One-third of sex workers interviewed in a recent survey by the Chad government thought mosquito bites or sharing a meal could spread HIV. Almost half the workers had been tested, but few had a clear understanding of the disease, with the most misinformation reported in the central and northern regions.
More than 20 percent of sex workers were found to be infected, compared to a national HIV prevalence of 3.3 percent; infections were likely to be higher among sex workers in the Lake Chad area, where testing was recently offered for the first time and the last government survey of prevalence was in 2001.
There are hundreds of islands and islets in Lake Chad and research was limited to places that the surveyors could reach, according the regional coordinator of HIV programmes for the Lake Chad Basin Commission.
The government banned fish exports for the last 18 months, causing the industry in Lake Chad to dwindle. Hadjé Gomssou, a sex worker and president of the association of "free women" on the island of Fitiné, said clients had become scarcer.
"We used to have more clients until the fishermen left. Since then, it has been much more difficult," she told IRIN. The Fitiné association has more than 100 members who contribute money to support each other, mostly during illness.
The government recently lifted the ban on fish exports, originally put in place to keep food in the country when poor harvests caused food prices to spike. Drought cut the harvest in 2009 by one-third of what it had been in the previous year.
Gomssou said she had never known anyone who had been tested for HIV, and had been away in Nigeria when health workers offered HIV tests for the first time on the island in April.
"A lot of women did not even know there was going to be testing, or what the test was about. I am thinking about going to Bol [regional hospital, five hours away by motorboat, depending on the season], but the results will scare me and cause me anxiety," she said.
"We did not reach as many as we had hoped, and not those at highest risk," regional health director Raoul Ngarhounoum told IRIN. Regional health authorities met on 15 June in Bol, the administrative town on the mainland, to discuss how to improve testing on the islands.
Gomssou told IRIN that the more the islanders learned about HIV, the more they blamed infections on sex workers. "People start to fear us - it is not like before, when we were much more valued."
This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions