Across Namibia, the lived realities of sex workers are shifting in ways that are often unseen, undocumented, and misunderstood. Through the voice of Rachel Love Gawases, an activist, community leader, and transgender sex worker, these experiences reveal a deeper story of resilience, loss, and survival.
Namibia remains one of the countries most affected by HIV in Southern Africa, with an estimated adult prevalence of 9.7% according to the Centre for Disease Control {CDC). Yet within this national picture, key populations such as sex workers continue to carry a disproportionate burden.
“I am an activist, mentor, motivator, leader, and a current transgender sex worker working closely with sex workers in Namibia. My work focuses on human rights, access to health & justice services, and strengthening community systems to ensure sex workers are meaningfully included in health and policy responses,” Gawases says. “Above all, I take pride in advocating for decriminalization of sex work and recognition thereof.”
Her story is not just her own. It reflects the broader experiences of sex workers navigating daily life in a changing and increasingly constrained environment.
For many sex workers in Namibia, daily life was never easy, but it was more manageable when community-led systems were in place.
“Before funding reductions, daily life, while still challenging, was more stable,” Equal Rights for All Movement Executive Director Gawases explains. “Sex workers had relatively consistent access to outreach services, peer educators, and safe spaces.”
These services formed part of everyday survival, offering HIV testing, treatment support, prevention tools, psychosocial care, and legal assistance. Peer-led approaches helped build trust and ensured that people stayed connected to care, as evidenced by the Namibia Ministry of Health and Social Services, which shows that between 46.9% and 73.6% of sex workers were reached by prevention programmes in earlier years, highlighting the scale and importance of these interventions.
“The journey has been marked by resilience,” she says, speaking about sex workers living with HIV, “but also systemic barriers such as stigma, criminalisation, and inconsistent service delivery.”
Today, those lived realities are changing.
“There have been disruptions, particularly in community-based support systems,” Gawases notes. “While public health facilities still provide ART, the loss of community linkage systems has made consistent access more difficult.”
Namibia has made significant progress in expanding access to treatment, with the CDC reporting that over 197,000 people are receiving antiretroviral therapy (ART) nationwide. However, access alone does not guarantee adherence—especially for communities that relied on peer support.
Without outreach and peer support, maintaining treatment routines has become harder.
“Adherence has been negatively affected for some, particularly those who relied on peer support for follow-ups. Interruptions in support systems increased the risk of defaulting and poor health outcomes.”
What once existed as structured support has diminished.
“There has been a noticeable reduction in outreach activities, fewer to no peer educators, limited access to prevention commodities, and reduced psychosocial and legal support services.”
Services like mobile clinics, peer navigation, and condom and lubricant distribution are no longer reliably accessible. The lived realities extend beyond health; they shape livelihoods, families, and futures.
“Reduced support has increased economic vulnerability,” Gawases explains. “Without integrated support services, many struggle to balance income generation with health needs, which directly impacts their ability to care for their children.”
Within households, the effects are tangible.
“Children are indirectly affected through reduced household stability. This may manifest in disrupted schooling, limited access to nutrition, and reduced healthcare access.”
Parents are often forced into difficult trade-offs as some parents have had to prioritise immediate survival needs over long-term investments such as education or preventive healthcare.
Even where services exist, barriers persist.
“Access exists through public systems, but barriers such as stigma, lack of documentation, and financial constraints can limit utilisation.”
For many, the hardest parts of these realities remain invisible.
“They face layered stigma (HIV status + occupation), fear of disclosure, inconsistent adherence support, and mental health burdens that are often overlooked,” Gawases says.
Discrimination continues to shape everyday interactions.
“Stigma and discrimination remain significant barriers, particularly in public health facilities and law enforcement interactions.”
Safety, too, has been affected as reduced outreach and support services have increased exposure to unsafe working conditions and reduced access to protection mechanisms.
Yet, even within these constraints, resilience persists.
“They rely on informal support networks, peer solidarity, and limited remaining services,” she says. “Some have adapted by forming smaller community support groups.”
For Gawases, documenting lived experiences is not just about storytelling; it is about visibility, accountability, and change.
Her message to decision-makers is clear: “Investing in sex worker-led interventions is not optional; it is essential for public health outcomes. Sustainable, community-driven responses yield measurable impact and must be prioritised.”
As these realities continue to unfold, one thing remains evident: without listening to and documenting the voices of those most affected, the true impact of funding cuts and the solutions required risk being overlooked.
