New research shows commercial sex workers in Uganda have one of the highest HIV infections rates in the world.
By Joyce Nyakato
New research published in The Lancet, an international medical journal, has revealed that commercial sex workers in Uganda have one of the highest rates of HIV infections in the world.
Some 99,878 female sex workers in 50 countries (14 in Asia, four in Eastern Europe, 11 in Latin America and the Caribbean, one in the Middle East and 20 in Africa), were subjects in the study conducted between January 1, 2007 and June 25, 2011. Results of the study, which was led by Dr. Stefan Baral of the US-based John Hopkins School of Public Health, were released on Thursday.
The study, which assessed the burden of HIV compared to that of other women of reproductive age, found that the burden is disproportionately high and concluded that there is an urgent need to scale up access to quality HIV prevention programs for sex workers.
State minister for ethics and integrity Fr. Simon Lokodo agrees that like all Ugandans, sex workers have a right to HIV treatment and attention.
“However, giving them the leeway to operate as a business is too much to ask from the Government,” he said.
The four-year survey funded by the World Bank and the United Nations Population Fund ranked Uganda as one of the countries where sex workers had a higher HIV prevalence than other women.
Women who sell sex came sixth among the 20 African countries after Malawi, Zimbabwe, South Africa, Kenya and Benin.
An average of four sex workers in ten will have HIV.
This rate is about five times more than other women of reproductive age, who have 7.7% prevalence, according to the recent AIDS indicator survey released by the Ministry of Health last week.
In addition, the likelihood of new HIV infections among sex workers stands at 15%.
“These findings suggest an urgent need to scale up access to quality HIV prevention services among female sex workers because of their heightened burden of disease and the likelihood of onward transmission through the high number of sexual partners as clients,” Stefan wrote.
“Considerations of the legal and policy environments in which sex workers operate and the important role of stigma, discrimination and violence targeting female sex workers globally will be required to reduce the disproportionate disease burden among these women.”
However, Lokodo insists that Uganda cannot legalize sex work. “Legalizing prostitution is a sign of moral decadence,” he stressed.
Prostitution is illegal in Uganda and intervention is somewhat a challenge.
According to Dr. Stephen Watiti, an HIV/AIDS activist and expert, sex workers are not able to negotiate for safe sex with their multiple partners. This is because the lack of institutional protection gives their customers undue power of impunity.
“If they were empowered to use condoms consistently, infections would have dropped,” he argues.
Watiti cited another study that found a high HIV prevalence in the fishing communities, among internally displaced persons and long-distance truck drivers—groups which are said to be associated with prostitution.
“While commercial sex is illegal and shunned, it is a problem that cannot be overlooked,” he says. “Sex workers may be a minority group, but the cycle gets repeated because they have sex with people who are in relationships as well.”
In most of Africa, sex workers had substantially higher levels of HIV than other women, posting more than 20% of prevalence.
Of all the prostitutes in the 50 countries, those in sub-Saharan Africa had the highest HIV prevalence. Only two of the African countries studied, Egypt and Madagascar, had zero HIV rates among women who sell sex.
37% sex workers are HIV-positive