Hellen, 35, sits on the bed of the minimalist windowless room she rents by the day in a small hotel in Busia, a small Kenyan border town through which truckers travel to Uganda daily. Her personal belongings are piled haphazardly on a blue plastic chair next to the door. The music from the next room, where a few men are having a drink, echoes down the hall. Clients are scarce that night and the sex worker, who has HIV, is willing to tell her story.
“I started seeing a client regularly and I didn’t know he was HIV-positive,” she explains. He took off his condom during the act. It happened three times. A colleague then warned her that the man had HIV. Shocked and worried, she hastened to buy a bottle of coca-cola: she had heard a rumor that it would “cleanse” her of any infection. She received a positive HIV test result soon after.
Hellen then began antiretroviral (ARV) treatment, which she took on and off, and eventually stopped due to the negative physical effects she was experiencing. It continues its activities despite everything, while being very transparent with customers who, by chance, would not want to protect themselves. “I am a single mother and I have three daughters, she justifies herself. I won’t be able to make enough money if I drop this. I have to pay food, rent and school fees. »
Kenya is active in ensuring that HIV is no longer a threat to public health by 2030. But in its latest annual report 2022, the National Syndemic Diseases Control Council (NSDCC) revealed that infections, which were in steadily declining for years, jumped 7.3% in 2021.
There is no law criminalizing the sale of sexual services in Kenya. The sex trade is very active in Busia, and truckers make up a large part of the clientele. But sex workers are a “key population” particularly affected by HIV, with a prevalence of 29.3% nationally.
In the main street, during our passage that evening, a line of tank trucks filled with oil stretches for almost a kilometer. The drivers are waiting to go through customs and the line is moving slowly. In the small hotel where Hellen has established his quarters, a dozen other prostitutes, in their early twenties to late thirties, also rent rooms. Negotiating the condom can be complicated.
“It’s a problem, some take it off during the act,” says Lilian, 38. Sometimes customers pay and bring us outside our place. We find ourselves on their territory. They can do whatever they want. »
The women are seated on the outdoor terrace at the back. Several leaned on a pool table, the time to talk to us. They are warm and tactile, with a rough and insightful gaze, and from time to time throw back lines tinged with humor.
“Some claim to be allergic to condoms,” says Susan*. But when that happens, I cut it short and fire the client. Some of the new infections, however, come from regular clients, says Christina Ayako, a peer educator for Survivor, an organization founded by local sex workers who works hard to prevent sexually transmitted diseases.
“The regulars help support the girls’ children or pay their rent. It’s like a marriage and their husband, so they’re not going to use protection. But we don’t know what they are doing in the meantime,” she said. Girls may also be too intoxicated to think about putting condoms on with their clients.
Jump in infections among young people
However, it is the youngest who are fueling the rise in the country: 52% of the 34,540 new infections recorded by the authorities in 2021 affect people aged 15 to 29.
In Busia, sex workers speak with some exasperation about underage girls. “They hide in the bushes or go in the trucks, and don’t understand themselves, drops Monica*. They don’t know how to negotiate condom use and clients take advantage of them. Sometimes the client knows he has HIV and the girls lack information about it. »
Some turn to prostitution after rebelling against their family and dropping out of school, or out of attraction to these activities. But others want to make money to support their loved ones in a context where the economic situation is more difficult and poverty is very present.
The Survivor organization has recently been active in raising awareness among these young girls. “The figures are alarming,” says the director, Caroline Kemunto. It’s complicated for us to reach them because of the law, we are afraid of being accused of recruiting minors to do sex work. The organization therefore plans to approach them with young people of their age.
In their offices, a map is marked with dozens of “hot spots” in the region, where customer requests are concentrated. “It allows us to know where to go to offer our services,” explains Caroline Kemunto.
Problem of tests and condoms
Survivor also runs a clinic. They offer ARV treatment for positive people, as well as sexual post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP). This tablet, widely used in the region and essential in the fight against transmission, reduces the risk of infection for people potentially exposed. Many sex workers take PrEP continuously in 30-pill bottles. But some don’t like the effects of the drug and supply remains a challenge.
The organization, like other clinics we spoke with, however, lacks tests to detect HIV. “This morning I had a patient and I was not able to test him, it is dangerous for the community, reports Kennedy Kekedi, nurse manager of the private clinic PESI. It is a nationwide problem. »
Condoms have also been in short supply for some time, and the costs are high in stores. “We received five boxes of condoms three months ago, it’s a major problem,” said Paul Otieno, community health worker at Survivor. And the lubricant, let’s not talk about it. »
He adds that it is not easy for young people to have access to condoms. “There is a stigma,” he explains. It’s a small town and people know each other. They are afraid of being singled out because people assume that if you buy condoms, you are a prostitute. »
* Assumed first names
This report was financed thanks to the support of the Transat International Journalism Fund.The duty.