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Men who have sex with men hard hit with HIV

Written by Arthur Okwemba

In major nightclubs in Nairobi, a new phenomenon is taking shape: the number of male sex workers is on the rise as more men turn to the act as away of eking a living.

Most of these men, who cut across the ethnic and race divides of this country, are aged between 12 and 60 years.

While many people have associated Mombasa with men who sell anal sex, it is emerging that Nairobi is now a hot-spot for this business.

Men who engage in this act for commercial reasons are easy to come by than was the case in the past, says Dr Joshua Kimani, whose research work has enabled him to come into contact with some of them.

The AWC has leant that as more rich people offer good pay for one night act with these men, more and more of them are now willing to sell their bodies. Their clients include the rich and mighty and married men who sneak from their wives to engage in such acts.

At the moment, it is estimated that there are over 500 and 1,000 men who have sex with men in Nairobi and Mombasa respectively. A good percentage of these are engaged in commercial sex.

This development is occasioning a cutthroat competition between male and female sex workers as they fight over clients.

Women commercial sex workers are said to be offering anal sex in an attempt to compete with their male counterparts. From interviews with researchers and commercial sex workers, some women are doing this because there are clients who pay more for anal than vaginal sex.

Others are engaging in the act arguing that anal sex is safer than vaginal; a belief scientists are terming as very dangerous. HIV experts dealing with these women say this new strategy of making money may deal a heavy blow to the fight against the disease.

“The women we attend to say they are ready to go by the client’s preference including having sex in order to survive in the business,” says Dr Joshua Kimani, the Clinical Director for University of Nairobi and University of Manitoba.

The biggest worry among HIV experts is the rising number of HIV prevalence rate among these men who have sex with men either for pleasure or for commercial purposes. Those whose clinics are providing health services to these men say for every five of them three are HIV positive.

HIV prevalence is estimated to be as high 40 percent in some of these clinics. And the rate at which they are acquiring the virus is even higher than their female counterparts.

The experts think one of the main reasons for this high prevalence is these men lack information and services to help them prevent HIV infection. HIV/AIDS messages, whether delivered by the government or the civil society do not target them.

Clinics offering services to these men are too limited in number and lack expertise on how to handle them. All these gaps are due to the stigma and hatred leveled against such men, making many of them fail to seek medical attention or advice from health personnel.

“Majority of the male Commercial Sex Workers (CSW) are concerned about the confidentiality and male friendless of the HIV prevention centres they are expected to consult,” says Dr Kimani.

At their clinic on River Road known as SWOP (Sex Workers Outreach Programme) that deals only with CSW’s, male sex workers have been sending emissaries to find out how friendly the clinic is to them.

Dr Kimani and his team are now having discussions with the representatives of the male sex workers to chart out ways of making the clinic male friendly.

“The other thing we have decided is to train our staff on how to handle these men once they start knocking on our doors,” says Dr Kimani.

Similarly, research is showing these men are more vulnerable to infections due to high partner turnover and the trauma caused on their anal mucosal membranes-a physical barrier that among many other things keeps away disease causing elements-during sexual intercourse.

The damage to these membranes leaves them very vulnerable to infections.

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