaborating at the heart of care

Based in Nairobi, Kenya, I support North Star Alliance by designing an efficient and aligned stock management system across East and Southern Africa. Working with Dirk Tuchbreiter, another J&J Secondee with North Star Alliance currently based in South Africa, my goal is to remove as much bureaucracy as possible so that North Star’s frontline health workers can focus on what really matters: caring for people. It has been a real privilege to learn from North Star’s team of clinical officers, community outreach coordinators, and peer educators, and experience the impact of the work they do as well as the challenges they face.

HIV: still a huge challenge

Ninety million people around the world are infected with HIV and more than half of them live in sub-Saharan Africa. This week, our community comes together for the 22ndInternational AIDS conference in Amsterdam to discuss what remains one of the biggest health challenge of our time. As we address and recognize the interventions that are advancing progress and providing hope, I also wanted to cast a light on the people on the other side of the care system: the recipients of care.

Spotlight on sex workers’ stories

Accompanied by Timothy and Ruth, outreach coordinators at Mlolongo Clinic, I had the opportunity to interview two sex workers who became North Star peer educators. They shared more insight into their day-to-day lives, the obstacles they have faced, and the hope and change they are providing their communities.

Here are the stories of Betty and Shiro. Please note that some details in the story have been changed to maintain their anonymity.


Why did you start sex work? What are the main challenges you face?

Betty: I started sex work when my husband died. With four daughters and no source of income, I had to find a way to support my family. I moved to Mlolongo because I knew there would be many clients in this area. Unfortunately, stigma still remains part of my life as a sex worker. There is also a lot of addiction within the hotspots that I work, especially to alcohol and khat [a stimulant popular across Africa].

How did you learn about North Star Alliance and become a North Star peer educator?

Betty: At first, this work was very difficult for me because I did not know how to negotiate, and I was very shy. I was misused, and I contracted syphilis. However, there, I met other sex workers who are also North Star peer educators. They taught me how to stay safe in my line of work and how to use a condom, and they empowered me with the skills and knowledge, so I could better manage my relations with clients. This experience made me realize I wanted to be a peer educator too, to help other women in my situation better understand the risks of our work and how to prevent them.

Shiro: When I first discovered I had contracted HIV through my former partner, I was devastated, and I thought I would die really soon. I left him and to sustain my mother and children’s needs, I began a life of sex work. It was through this that I met a North Star Alliance peer educator who invited me to join a support group for people living with HIV. Through this network, I learned that there were solutions to help you live happily and successfully even with HIV. I heard incredible stories of people living normal lives with HIV, even young women delivering their babies without HIV transmission. This group motivated me to start ARVs and since then, I have never defaulted. It has been ten years now, and I am grateful to still be alive and in good shape. My viral load is very low now and I hope to live a long life.

How do you deal with stigma regarding sex work and HIV? How do you manage your day to day life with your family life?

Shiro: My family does not know I am a sex worker. They think I am in sales, and I go back to my village to see my children and my relatives only a few days in a month. Then I come back to Mlolongo.

My family knows that I am HIV-positive, and I’m comfortable disclosing it outside of Mlolongo in some training groups to increase awareness. It was through these peer groups that I was taught about living with HIV, and I’m proud to help others be empowered by knowing their status and finding ways to live life to the fullest.

About the Johnson & Johnson Global Community Impact Secondment Program

Johnson & Johnson Global Community Impact invests in people on the front lines of care as they change the trajectory of health for the world’s most vulnerable people, their families, and their communities. We are inspired to help create a world where people, no matter their circumstances, have access to quality health care. The Secondment Program is a long-term collaboration between Johnson & Johnson, our employees, and our NGO partners to invest in and build the skills of people on the front lines of care in Europe, the Middle East, and Africa. Through full-time field assignments of up to six months, Johnson & Johnson employees transfer their knowledge, expertise, and passion to our partners at the heart of delivering care, uniquely give back to society, and change the trajectory of human health. Learn more here.