Ivory Coast prostitutes at centre of Aids web



Mark Huband in Abidjan, where the clients shun condoms and the girls must follow suit

The Guardian, 19 July 1991

By about 7.30 am, men are usually waiting outside the brothel: men on their way to work, foreigners in Abidjan for a few days, lorry drivers a long way from their homes in Burkina Faso or Mali, businessmen from all over West Africa.

On a good day working at the brothel, Maria says she can earn 1,000 CFA francs, or about £2. But the work has become more difficult because of Aids – not because of the dangers, but because of competition between prostitutes who want safe sex, and those who don’t care as long as they get paid:

“I know about condoms,” says Maria. “I sell them to my friends and the doctors have told me about them. But most men just won’t use them, particularly the Muslims. They say their religion won’t let them. “I say I want to use a condom. Then they say that I must be sick with gonorrhoea or something. They say they are going to leave, they will go and find another girl. And they do. I know. We all want to have money, then we can be independent.”

While the World Health Organisation says Ivory Coast has the sixth highest incidence of Aids among African countries, Abidjan is seen as the epicentre of the epidemic in West Africa, mainly because of its role as a regional business centre and major port. And largely responsible for spreading the disease are the city’s 12,000 prostitutes.

Around the corner Maria says hello to the Queen Mother of the Koumassi quarter, who is sipping Martini in a restaurant. ‘She is the adopted mother of 30 prostitutes, some as young as 13, who arrive from Ghana every month.

The Queen Mother gave up prostitution six years ago after doing it for 10 years. Now she sells soft drinks on the steps of her house and advises the young girls who come to see her. “I tell them that if a man comes to them and refuses to use a condom, they should refuse sex, they should refuse work. If all the girls refused then the men would have to accept the condoms.” But Marie shakes her head: “They [the girls] will just do it secretly. The men know that.”

Aids is the main cause of adult death in Abidjan. WHO figures show that the Ivory Coast has 6,836 Aids cases. Doctors believe the real number is perhaps seven times higher.

There is a 12 per cent HIV infection rate among women in Abidjan’s paediatric wards, putting the annual birth rate of HIV positive babies in Abidjan alone at around 3,300. Among new blood donors, 15 per cent are infected with HIV.

“Prostitutes are severely infected – around 50 per cent of them in Abidjan,” says Dr Justine Agness, director of the centre for infectious diseases at Abidjan’s university hospital.

. “We find that the people who come to the centre have often been with prostitutes. But despite the knowledge of the dangers, it doesn’t appear that behaviour is changing.”

Among the generality of patients receiving treatment at the centre, at least 60 per cent are HIV positive.

Doctors working in Africa believe Aids will increasingly be seen as a Third World problem: “There’s a grave danger of Aids being seen as part of Africa as a problem area,” says Dr Kevin De Cock, director of the Retro-Cl Aids programme set up in Abidjan by the United States’ Centre for Disease Control.

Until recently, official warnings linking Aids with sexual behaviour have been few. Now a national aids committee, jointly sponsored by WHO and the Ivorian government, is about to launch a condom campaign.

The intention is to make packets of four condoms available at 100 CFA francs (20p) in bars, night clubs and pharmacies. For prostitutes seeing several customers a day, though, the cost will be a significant part of their income.

In April the Ivory Coast’s National Institute of Public Health established a one-year programme aimed at educating the city’s prostitutes on the dangers of the disease, and identifying prostitutes who might distribute condoms.

The project is still in its early stages but has now exhausted the $10,000 (£62,500) grant it was given by the WHO. In any case, it has been working in a small area of one city. The interior of the country has been largely ignored.



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