AEGiS-14IAC: If I get AIDS, I go home to my village and die: perception of individual HIV-risk in urban sex workers in Lagos.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

If I get AIDS, I go home to my village and die: perception of individual HIV-risk in urban sex workers in Lagos.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. LbPeG9060)

Masi V, Sommerfeld C
Medecins Sans Frontieres, Lagos, Nigeria

BACKGROUND: The HIV sero prevalence in Nigeria at the end of 2001 was estimated at 5.8% --3.1 million persons. Nigeria has the second highest number of HIV-positive persons in the world, behind South Africa. Among the high-risk groups, female sex workers (FSWs) are of special interest because they are highly stigmatised and discriminated. Due to the high incidence of sexually transmitted infections (STIs) among them, they are vulnerable to HIV infection.

METHOD: In October 2001 Medecins sans Frontieres (MSF) began an outreach project with brothel based FSWs. The main objective was to offer HIV/AIDS/STI education and provide syndromic management of STIs. To understand their living conditions, MSF conducted a knowledge, attitude, practice and behaviour (KAPB) survey. Using questionnaires and focus group discussions, the individual perception of risks concerning their work and life were examined. The survey was conducted in eight brothels in a low-income area in Lagos and included 100 women.

RESULTS: The majority were between between 12 and 24 years (79%) and came mainly from two states, Edo and Delta (64%). They view their work in Lagos as transient and are highly mobile, with 83% remaining in Lagos for a year in the same brothel; 40% have children. Although the level of HIV/AIDS knowledge among the FSWs is incomplete, they are aware of the risks. One third of them had been tested for HIV antibodies (34%) and nearly half are willing to be tested (46%). If they found themselves to have HIV/AIDS, half of them would stop sex work and return to their villages to die, 14% said they would commit suicide and only 1% would seek medical care.

CONCLUSIONS: There is minimal care and support for people living with HIV/AIDS in Nigeria. FSWs have few avenues for receiving care if they are HIV-infected. FSWs are highly vulnerable to HIV infection and are neglected by the Nigerian health care system. Modalities of care and support need to be developed for this vulnerable group.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, Prostitution, HIV Infections, Prevalence, Perception, Incidence, Nigeria, South Africa, Human, Female, Child

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