HIV prevalence among sex workers declines

SANGEETA RIJAL

KATHMANDU, Three years ago when Manju (name changed) was invited to join awareness raising camp on HIV and AIDS organized at Koteshwor, she participated not because she was interested in the topic but was allured by the scheme of free beauty treatment thrown in.


"I had no concern with the key issue of program -- HIV and Sexually Transmitted Infection (STI)--, instead, I was keen to make myself beautiful through the beauty treatment they offered for free," recalls 28 years old Manju, who is into sex trade for the past three years now.
But the desire to be seen more beautiful in the eyes of her clients made her learn to be safe from HIV and STI. She started using condoms regularly and visited Voluntary Counseling and Testing (VCT) and STI center as frequently as possible. "After listening to counseling, I realized that appearing beautiful was necessary to keep on with my work. But more important was practicing safe sex," she says, adding, "That's why I am safe from HIV though I am into the flesh trade."


Manju is one among thousands of commercial sex workers who are safe from HIV and AIDS.

According to the government's recent Integrated Bio-Behavioral Survey (IBBS), HIV prevalence rates among Female Sex Workers (FSW) have decreased significantly in Kathmandu and in the 16 eastern Tarai highway districts, where flesh trade is rampant. In 2006, HIV prevalence among FSW in Kathmandu was 1.4 percent, a decrease from two percent in 2004. In the Tarai highway districts the prevalence rate decreased from three percent in 2003 to two percent in 2004 and to 1.5 percent in 2006.

Nepal Progress Report, prepared for United Nations General Assembly Special Session on HIV and AIDS (UNGASS), says that condom promotion and distribution, behavior change (having less sex partners), STI treatment and VCT for high-risk groups like FSW are being implemented by over 200 organizations and networks in the country.

There has been a notable expansion in the number of clinics managing STI and giving VCT services for key target groups such as FSW and clients among other high risk population. In 2005, there were only seven VCT centers, which have now gone up to 106, the report says. It also said that STI service delivery has also expanded from 132 in 2006 to 155 by the end of 2007.

A total of 60,096 clients of sex workers were treated for STI in 2007. FSWs and female and male clients in the mid-western region accounted for 76 percent, that is 30,521 of all STI cases treated in the non-government sector. "Coverage is higher for FSW above 25 years, as well as clients of sex workers above 25 years as they may often be more "established" and easier for programs to engage with and reach," the report says.

According to Dr Sarad Onta, executive chief at HIV and AIDS Control Board, a cabinet formed semi autonomous entity, the rate of new infection among sex workers has decreased. "About a decade back HIV prevalence among FSWs was 15 to 20 percent," Dr Onta says.

Condom use among sex workers has also increased. It was 74 percent in 2004 and 77 percent in 2006. It was 93.1 percent in 2007 for male sex workers in Kathmandu.

Only 6.8 percent of FSWs correctly identified ways of preventing sexual transmission of HIV and rejected major misconceptions about HIV in 2005. But this has gone up to 30.2 percent in 2007 in Kathmandu.
The estimated number of female sex workers in Nepal is approximately 30,000. However, of these, almost 28 percent, or 8,500 women, are believed to be 'hidden'populations, the report says.