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General News of Wednesday, 18 February 2004

Source: Chronicle

OPINION: Legalising Sex Work Could Cut Down Aids Deaths

by Druscilla Lartey/ Charles Methot

Every night, Kate Owusu walks the streets of circle looking for clients. She has been a sex worker for one year. A friend introduced her into the profession when she was 24 years old.

She lost her father one year after she had completed junior secondary school. Kate says life become very difficult for her and her five siblings. "My mother is a fetish priest but she couldn't provide food for all of us," she says.

She joined her elder sisters in selling bathroom slippers and plastic containers at the Rawlings Park near Makola. Even though she made some money, it was not enough to feed her.

Kate, who is now 25 years old, says her best friend at Junior Secondary School talked her into being a sex worker. "I started working as a sex worker in February last year. I followed my friend to all the clubs she visited during the night," she says.

During her time as a sex worker, she has faced not only the risk of HIV, but also of men who have tried to rob her. In one of her earliest experiences as a prostitute, a man enticed her into his car and then sped off with her bag when she went to the toilet. Luckily, none of her clients have beaten or abused her.

Kate has faced all the challenges that come with her job. She says that on the days when she is lucky, she receives about 10 clients and makes a profit about ?800,000.

Asked whether she has voluntarily gone for a HIV/AIDS test, Kate says no. "I am not sure I have the disease because I take precautions before I have sex with my clients. I always have condoms in my bag and I insist my clients wear them before we go to bed," she said.

Kate admits that although some clients are prepared to pay more for having unprotected sex with her, she refuses because she stands a high risk of getting the disease.

A report by the Journal of Acquired Immune Deficiency Syndrome (JAIDS) on sex workers found that more than half of sex workers were infected with HIV within their first six months of work.

Meanwhile, a study conducted by the Ghana Aids Control Programme last year on commercial sex workers in Accra and the port city of Tema stated, " Four thousand three hundred and twenty eight commercial sex workers tested positive to HIV/AIDS." This means that three out of every four sex workers are HIV positive.

Another nationwide study into prostitution in the country by Doctor Matilda Pappoe suggests that there has been a rapid growth in prostitution over the past three years. The reason, the study suggests, is increasing unemployment.

Pappoe says in her report that three years ago, people would not openly talk about prostitution; now that people's friends are increasingly entering the trade, people freely discuss it.

Two of Chronicle's Social Justice reporters spent time speaking with commercial sex workers on a street near the Kwame Nkrumah Circle.

Patience Sunday has been a sex worker for 3 months. Like Kate, she also recognizes the importance of using condoms.

Patience, a Nigerian, came to Ghana to be a sex worker where no one would recognise her. The eldest among six siblings, Patience believes the quickest way of making money to pursue her goal of studying marketing in Nigeria is through prostitution. She has also faced the responsibility of supporting her family since her father's death.

"I want to make some money so that I can stop prostitution. I don't have friends. I don't want anybody to know what I'm doing."

Patience fears she can get infected with the HIV virus at any time, so she insists that her clients wear two condoms before sex.

"They entice us to make love without a condom but I don't accept," she says. She doesn't think that she has contracted HIV.

She also has plans of going back to Nigeria by the end of this year when she has saved enough money to join her family and hopefully, get married.

"The last time they saw me, I told them I was going to work in Ivory Coast so when I get back, none of them would know I had worked as a prostitute. I will go home and pretend to be a good Christian," she said.

"Whether you like it or not, commercial sex workers are there." So says Professor Sakyi Awuku Amoa, Director-General of the Ghana Aids Commission. Prof. Amoa strongly advocates decriminalizing sex work as a solution to limiting the spread of the disease.

The son of a Presbyterian minister and a full Christian, Prof. Amoa thinks that the issue should be looked at from its relevance as an effective solution. "The issue should not be seen from a personal value point of view. It's not what one likes or dislikes. We are managing a national response and what can really help us in dealing with the pandemic."

The Ghana AIDS Commission and other studies have found ample evidence that links commercial sex work with the spread of HIV. In cities such as Kumasi, Tema, Obuasi, Koforidua, and Manya/Krobo, the rate of HIV infection soars among sex workers.

These cities also happen to have the most dominant commercial sex industries due to high numbers of migrant workers such as miners and truck drivers who frequent prostitutes.

Another study finds that women with STIs (Sexually Transmitted Infections) such as syphilis and gonorrhea are 10 times more likely to contract HIV as well. STIs are very high among commercial sex workers, increasing their chances of contracting the virus.

There are many who say decriminalization is the answer. How can decriminalization help? "By providing them with health care, by giving them opportunities to treat STIs that they have", says Prof.

Amoa. "If we legalize the environment, it will then make it easier for them to be organized for health care and treatment."

Prof Amoa also stresses that decriminalization will allow us to better understand the root causes of why women decide to become sex workers. "We will be able to study whether it is poverty that is forcing them to go underground. If they register, then we know who we are trying to help, by giving them loans and training to get out of the business. You can't give money to unidentified individuals."

Another benefit of decriminalization may be a reduction in the number of sex workers. "I strongly believe that decriminalization will reduce the number of sex workers, because most of them want to work underground.

The moment you legalize it and do it openly, it would demand people who are really bold to come into the open. The majority of girls will stop, a number of them will feel shy and will not come into the open," Prof Amoa asserts.

There are examples of decriminalization having a positive impact in other countries. In Senegal, the rate of HIV infection has come down significantly, to about 7 percent, since the government organized commercial sex work. By providing free medical treatment and condoms, the government has helped to protect the sex workers and limit the spread of infection.

There is still strong opposition to the idea of decriminalizing prostitution, based upon moral and religious beliefs. Others believe that by allowing decriminalization, the government will be condoning prostitution, encouraging young people to begin.

Prof. Amoa dismisses these arguments as missing the point: "The question is, do you close your eyes to what is the reality? Do you use morality as an excuse for not doing what needs to be done?"

Meanwhile, at 8 pm, Kate Owusu, clad in a low-cut blouse and tight miniskirt, joins the other young women who stroll the streets, waiting for customers. The prevalence rate of HIV among 15-35 year-olds has gone up 50% in the past 3 years.

Rates of HIV infection in 5 cities: Koforidua: 8.5% Manya/Krobo: 7.8% Tema: 6.6% Obuasi: 6% Ekpe: 6%

39 of 121 sex workers studied claimed to have begun working as prostitutes after their trading businesses collapsed.

The rate of HIV infection among sex workers is 25 times higher than that of the general population.