By Gatonye Gathura
Researchers have been offering a group of prostitutes in Nairobi Sh 1,000 (US$10) daily to abstain from sex but chastity has so far proven elusive.
In a lesson crucial to Kenya government, which is planning cash handouts to keep prostitutes from the streets, the researchers learnt sex work may be much more than just cash transfer.
The researchers from the University of Nairobi, Kenya, University of Manitoba, Canada and Karolinska University Hospital, Sweden, have been searching for a HIV vaccine among Kenya’s prostitutes for three decades.
In the current study they want to understand how the virus affects the virginal tissue. In a two phased process they collected cervical biopsies from 78 sex workers from Pumwani in Nairobi.
Naturally the act of taking a biopsy or tissue sample leaves a scar on the surface of the cervix which requires between 2-5 weeks or even in some cases up to 14 weeks to heal completely.
And this is where the whole problem begins, explained the researchers in their report published last month in the American Journal of Reproductive Immunology.
During the healing period the women are at a higher risk of HIV infection, or for those already positive at elevated level of transmission to partners.
To reduce such risks, the team advised the women to abstain from any virginal sexual activity, for at least one month but for those who could not to always use a condom.
During planning, the researchers discussed with the sex workers to among others establish a financial compensation rate that was equivalent to the daily average income for prostitutes working in the Pumwani region of Nairobi.
“It was agreed that a daily compensation of (US$10) for 30 days was appropriate. It was estimated that abstaining from sex work for one month was feasible with the support of the financial compensation,” the authors write.
During the first phase sexual abstinence was found to be very low with up to 63 per cent having had unprotected sex during the healing period.
However only three participants had owned of having sex during the healing period but when samples were tested for the presence of semen in Winnipeg, Canada it was found indeed majority of participants were eating their cake and keeping it.
Following this high abstention failure rate the researchers introduced further measures to improve adherence.
These included short text messages twice a week to remind the participants to continue abstaining from sex.
“To ensure privacy, the message was selected to be understood only by the participants and could not be associated with the participant’s involvement in sex work or in the study.”
This researchers say improved the rates of abstention in the next phase but a significant number of participants were found to continue engaging in virginal intercourse during the healing period.
Study participants owned to having had unprotected sex during the healing period with either casual clients or regular partners.
Luckily, says the study, none of the HIV negative participants were infected even six months after the study.