TRANSACTIONAL SEX LESSONS LEARNT PRESENTATION 10 TH ANNUAL MEETING OF INTER-AGENCY WORKING GROUP (IAWG) ON REPRODUCTIVE HEALTH IN CRISIS SETTINGS PROF. ELIZABETH N. NGUGI DIRECTOR UNIVERSITY OF NAIROBI CENTRE FOR HIV PREVENTION & RESEARCH (UoN-CHIVPR) DIRECTOR & FOUNDER MEMBER SOCIETY FOR WOMEN AND AIDS IN KENYA (SWAK) DIRECTOR & FOUNDER MEMBER KENYA VOLUNTARY WOMEN REHABILATATION CENTRE (K-V0WRC)

Let me start by saying that I have worked with and for women and girls in sex trade for over two (2) decades. About 90% of women in sex trade in Africa is poverty driven. And so this afternoon, my aim is to show that this phenomena becomes more pronounced in refugees’ situations, hence the need for targeted interventions.

By and large, sex-workers have frequent partner change i.e per day depending on class --- the higher the class, the less the clients.

Unless and until they are reached by targeted HIV/AIDS interventions, the level of condom use is low e.g. 4% (Kenya). Thus experiencing poor reproductive health status (frequent STDs and unplanned pregnancies). E.g. HIV infection is 20-88% (Kenya).

SEX FOR MONEY OR KIND IN REFUGEE CAMPS Sex trade exists in these camps (e.g. Kakuma and Dadaab) It is highly stigmatized It is a gender issue It is associated with HIV/AIDS The women are displaced and are poor.

Because of stigma, even access to condom becomes a problem e.g. “when people see us going to workshops” they point at us Malaya (prostitutes are going to collect condoms” (Kakuma 2002). In one refugee camp, sex work was said to exist secretly, and the majority being young years (Dadaab 2002).

It was said to be poverty driven and being dumped by men when they become pregnant “cheated by men that they would marry them, made them pregnant and then exited their lives”. Hence the “secret sex work”).

Clients are said to come from the displaced males as well as the surrounding community of host country. Quote: “Miraa chewers (refugees) beat their wives saying “they cannot get sexual satisfaction from their wives and therefore they can go with prostitutes. They thus can bring infection to an innocent wife” (Kakuma 2002).

Some of the sex-workers move in and out of refugee camps to big towns such as Nairobi. The scenario demonstrates how the chair of STD/HIV transmission cannot be cut unless targeted HIV prevention, control, care and support across continuum is implemented.

This should also include cross cutting issues ---  Gender  Human Rights  Economic alternatives

CUTTING HIV TRANSMISSION CHAIN SOURCE: NGUGI E.N. Other men Other men/women Other men Other women Other women/men Other men Other men/women