A consultant public health physician, Dr Adegboyega Oyefabi, says prevention and control of HIV in Nigeria should be directed to commercial sex workers.
Oyefabi of Barau Dikko Teaching Hospital, Kaduna, and also a Senior Lecturer, Kaduna State University, Kaduna, spoke with the News Agency of Nigeria in Lagos ahead of the 2020 World AIDS Day slated for December 1.
According to him, the United Nations Agency for International Development report shows that sex workers are 13 times more at risk of HIV compared with the general population.
“This is because most commercial sex workers are economically vulnerable and unable to negotiate consistent use of condom.
“UNAIDS report shows that unprotected heterosexual sex accounts for 80 per cent of new HIV infections in Nigeria, with the majority of remaining HIV infections occurring in key affected populations such as the commercial sex workers.
“The HIV situation in Nigeria can be described as a mixed epidemic.
“This means that HIV infection though, high in the general population, certain group of people are with high risky sexual behaviour.
“They include commercial sex workers (CSWs), men who have sex (MSM) with men and injection drug users (IDU) accounts for more than one third of the infection in the general population.
“It is noteworthy that this high-risky sexual population are less than five per cent of the entire population.
“However, reports show that they are responsible for estimated 32 per cent of HIV infection in the country,” Oyefabi, also Team Lead, Infectious Disease Control Centre, Kaduna, said.
The expert, however, called for community sensitisation on the need for consistent use of condom and provision of incentive for willing members of this group.
He said that they should be engaged in gainful employment, which should be incorporated into the health programme specifically meant for the target group.
Oyefabi, also Vice Chairman, Association of Public Health Physicians in Kaduna State, said that medical and psychosocial rehabilitation should be incorporated into prevention and control programme targeted specifically at the group.
The expert said that this should be done by all HIV/AIDS stakeholders in the country.
He said, “Sex workers are particularly vulnerable to HIV because of social stigmatisation, multiple sexual partners and abuse of drug injection by some of them.
“Migrant sex workers, especially those involved in movement across the borders are particularly vulnerable.
“The religious environment and socio-cultural practices in Nigeria discourage prostitution and commercial sex work.
“But, there is an urgent need to come up with social support programme that can be an incentive for young people to disengage from prostitution in the country to prevent undue spread of HIV/AIDS.
“In this regard, the support of credible religious organisations, in collaboration with other civil society organisations and National Agency for the Control of HIV/AIDS, is needed.
“This is to foster a sustainable HIV/AIDS prevention and control programme targeted at this high-risk sexual practice population.
“Proof of this kind of initiative can be seen in countries like Cambodia, the Dominican Republic, India and Thailand, where reductions in national HIV prevalence have been possible by initiatives targeting sex workers and their clients.”