A new survey of commercial sex work in Kenya, the first to include male sex workers, has revealed that 40 percent of female and male commercial sex workers are in marriages or stable unions.
According to the survey by the National AIDS and Sexually transmitted infections Control Programme (NASCOP), the World Bank, Kenya Prisons and Canada's University of Manitoba, there are an estimated 200,000 commercial sex workers in Kenya, 15,000 of whom are men.
The study, which covered all the country’s urban areas with the exception of North Eastern Province, found that Rift Valley and Nairobi provinces had the biggest number of sex workers.
"[A] majority of the male commercial sex workers have sex with men, and this puts them at greater risk because anal sex, as is already known, is a catalyst for the spread of HIV, and because of the stigma involved, many do not seek services like HIV testing," said Nicholas Muraguri, head of NASCOP.
Muraguri said the high number of married commercial sex workers could accelerate the spread of HIV within marriage - statistics show that people in stable sexual partnerships account for 44 percent of new HIV infections.
"Their spouses or girlfriends or boyfriends do not know they are engaged in commercial sex work, which puts marriages and stable unions at even greater risk of HIV," he pointed out.
The survey did not assess the level of condom use between sex workers and their clients, but Muraguri told IRIN/PlusNews initial studies had shown that "The level of condom use between them [sex workers] and their clients is just slightly above 50 percent, which is worrying. Sex workers tend not to use condoms with their regular clients."
|Their spouses... do not know they are engaged in commercial sex work, which puts marriages and stable unions at even greater risk of HIV|
According to the Kenya HIV Prevention Response and Modes of Transmission Analysis, 2009, commercial sex workers and their clients together contribute 14 percent of all new HIV infections, while men who have sex with men and prisoners account for 15.2 percent.
The Kenya National AIDS Strategic Plan 2009-13 identifies the most at-risk populations as key drivers of new HIV infections, making up one-third of all new cases.
Muraguri said the government has recognized the need to create safe access to HIV services for often marginalized high-risk groups.
"These are groups that continue to operate secretively because there are no safe conditions for them," he said. "We must provide this [access] either within the law or through change in societal mentality to ensure they receive services to save them and the general population."