James Hall

Sex workers join efforts to contain spread of AIDS

MBABANE — Commercial sex workers are not responsible for the rise in AIDS cases regionally, but their activities do contribute, and efforts to contain the spread of HIV now include members of the world's oldest profession.

"The activities of commercial sex workers tell researchers much about societies in a stage of transition, about mobile lifestyles like commercial truckers and contract workers, and about changing morals," Alec Dube, a sociologist with the University of Swaziland, told IPS.

Dube has been studying commercial sex workers as part of an initiative called Corridors of Hope. The HIV-containment programme, sponsored by the Family Life Association of Swaziland, recognises the reality of prostitution in the most mobile profession of all, the modern highwaymen of long-distance taxi and bus drivers, and truckers.

Because they turn to prostitutes for sex, long distance truck drivers are at high risk of contracting HIV when they find their sex on the road, health ministry studies have shown. The Corridors of Hope programme uses commercial sex workers to bring condoms and AIDS awareness information to road freight haulers.

"We have lost too many valuable drivers, and the absenteeism we are seeing now shows we will lose many more. This initiative is overdue," the manager of a trucking firm at the Matsapha Industrial Estate in Swaziland told IPS.

Sex workers are being trained by the Family Life Association of Swaziland as "peer educators," and provided with condoms and literature by Population Services International (PSI). The U.S. Aid for International Development (USAID) is financing the project.

Thus far, 20 commercial sex workers have been trained and posted at Oshoek border gate at South Africa, which is used by most road freight traffic to and from Johannesburg and Pretoria. Ten "peer educators" will be attached to the Lavumisa border gate connecting Swaziland with the South African province KwaZulu/Natal. Ten other prostitutes trained by the programme now operate at the Lomahasha border with Mozambique.

"Fifteen commercial sex workers will be recruited in both Manzini and Mbabane, because when truckers finish their jobs, they go to those towns," Jerome Shongwe, programme coordinator for Corridors of Hope, told IPS.

In addition to promoting safe sex themselves, the peer educators will hopefully instil the message among their clients, and other sex workers.

Itinerate professionals, like long-distance truck drivers, have fallen outside previous AIDS awareness campaigns because they are never in one place to receive messages and counselling, like other company workers.

Commercial sex workers have also eluded AIDS containment projects thus far.

"There has been some discomfort in the past in dealing with commercial sex workers, mostly because of the morality factor. Remember, many hospitals and clinics in Southern Africa were founded by European missionaries, and are still funded by religious organisations," nurse Agnes Kunene told IPS.

An international health disaster like AIDS, which respects no borders, is changing attitudes. "Health policymakers will do anything to save people from the pandemic, and are going to places they've never entered before, like brothels," Kunene said.

Social welfare workers like South African psychiatrist Dr. Beatrice Simelane have viewed commercial sex workers as a by-product of economic hard times.

"Unemployment, lack of opportunities, especially for women, and changing social structures like the break-up of the traditional family have all played a role in the rise of prostitution in Southern Africa. Even before AIDS, prostitutes could contract more traditional sexually transmitted diseases. But girls faced with the bare necessity to survive had little recourse but to sell themselves, they have told us," Simelane said.

Neither Simelane nor others care to speculate on the number of commercial sex workers operating in Southern Africa.

"Certainly, the number is in the tens of thousands, but the occupation is extremely fluid. Women get out of the profession as soon as they can, but often return to it when they have to. Also, it is an occupation of opportunity, when opportunity arises," she said.

Commercial sex workers are often an ad hoc association of women in need of earnings who appear wherever men congregate on jobs. They can be found at places where long-distance truck drivers rest for the night. Where soldiers are posted, they can be found. Where workers hostels are erected beside mines and factories, commercial sex workers also migrate.

A study by Botswana's Ministry of Health found a direct correlation between the rise of AIDS-related deaths and the construction of highways through the affected areas. Several years after the highway projects appeared, cases of HIV grew into full-blown AIDS, and affected persons died of opportunistic diseases.

Nearly 40 percent of adults in Botswana are HIV positive or have full-blown disease, many of them linked to the construction of the highways.

"Disease pathologists traced the cause of the deaths back to when the highways were being built. Construction workers had sex with commercial sex workers, or they had sex with the women of the area where the highways were being built. Either way, HIV was spread. After a five to 10-year incubation period, AIDS mortalities appeared," said nurse Kunene.

Such studies led to the instigation of the Corridors of Hope and other initiatives. Prostitution is still illegal in all 14-member states of the Southern African Development Community (SADC), and efforts to involve sex workers in AIDS prevention programmes are not seen as a way of legitimising the occupation in preparation for legalisation.

"We are just recognising reality, the way people behave," said Kunene. Adds Simelane: "Nobody likes prostitution compared to other types of sexual relationships. Even prostitutes would prefer other less dangerous and more respectable work. But while they are with us, commercial sex workers cannot be ignored."

Nearly 30 million people in Africa are living with HIV/AIDS, including three million children under the age of 15, according to the World Health Organisation (WHO). South Africa alone has five million people living with the disease.