The customer is King

Despite high levels of awareness about HIV/AIDS and condoms among Nigerian sex workers, their knowledge of transmission and risk factors surrounding the disease was low, a new study has found. Researchers from the Society for Family Health (SFH) discovered that only one in five of the 2,634 women working in brothels that were interviewed was aware of asymptomatic transmission. Consequently, many of them assessed risk by looking at the physical features of the client. SFH created an archetypal Nigerian sex worker and named her Sisi. She would most likely be a 26-year-old divorced mother, who had been a sex worker for the past two years. She plays down the risk of HIV infection by using what she mistakenly believes are HIV "risk reduction strategies". After sex, she uses antibiotics and she examines clients to see if they are healthy. She may not use condoms if she thinks the client looks fit, the study said. According to the study, funded by the UK Department for International Development (DFID), many of the sex workers adopted "insufficient measures" to prevent contracting diseases. Although AIDS was a worry for 81 percent of the women, only about 55 percent reported consistent use of condoms in the week before the survey. Sex with "regulars" and boyfriends was often unprotected. Older sex workers and those who worked from cities reported higher percentages of regular condom use than those in "junction towns", which are points on the country's highways where truckers stop to rest and often patronise sex workers. However, more than three-quarters of women who had been sex workers for less than a year, said they asked all clients to wear condoms. "Non-use or inconsistent use of condoms in sex work is a result of multiple factors related to power disparity between the sex worker and her customers," the study said. For Sisi, the economic necessities are more relevant than the risk of contracting HIV. She complains that too much time would be spent trying to convince clients to use condoms, and this would affect her income, the study said. "Maybe you don't have any money at your room that day and that person wants to give you N2,000 (US $18.2) and if he said that he will not use condoms, and you don't have money, you will just risk your life to collect that money," a participant was quoted as saying. The belief and trust in God offered safety and security for many of the sex workers, the study discovered. This belief created some form of "risk relief" as they strongly believed that God would protect them from contracting HIV/AIDS. Many of the women refused to think about HIV/AIDS and this was based on the prevailing cultural belief that "what you say is what you get". Many believe that those who die from HIV/AIDS are those who think and perceive a possibility that they are at risk, the study said. An important finding of the study was that 76 percent of the sex workers who asked all clients to use condoms, reported consistent condom use. "It would appear that if they were encouraged to ask all clients to use condoms, condom usage rates would be increased," the study said. The main reason for inconsistent condom use was the inability of sex workers to negotiate condom use, particularly with their regular clients and partners, the study suggested. The researchers called for programme interventions aimed at enhancing negotiating skills among sex workers. Another key finding of the study was that most sex workers had aspirations to save money and eventually leave sex work to marry and raise children. This could provide programme managers a lever to educate sex workers and promote condom use. Programmes could offer the condom as a preventive measure for both pregnancy and STDs as many of the women used abortion as their main method of contraception, the study said. For further information contact: Muyiwa Oladosu or Olaronke Ladipo Population Services International 1120 19th Street, NW Suite 600 Washington, DC 20036 USA Tel: +1 202 785-0072 Fax: +1 202 785-0120 Email:[email protected]