A groundbreaking survey in Swaziland has produced a truly shocking statistic – HIV prevalence among sex workers stands at 70.3 percent.
Around the world, female sex workers are at greater risk of HIV infection than the general population but until the Swaziland HIV Bio-Behavioral Surveillance Study and Qualitative Study among Most At-Risk Populations, no one knew how serious the situation was in Swaziland. Now they do.
Conducted by Population Service International in conjunction with Johns Hopkins University in the United States, the study shows that HIV prevalence among sex workers increased with age. However, even the youngest group of sex workers had an HIV prevalence rate of 44 percent – far higher than the general population.
Despite the high HIV prevalence among sex workers, some of their clients continue to insist on having sex without a condom. Out of the 325 sex workers who participated in the study, less than a quarter said that they had always used condoms in the past month.
In particular, condoms were used less often with regular clients and non-commercial partners.
Meanwhile, the study also surveyed men who have sex with men (MSM) in Swaziland and found that half of them use condoms each time they have sex – and that the HIV prevalence rate among MSM is relatively low at 17.7 percent, substantially less than the general population.
While few men are brave enough to openly disclose their sexuality, 325 MSM participated in the research –70 percent of whom were younger than 25. The study found that 54 percent of MSM felt rejected by friends due to their sexuality, while 55.3 percent of them were afraid to seek health care for the same reason.
Just like sex workers, HIV prevalence increased with age. MSM were also more likely to be HIV infected if they had syphilis, had been in prison, or reported excessive alcohol use.
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1 Comments
I must say the prevalence of HIV among sex workers is quite alarming at 70.3% in comparison to an estimated adult prevalence of 26.3% but I must say similar rates were seen in Malawi where female sex workers have the highest prevalence of HIV at 70.7% (NAC 2009). While many governments and other stakeholders are grappling with moral and legal issues around sex work, many sex workers continue to be vulnerable to HIV infection. While interventions are being scaled up in the general population this key group is being left behind and what we seem to forget is that sex workers do not exist in isolation but interact (bridge) with the general population. This is what I would refer to as the “untamed source” and for as long as “little fires” like these continue to burn fiercely, we are far from extinguishing the “larger fire”.
It has been observed world over for a decade now that males who have sex with males (MSM) have a higher risk of HIV infection than the general population. The results in this study indicate that MSM in Swaziland have a relatively low HIV prevalence standing at 17.7% in comparison to the adult prevalence of 26.3%. This makes our situation a little uncomfortable because our mantra has been that MSM have higher prevalence than the general population. This is a call for us to rethink our position of argument and begin to look at broader human rights and right to health frameworks to justify interventions for marginalized and criminalized groups like MSM and not to be solely dependent on the high prevalence argument as research may spring a few surprises like this one.