NAIROBI, 21 October 2010 (PlusNews) – Shunned by mainstream society, sex workers with HIV-related illnesses in Nairobi are unlikely to receive help from concerned neighbours. Instead, some of them are being cared for by fellow sex workers.
A group of 25 sex workers who call themselves ‘Knight Nurses’, have been active for a little over a year in the slum of Huruma. They regularly visit fellow members of the group and their family members who are HIV-positive and bedridden to cook for them, wash them and tidy their homes. They also organize hospital visits and ensure they are taking their drugs.
When Teresa Wangui’s* father fell ill with an HIV-related condition last year, the “Knight Nurses” came to the rescue. My friends would fundraise and hire a taxi to take Dad to hospital whenever he had an [opportunistic] illness, she told IRIN/PlusNews. ?They would also help in caring for him at home before he died last year.?
Since the breakdown of an abusive marriage 12 years ago, Fatuma Mohamed*, 40, has been accepting clients in her Nairobi home and occasionally seeking them out in bars. She said the ‘Knight Nurses’ have helped her to accept her HIV-positive status and to remain healthy.
“I am now less bothered whatever people say regarding HIV and myself,” she said. The girls keep watch over me, ensuring that I feed well and take my ARVs (antiretroviral drugs) as prescribed.
At a weekly “Knight Nurses” meeting, the 20 members in attendance donated 20 Kenya shillings each (about US$0.25) and assorted food items for two sick members.
The weekly meetings stress the importance of safe sex to prevent HIV infection and re-infection and are a vital source of information for those in attendance who have no safe sex messages directed to them through government programmes.
Teresa Wangui said she was hesitant to go for an HIV test after a worrying incident with a client. He was very rough and the condom burst… Next, I had him wear two condoms but when I reached home I discovered one condom was still in my body, she said.
“I was not alive to the correct use of the condom,” she added. Now I know that condoms reduce the risk of HIV and only one should be worn per session… With each weekly discussion, I build up confidence to know my HIV status. Once I gather enough courage, I will visit a VCT [voluntary counselling and testing] clinic.?
The meetings also discuss issues such as alcohol abuse and the occupational hazards of practising their trade. The girls report harassment – regular arrest and extortion of earnings by the police and city council officers who demand free sex in exchange for not arresting the girls; and sexual molestation by clients who refuse to pay for sex or to wear the condom,? said Miriam Murugi, chair of the ‘Knight Nurses’.
She noted that little help was available when complaints were raised with the authorities; group contributions are sometimes used to bail out jailed members.
Need for vigilance
Swistan Ngara, a community mobilizer with the National NGO, Liverpool VCT, which set up a testing tent in Huruma in August, attends ‘Knight Nurses’ meetings to explain why they must be vigilant about condom use and HIV testing, and gives them the skills to negotiate for safe sex with their clients.
We work with the most-at-risk populations – we have managed to reach out to such groups as commercial sex workers to enable them access to VCT, reproductive health services like family planning and STI [sexually transmitted infections] prevention and treatment services,? he said.
According to National AIDS and STI Control Programme director Nicholas Muraguri, there are an estimated 7,000 sex workers operating in Nairobi’s central business district alone. He said the HIV prevalence among this group was an alarming 33 percent, compared to an average rate of about 9 percent in Nairobi Province.
Adding that sex workers and their clients are responsible for an estimated 15 percent of new HIV infections nationally every year, he stressed the importance of working with this group to ensure they reduced their risk of transmitting and contracting the virus.