Adapted from The Daily Nation
By ARTHUR OKWEMBA email@example.com Posted Tuesday, December 14 2010 at 21:00
Concern over the failure by prostitutes to access Aids information and contraceptives is sending jitters in government and civil society.
With HIV prevalence among prostitutes standing at 14.1 per cent, twice than the national prevalence of 7.1 per cent, Ministry of Health officials are worried that failure to reach them will severely undermine prevention efforts.
Recent studies show that a higher number of prostitutes and their male clients are not using condoms, exposing themselves to HIV and other sexually transmitted infections.
One of the studies, which targeted sex workers in Kibera slums, and which is expected to be published early next year, had two startling findings: the failure by male clients to use condoms and the sexual violence female workers are subjected to.
According to the study conducted by Prof Elizabeth Ngugi, a lecturer at the University of Nairobi, of the 2,978 sexual acts the 161 prostitutes had with male clients in a month, condoms were not used in 900 acts.
This was disturbing because the prostitutes who were HIV positive confessed that in 177 sexual acts, they did not use a condom. On average, a prostitute has between two and three male partners in a day, sometimes engaging in several sexual acts with the same client.
Many of these men are either married, or have other female partners.
The study further found that of the 143 prostitutes who were tested for HIV, 27 per cent returned positive results. When the women were asked why they were not using condoms, they said sometimes their male clients threatened them with death if they insisted on safe sex.
For others, the male clients offered to pay a higher fee to have unprotected sex. The prostitutes said the risk of unprotected sex is high hence the need to charge a higher fee.
Others said they were raped or subjected to other forms of sexual violation like burning their genitals with cigarettes if they refuse to have unprotected sex.
Equally disturbing was the finding of an increasing number of young girls between 10 and 18 years entering the sex trade. These are the sex slaves, who are most vulnerable to HIV infection because they lack, among other things, negotiation skills when dealing with older men.
Another study conducted this year, and which involved mapping of prostitutes in Kenya, Uganda, and Tanzania, revealed the serious human rights violations facing prostitutes.
Supported by Open Society Foundation and HIVOs of the Netherlands, the mapping found how prostitutes are struggling to stave-off the violations they are subjected to daily.
To survive, they have formed networks through which they notify each other of violent male clients, police raids, bail out those arrested, and pay medical and burial expenses for colleagues who die as result of these violations.
The prostitutes point out police, clients, and the law as the main source and cause of the brutality they are experiencing.
It is this brutality and the discrimination by the society that is making it difficult for prostitutes to come out and share their tribulations.
Many are also unable to access information on family planning, condoms, maternal health service, and prevention of a range of sexually transmitted infections.
According to Ms Wanjiru Ngugi, the programmes coordinator at Life Bloom Service International, a group that rehabilitates and provides life skills to prostitutes, the reasons for this state of affairs is the intense stigmatising and abuse prostitutes are subjected to, and the failure by the law to legalise the trade. It is this stigma that makes their male clients violate them with abandon.
“The stigma makes it difficult for them to come out and seek reproductive health information and condoms even when they need them,” Ms Ngugi says.
The society also labels prostitutes as people of base character who are blamed for every social ill that afflicts humanity from high HIV prevalence to impoverishing men. Police harass them under the pretext that they are engaging in a criminal acts.
Such tagging has made prostitutes operate incognito, thus emerging as one of the most difficult groups to identify, provide reproductive health services for and protect their human rights.
Dr Ibrahim Mohammed, the director of National Aids and STD Control Council says “because of the way they are labelled, prostitutes and their clients sometimes live reckless lives.
“While much has been done in helping them access HIV prevention, management and other reproductive health services, they remain prone to unsafe sex.”
Ms Mary Achieng’, who has been in sex business for eight years, confirms: “Many of us feel the society does not love us, and hence do not care whether we infect people or harm them.”
“If you love and appreciate our human rights, then we are likely to have self-esteem and listen to what the society is saying,” adds the 34-year-old mother of two.
Health analysts argue that because of the stigma by the society and brutality by police and male clients, prostitutes are one of the groups that is both vulnerable to infections and one of the key drivers of the disease.