AFRO-NETS> Why Senegal's Bold Anti-AIDS Program Is Working

[Claudio Schuftan <aviva@netnam.vn>]

Why Senegal's Bold Anti-AIDS Program Is Working
-----------------------------------------------

Boston Globe (01.05.03):
Nicholas Thompson

"...Prostitution was legalized in this predominantly Muslim country 
[Senegal] in 1969, and today the government tolerates it as long as 
each prostitute registers with the state, is over 21 years old, and 
comes regularly to a center run by the Ministry of Health for check-
ups, education and medical treatment. And that's a big reason why 
[Senegal] has an HIV infection rate of about 2 percent while... some 
Southern African countries, such as Botswana, report that a mind-
boggling 39 percent or more of the adult population is infected.

"As University of Notre Dame physicist Albert-Lszl Barabsi sought to 
demonstrate in his recent book, 'Linked: The New Science of Net-
works,' an epidemic like AIDS spreads, to a large degree, from a very 
small number of individuals.... And as in other networks, like the 
World Wide Web, these 'hubs' bear the lion's share of responsibility 
for connecting everyone else - which in this case means spreading the 
disease. Educating one typical young man or woman about AIDS might 
save five additional people. But educating and protecting a single 
prostitute might save thousands, or even more....

"Senegal is desperately trying to stop infections from spreading 
among people who could serve as hubs by regularly checking prosti-
tutes from AIDS and other [STDs]. If they are HIV-positive, they have 
the option of government-funded treatment. If a prostitute is discov-
ered to have an STD, she will lose her little green license card un-
til she's finished treatment, largely because infection with one STD 
dramatically increases one's risk of contracting HIV. This program is 
similar to one in... Nevada, where prostitutes are tested and 
screened for AIDS and other STDs before they are licensed to work. 
But where Nevada bans HIV-positive prostitutes from working, Senegal 
allows most of them to go back on the streets after undergoing addi-
tional AIDS education. Banning HIV-positive prostitutes, the govern-
ment's reasoning goes, would both stop these women from coming in for 
checkups and increase illegal, unregulated prostitution....

"And the program is working. Fewer than 15 percent of women who come 
to the center test positive for HIV.... Educating even a few prosti-
tutes about AIDS helps spread information throughout the profes-
sion....

"...Senegal has simply been smart and original in recognizing that 
prostitution exists, that it feeds the epidemic, and that it's better 
to deal with this problem instead of ignoring it...."

The author is a fellow at the New America Foundation.

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