Sex workers still shun condoms in Lebanon
BEIRUT, 1 December 2009 (IRIN) - Four years ago, at 16, Rana's husband forced her into prostitution. Despite the risks of sexually transmitted diseases (STDs), Rana, like many local sex workers - estimated to number at least 6,000 - often did not use condoms.
"It's up to the client," said Rana (not her real name). "I want to use condoms, but most of the clients don't." Asked why she ignores the risks of contracting HIV or STDs she simply says: "I don't want to lose the client."
Elie Aaraj, head of Lebanon's SIDC association, warns that the lack of condom use among local sex workers could soon become a public health issue.
"So far there are no recorded HIV cases among the country's surveyed sex workers," he said. "But once the virus gets into the community it could explode."
In a survey over five months in 2008, SIDC interviewed 502 sex workers in Lebanon and found a third of them had been infected with STDs.
According to the National AIDS Control Programme, among the general population there are 1,234 HIV-positive cases, while it estimates between 2,500 and 3,000 people are infected, but unaware of it.
"This figure shows a low prevalence in the country, it is less than 1 percent," said Lara Dabaghi, UNAIDS Project Coordinator - ASAP (Aids Strategy and Action Plan), National AIDS Control Programme. "We want to keep it this way."
Only about 200 sex workers have had an HIV/AIDS test in Lebanon, according to UNAIDS, and none tested positive.
Health workers put that down to the low prevalence of the virus in Lebanon, but recognize that could change quickly. "Some people don't know they are infected," said Dabaghi. "Only 10 percent of infected people know they carry the disease globally."
A task force has been established comprising various ministries, NGOs, UN agencies and the National AIDS Control Programme to design a nationwide awareness campaign, in a bid to keep prevalence low.
One of the aims is to increase condom use. "We have found that only 28 to 30 percent of sex workers use condoms," said Dabaghi. "The problem is that the client is king [and gets what he wants]."
Hiba Abu Chakra, a social worker at Dar al-Amal, a local counselling centre for sex workers, said: "The profile of the local sex worker in Lebanon is generally a poor, abused woman often without education [or] good persuasive skills. Many of the women work on the highways or in brothels where they are often abused."
Dar al-Amal has documented cases of women trading sex for food. Under such circumstances, said Abu Chakra, women have little interest in losing a potential client for the sake of a condom.
A 2008 National AIDS Control Programme report found that while 23 percent of sex workers would try to persuade a client to wear a condom, just over half would accept sex anyway if the client refused.
Legalizing sex work
According to Lebanese law, sex work is legal in brothels; however, the government has not issued licences for brothels since 1975.
"We are advocating legalizing prostitution," said Dabaghi. "If prostitution is legal you can better reach the sex workers and set up prevention programmes. As it stands now, prostitutes are prevented from using condoms or are having to hide them from the police."
According to Abu Chakra, police often arrest women for possession of condoms and they can face up to six months in prison for prostitution if convicted. This makes carrying condoms risky for sex workers.
Campaigners for legalizing sex work argue that sex workers will have better protection under the law, better testing and counselling facilities as well as a greater chance of successfully negotiating safe sex.
Rana lives with the risk of contracting HIV every time she has unprotected sex. "I know about the risk of HIV and I feel more comfortable when the client asks for a condom," she said.