Country Case Studies on Sex Work and HIV Prevention 111
Early research demonstrated that a great proportion of sex work in Nigeria was associated with male clients’ occupations that involve transportation and long durations spent away from home, such as trucking, oil production, and naval service; factors which are still fairly consistent today. This can encourage an establishment of relationships, either temporary or long-term, in transit or destination areas. Men in these occupations constitute a majority of the sex worker’s clientele; for example, truckers may be the predominant clients in junction towns that are geographically distant from other areas of commerce. Seventy-eight percent of the male clients surveyed in the Nigerian Transport study were married, half of whom were involved in a polygamous marriage, spend approximately nine days away from home during trips, and have an average of 6.3 current partners with approximately 25 lifetime partners. Though all truckers were knowledgeable of HIV, only half had ever used a condom and 15% used them on a regular basis (Orubuloye, Caldwell et al. 1993). A study of Naval personnel in Lagos found that 32.5% reported sexual contact with female sex workers and 19.9% within the last six months. These men reported an average of 5 lifetime partners and approximately 69.2% of the female sex workers’ clients from the Navy were married. Low condom use was reported among Naval workers as well, 41% of whom did not use a condom at last sex with a female sex worker, and a majority reported being under the influence of alcohol at the time (Nwokoji and Ajuwon 2004). Low condom use may be an outcome of the high proportion of naval personnel who felt that they were not at their risk for HIV was low (68.8.%) and the perception that multiple partnerships is a tradition of naval officers, is common (Nwokoji and Ajuwon 2004). Through the course of qualitative research, investigators further found that naval personnel rejected condoms because of decreased sensation and pleasure, alcohol use, and the physical barrier between male and female partners (Nwokoji and Ajuwon 2004). The 2010 IBBSS most recently reported lower figures of sex with sex workers in the last 12 months among these client groups, ranging from 5.0 to 8.9 among armed forces, transport workers and police, which may suggest a decline in high risk sex or a reporting bias. Nevertheless, the low proportions of these men who demonstrate accurate HIV knowledge (29.6 to 57.9%), suggests that interventions involving clients, particularly these occupational groups, are warranted (Federal Ministry of Health [Nigeria] 2011). These findings highlight the cultural norms that influence sexual partnerships and potential risks. They further suggest that traditional concepts