FITINÉ, Paying members of an association of sex workers on Fitiné Island in Lake Chad were having a harder time making a living, said Hadjé Gomssou, 45, the association president. Although she has been widowed twice, she has never been tested for HIV. For years the fishing industry provided her with a steady stream of clients, but recently it has declined, and with it the sex trade.
“Men can choose whether or not they want to use condoms, but not us, because we are desperate and do not have the choice. Plus, I have fewer clients than before because a lot of the fishermen have left the islands, unable to find fish, or [until recently] banned from selling it.
“Clients and sex workers say condoms spread AIDS because they [condoms] have the virus implanted. I have heard that there are pills you can take if you get the virus, but it would be too hard for us to get treatment. It is hard for us to get off the island, especially because we cannot leave our children if we need to go to the hospital.
“I had never seen anyone get tested for HIV until recently, and they almost always hide their results. When health workers recently came for testing [on the island] I was in Nigeria.
“A lot of women did not even know there was going to be testing, or what the test was about. I am thinking about going to Bol [regional hospital, a five-hour trip by motorboat], but the results will scare me and cause me anxiety.
“The more people learn about HIV, [the more] people start to fear us. It is not like before when we were much more valued.”
“Sex workers are between two fires of illness and poverty, which can both push us into prostitution.”
One-third of sex workers interviewed in a recent survey by the Chad government thought mosquito bites or sharing a meal could spread HIV. Almost half the workers had been tested, but few had a clear understanding of the disease, with the most misinformation reported in the central and northern regions.
More than 20 percent of sex workers were found to be infected, compared to a national HIV prevalence of 3.3 percent; infections were likely to be higher among sex workers in the Lake Chad area, where testing was recently offered for the first time and the last government survey of prevalence was in 2001.
There are hundreds of islands and islets in Lake Chad and research was limited to places that the surveyors could reach, according the regional coordinator of HIV programmes for the Lake Chad Basin Commission.
The government banned fish exports for the last 18 months, causing the industry in Lake Chad to dwindle.
The government recently lifted the ban on fish exports, originally put in place to keep food in the country when poor harvests caused food prices to spike. Drought cut the harvest in 2009 by one-third of what it had been in the previous year.
“We did not reach as many as we had hoped, and not those at highest risk,” regional health director Raoul Ngarhounoum told IRIN. Regional health authorities met on 15 June in Bol, the administrative town on the mainland, to discuss how to improve testing on the islands.
