COMMERCIAL SEX WORK AND SPREAD OF HIV/AIDS

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COMMERCIAL SEX WORK AND SPREAD OF HIV/AIDS

ABSTRACT

The commecial sex workers has been implicated in the spread of HIV across the globe. In this article we propose a simple theoretical model consisting of two core groups of interacting heterosexual populations. One of the core group consists of male truck drivers and the other group consists of female sex workers. The truck drivers need for entertainment and female companionship make them use the services of the female sex workers in stop-over towns near major transportation routes. The resulting co-mingling of these sexually active, high-risk populations not only explains high prevalence of HIV in truck drivers and female sex workers and the subsequent spread of the disease in

general population, but also points out the magnitude of the problem and the urgency of introducing effective controls. Our model assumes (i) a low level of condom use among the trucking population and female sex workers, (ii) high level of HIV in both truck drivers and female sex workers, and (iii) continuous recruitment in both groups

when losses due to AIDS or natural factors occur. We give the complete analysis of the disease free and endemic eqUilibria. With that w~ also show the effect of reducing HIV cases in both groups by lowering of HIV transmission rates (e.g. by using condoms).

CHAPTER ONE

1.0 INTRODUCTION

1.1 BACKGROUND OF THE STUDY
The sex industry is a major factor in spreading of the human immune deficiency (HIV) in Nigeria and the whole world Hiesh and Chen (2003). According to Idoko (2004: P.104]), bridging” the populations in Nigeria such as long distance truck drivers, commercial motor cycle riders and the uniformed services who are the primary clients of female sex workers as major contributors to the spread of HIV in the general population..

The female sex workers are considered as one of the risk groups driving’ the epidemic because of their high HIV levels and exposure to multiple partners while the truck drivers are at elevated risk because they spend many nights away from home and their need for entertainment and female companionship makes them use the services of the female sex workers in stop-over towns near major transportation routes. Although sex workers are often subject to great deal of stigma and exploitation, the industry has continued to thrive because of extreme poverty and falling standard of living in Nigeria. Thus, the female sex workers enter the profession out of necessity and only quit when they can.

On the other hand, truck driving is a lucrative profession which unskilled males are willing to take, when such opportunities present themselves because of enormous material and monetary benefit associated with it by local standards. Though the truck drivers are engaged in legitimate businesses, they are often seen as a “bridge” population, or the one through which HIV reaches the larger population, particularly people who are considered at ·lower risk. Most of the truck drivers have wives and other sexual partners in their communities who are always at risk of HIV infection by the truckers. In 1991 a study of truck drivers’ sexual cultures was conducted in which the truck drivers reported an average of 6.3 current sexual partners (sex workers), 12 sexual partners during the previous year and 25 partners besides their wife during a lifetime Orubuloye et al.(1993: p.93]). A similar study of truck drivers between 1999 and 2001 Ogboi et aI (2001), found out that the prevalence of HIV infection among truck drivers in Nigerian transit towns was 54 percent as compared to 17 percent in the non-transit towns. A number of studies have documented similar findings across Nigeria. Nigeria have HIV prevalence of 35 percent among truck drivers, and 37 percent of truckers estimated having more than 50 ferriale sexual partners during their lifetimes Von Reyn, (1990: p.90]).

The spread of HIV has reached an epidemic proportion in Nigeria and its impact

on the transport industry is especially significant when considering that truck drivers are

largely transporting goods from the rural areas to major urban centers. In addition, young

men and women are being lost to AIDS in their productive years. In 2001, an estimated

number of adults and children who died of AIDS was 170,000 (Epidemiological Fact sheets, 2002 update). Thus, most efforts at the understanding the dynamics of the AIDS epidemic within risk groups have been targeted at the two core populations, namely, the truck drivers and female sex workers. For instance, Orubuloye et al in [Or93] considered the role of highrisk occupations in the spread of AIDS among truck drivers and itinerant market women in Nigeria along the Ilorin-Ibadan-Lagos highway and concluded that occupation demands had resulted in a network of multiple partners. Sunmora 2005, [S05] investigated sexual practices and barriers to condom use among truck drivers in Nigeria and concluded that the use of condom among the truck drivers was only 9 percent, though about 70 percent of them knew about condom HIV preventative measure.

On the other hand, condom usage is generally acceptable by female sex workers (Orubuloye et aI, 1999, [Or99]), but their clients sometimes insist on non usage, thus placing the sex workers as well as their clients at risk of contracting HIV. In this study, we consider via mathematical modeling the role of commercial sex work as it affects the dynamics of HIV / AIDS within these two core groups as a first step on our study on its implication on the general population.

1.2 STATEMENT OF THE PROBLEM

When sex work is characterized by high rates of client change and unprotected sex, it is associated with high rates of HIV and other STIs. Data on HIV prevalence among sex workers are available from biological surveillance and studies in each region of Africa. It is not possible to make direct comparisons between survey findings, as sampling methods and the population of sex workers and clients vary markedly. Repeated surveys among the

same population of sex workers and clients, using identical survey methods, would provide more comparable estimates of the trends in the burden of HIV and other STIs over time but such data are extremely difficult to obtain due to the hidden nature of sex work.

Client groups such as transport workers and truckers have frequently been shown to have a higher prevalence of HIV than that estimated in the general population.11,32 Wherever possible, it is important to monitor HIV prevalence in sex workers and clients to track trends in HIV prevalence in these groups. In an example of this, repeated sentinel surveillance showed that a decline in HIV prevalence had occurred over seven years among sex workers in Abidjan, Ivory Coast due, in part, to prevention initiatives.

1.3 OBJECTIVE OF THE STUDY

1. To examine commercial sex work and risk of HIV/AIDS contraction.

2. To examine the causes of commercial sex work among people in Nigeria.

3. To examine the contribution of commercial sex work in the spread of HIV/AIDS in Nigeria.

1.4 RESEARCH QUESTION

1. Does commercial sex work involve high risk of HIV/AIDS contraction?

2. What are the causes of commercial sex work among people in Nigeria?

3. Does commercial sex work contribute in the spread of HIV/AIDS in Nigeria.

1.5 RESEARCH HYPOTHESES

H0: Commercial sex work involve low risk of HIV/AIDS contraction.

H1: Commercial sex work involve high risk of HIV/AIDS contraction.

1.6 SCOPE OF THE STUDY

The scope of this study commercial sex work and spread of hiv/aids

.1.7 LIMITATION OF THE STUDY

The limitations to the study include:

Finance: There were some difficulties in the funding of the research work for it was personally funded.

Materials: Inaccessibility and paucity of materials where necessary posed a great challenge to the exercise.

Time and Resources: The researcher did not have all the time and resources for effective study. Often the respondents did not have enough time to attend to the researcher as some refused to respond.

1.8 DEFINITION OF TERMS

Commercial Sex : Commercial sex’ means sexual exchange that involves a pre-determined contract, usually a cash payment to a woman (in most cases) who provides sex on a more or less professional basis

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