December01,2022

Abstract Volume: 3 Issue: 3 ISSN:

Human Immunodeficiency Virus the Risk of Spread; Interview with A Sex Worker

Mohammad Othman*


Corresponding Author: Mohammad Othman, Assistant professor of Obstetrics and Gynaecology, Fakeeh College for Medical Sciences, Jeddah, Saudi Arabia.

Copy Right: © 2022 Mohammad Othman, This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Received Date: June 02, 2022

Published Date: July 01, 2022


Abstract

Female sex workers are immensely prone to HIV many folds more than general population. With ignorance and literacy more clients to these women are getting infected and transferring this infection to their families and the community. In this article an interview was conducted with a female sex worker in one of the Gulf Council Countries (GCC). This subject is taboo in this area and if someone infected, they will be stigmatized.

The result of this interview demonstrates openly the importance of sex education and the need to address this problem. On the other hand, there is extreme deficiency of scientific research in the GCC regarding sex workers. 


Keywords: Female sex worker (FSW), HIV, Gulf Council Countries (GCC), Awareness, Transmission.

Human Immunodeficiency Virus the Risk of Spread; Interview with A Sex Worker

Introduction

Human Immunodeficiency Virus (HIV) affects the immune system leading to Acquired immune deficiency syndrome (AIDS). This infection results in increasing people vulnerability to infections and any opportunistic diseases. This susceptibility worsens as the syndrome progresses. HIV is available in infected person body fluids implicating semen, vaginal fluids, blood and breast milk. Likewise, passage of infection from infected pregnant women to babies during pregnancy, or during childbirth, and through breast feeding which compromise vertical transmission. HIV can be transmitted in different ways, such as sexual intercourse: vaginal and/or anal and through blood transfusion, and using contaminated needles [1, 2].

Although Female sex workers (FSW) make up a small percentage of all women, according to The Joint United Nations Program on HIV/AIDS (UNAIDS) there are “tens of millions” of sex workers globally [2, 3]. Sex workers are those persons who are paid for sex. FSWs have larger HIV virus load compared to general population. Available data from more than 110 countries documents that HIV infection is 12 - 30 times higher among sex workers than for the normal population as a whole [1-5]. Almost 15 – 33 % of all new HIV infections being attributed to sex work, including clients and partners of clients [1, 3, 5, 6].

The aim of this study is to evaluate the knowledge of FSW regarding HIV infection and what is the possible risk that they carry to themselves and their clients.

Interview

A 24 years old woman of Arabic origin (North Africa) lives in one of the Gulf Council Countries (GCC) and her profession is sex worker. Her monthly income as she claimed from her profession is $25000 - $30000. She started her profession in the last 5 years. In her original country, she finished intermediate school (9th grade) in her village. According to her, she is working almost daily with so many different customers she stopped counting how many men per night she had sex with. She accepts all types of sex based on the client request (oral, vaginal and anal) and she does not refuse any kind of customers (man, woman and group of any kind) and she does not discriminate between races or nationalities. She is using contraceptive bills regularly and she is not worried about pregnancy. She is not worried about sexually transmitted diseases (STD) either since, she asks any man, in advance, she is having sex with to have shower before intercourse. According to her; men are the only source of STD’s and having a shower before sex protects against transmission of the disease for few hours. She asks men to use condoms because, according to her knowledge, HIV only transmitted by men semen and this is the best protection against its transmission. However, If a customer refused to use condom then he must ejaculate outside her vagina and that’s enough as protection (as she argued) and usually she is having shower or wash the ejaculate with water immediately after she finishes. When she was asked, if a man did not control himself and ejaculated inside her with no condom, she replied I usually clean it with water of a shower or water spray immediately to make sure no HIV transmitted to me. She also added that she and most men prefer oral sex with no condom, and they can ejaculate in her mouth and it does not cause disease because mouth fluids and stomach acids will kill any disease. If a man wants to have sex with her then she must wash her vagina first to make sure no other man fluids were left in her and this way she thinks she is protecting herself and customers by these acts.


Discussion

This interview establishes with certainty that this FSW has no knowledge about HIV transmission. Moreover, she is not only at risk of acquiring HIV, but also exposing all her clients to the virus. Being in this base of poor knowledge will definitely make her a new HIV victim very soon [7]. Sex workers were known to have a high prevalence of HIV [8].  Young clients who escort this sex worker might believe her humble facts and they might become intermediate hosts of the disease spread especially local young ones.

Perhaps the reason behind the sex worker poor knowledge in HIV transmission is the sort of the job that she is doing, as it is not an accepted job in in the GCC (Gulf Cooperation Council countries), in particular which is part of the Islamic society or in the Middle East in general. Added to that, being not well educated hinders her capabilities to search and understand the facts of the disease and infection. Although, sex work as a profession in many other countries outside the Middle East is considered as any other job [9-11].

Sex workers in the GCC will never have the chance to learn about the risk of HIV that they might face or transmit since talking about it is offensive and taboo. In addition, most of these workers, if not all, come from low educational and socio-economic countries. As stated earlier, it is commonly assumed that most of her clients are from the young generation lads. Those men are usually unknowledgeable enough about the HIV or have the fear of asking about this topic to avoid the community stigma. Therefore, an increase in the rate of HIV as consequences to this is expected.

The data that extracted from this sex worker must be interpreted carefully. Although the fact that sex as profession is not accepted and will never be in this community, enforcement of better awareness, general knowledge in this matter to public is inevitable especially in young generation. Chastity is the only way that can help to decrease the risk of HIV spread. Furthermore, sex outside marriage should be completely avoided by young generation. Attitude of hiring FSW will never stop if public awareness is still poor, in fact it might increase the risk of transmission of the virus. Sex education regarding HIV transmission and prevention proved its effectively in many reports [6,12,13]. Therefore, public awareness campaigns, open community talks and workshops are needed. This will help the young generation and may be older ones to stick to the Islamic roles and avoid any prohibited acts that they should stay away from. There is a definite need for studies exploring the risk and perceptions among FSW in more depth and address the problem precisely to come back to plans that helpful in increasing the public awareness and knowledge. As all studies, this study has some limitation, the study was a qualitative study that contains one person only. Accordingly, generating a conclusion should be done with care.


Conclusion

Although, sex acts are completely illegal and prohibited in the GCC countries, some people do come from other countries to work hidden in this business. No matter how these workers continue this practice, there is a need for educational activities that increase the public knowledge in HIV transmission. If such activities were applied by the legal authorities, it will narrow the chances on FSW to practice this job in the GCC countries and might push them away from it.

By far, this is one of the earliest articles discussing this taboo subject in the GCC area. More research needed to help in controlling and managing HIV infection.     


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