Doctors worried over health of ageing prostitutes in Nairobi

By Gatonye Gathura

Medical experts are reporting high rates of obesity and overweight among older HIV positive prostitutes in Nairobi with a tendency to high blood pressure.

This, the medics say is mainly because patients on HIV drugs are living longer and getting exposed to age related health complications such as heart conditions.

But prostitutes, a study published on Thursday, in the East African Medical Journal say face higher risks to the heart because of substance abuse.

The study involving 3,197 of 27,000 prostitutes attending the Sex Workers Outreach Programme (SWOP) clinics in Nairobi found a third to be obese and worrying rates of hypertension.

SWOP is an initiative of the Ministry of Health, the University of Nairobi and University of Manitoba, Canada.

It runs 10 clinics in Nairobi dedicated to female and male prostitutes and drug injectors with about 6,300 on antiretrovirals (ARVs).

The study was led by Moses Masika of the University of Nairobi and overseen by Joshua Kimani, the Clinical Director at SWOP.

The team was investigating the prevalence of hypertension and obesity among HIV patients enrolled in SWOP.

All the 3,197 study participants were HIV positive with about 98 per cent on ARVs. The study group was aged between 18 and 74 with the majority falling under the 30 to 49 age bracket.

There were 266 females and 201 males aged over 50 years in the study group. The report indicates there were 35 male prostitutes and 338 females aged below 30.

Majority of the participants had only primary school education, were married, most being Christians with only 13 Muslims.

The study shows the males to be earning about Sh 10,000 a month while on average women earned Sh 7,000 in a month.

The researchers found a third of study participants to be either obese or overweight. Almost half of the whole group had a high waist-to-hip ratio.

Waist-to-hip ratio (WHR) is one of several measurements used to determine if one is overweight, and if that excess weight is putting their health at risk.

In this study women were likely to have a high waist to hip ratio, overweight or obese compared to men.

“Females, older participants and menopausal women were more likely to be obese,’ wrote the authors.

The other health problem the study was investigating was hypertension or high blood pressure which if not treated can lead to heart disease.

Some 246 of the study participants or 7.7 per cent were hypertensive with men more likely to have high blood pressure compared to women.

 “Hypertension was significantly associated with being overweight or obese, or having a big waistline,” says the study.

Men in the study, older participants, obese individuals, menopausal women and those with a higher income were most likely to suffer from high blood pressure.

The experts now want prostitutes to be provided with cardiovascular disease care alongside HIV services.


Age of study participants (both gender)

Below 30


Age bracket 30-39


Age bracket 40-49


Age 50 and above



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