HIV/Aids prevalence is increasing significantly among female commercial sex workers and the gay community despite the epidemic being generally controlled at 3 per cent.

This is according to a survey report released by the Rwanda Biomedical Centre (RMC).

The findings, which serve to give updates on the HIV status in the country, revealed that the prevalence of the disease among female commercial sex workers was 41.4 per cent, varying from province to province.

Further, men who have sex with men (MSM), who have been tested, presented a 3.3 per cent prevalent rate.

HIV prevalence among female commercial sex workers was higher among those aged 40 and above, compared to those in the 15-19 age bracket — perhaps due to a consistent condom use rate of 52.3 per cent in the group as opposed to those aged 40 and above, who were at 43.2 per cent.

However, results show that HIV prevalence is higher among female commercial sex workers aged 25 and above, compared to those between the ages of 15 and 24.

The two groups, which are categorised as high risk population groups, were found to be more susceptible to HIV infections, therefore needing more targeted intervention programmes to minimise risks of spreading the virus.

“This time around, the study we did incorporated HIV prevalence among men who have sex with men, we knew they were a risky group,” said Dr Sabin Nsanzimana, the head of HIV prevention and control at RBC. “But we didn’t know its 3.3 per cent.

“Every citizen, regardless of group, is our responsibility...to see that the HIV virus doesn’t spread and to care for those who live with it.”

Reports indicate that most homosexuals, especially men having sex with men, also exercise heterosexual relations, which has greatly increased the spread of HIV.

Findings also reveal that the reason behind the high spread of HIV among the gay community in the country is the stigma and resentment which is subjected to them by society and their families, which has made them continue practising it discreetly and dangerously.

Many of the homosexuals and other members of the LGBT community who live with HIV do not seek treatment while others do not go for HIV testing because they fear mistreatment from the public and medics, which many have been subjected to.

“There is always discrimination and other forms of mistreatment,” said Enoc Ndahenyuka, a member of the Rwanda Rainbow Rights, an association advocating for gay rights.

“We have had cases of our members who have sought medical treatment, and when the doctor sees that the infection is anal, they put you on the side and call other medics, who begin to ridicule them.

“This has made many shy away from anything related to medication.”

The survey indicates that some MSMs are involved in commercial sex, with those interviewed agreeing to having had at least two paying partners in the last 12 months. Some 42.5 per cent reported having ever been paid with money, goods or services for sex while 17.6 per cent reported sex work as their main source of income.

Fourteen per cent reported to have ever been forced to have sex against their will while 8.3 reported to have suffered forms of violence or abuse because they have had sex with other men.

“It is true, commercial sex among LGBT is high,” added Mr Ndahenyuka. “It’s because most of them are really vulnerable; some have no jobs, others have been rejected by their families and others have kept their orientation secret so that they don’t get thrown out of home.

“These secretly pay for sex.

“In some of these commercial sex activities, most of which are between foreigners and locals, they don’t use condoms. This is perhaps one of the reasons for the high HIV spread among LGBTs.”

Regarding the issue of cross-sexual activities, he said there are bisexuals who practise both, and there are some transgender who engage in penetrative sex with lesbians while having sex with homosexual men, which increases the risks of HIV spread.

However, when Rwanda Today contacted Jean Claude Uwihoreye, the executive secretary of My Right Association, which protects gay rights, he disagreed with most of the findings in the survey and also with the approach the government has taken.

“I don’t agree with most of these reports,” said Mr Uwihoreye. “When a person goes for treatment or HIV testing, does he go as an LGBT member or like any other person?

“I have been seeing RBC talking about these things on TV and I don’t entirely agree with them.

“They should train their health workers in how to handle members of the LGBT community, so that they become friendly and make it comfortable for them to freely test and also seek treatment.

“Some of our members are now accessing some of these services, some have got lubricants and condoms.”

On commercial sex in the gay community, he said they practise it just as it is practiced by heterosexuals, saying they are driven by socio-economic reasons just like the others.

Much as the government indicates that HIV prevalence has been stabilised to 3 per cent over the past 10 years, new infections, at 2.27 per cent, and people between 10,000 and 12,000 getting infected with HIV/Aids every year indicates that the spread to new people is not controlled enough.

And even as preventive measures such as condom use, circumcision and abstinence are being promoted, there has been a sharp decline in condom use in Rwanda, and this is feared to increase the spread if not checked.

On average, 5,000 people die every year of HIV/Aids in the country, most of them never having known what they suffered from.

Reports indicate that more than 600,000 men in Rwanda have undergone circumcision as an HIV preventive and control measure, but this is mostly those living in urban areas, while many in the villages are not circumcised.

The survey, which also sought to get updates on new viral hepatitis and contribute to global HIV scientific updates, was conducted over 12 months.

HIV prevalence was found to be high in women at 3.5 per cent compared to men (2.4 per cent), and higher in urban areas (5.6 per cent) than rural areas (2.6 per cent) while the prevalence increased with age in both sexes.

Authorities at Rwanda Correctional Services have recently come out to confirm the existence of homosexuality in prisons, raising concerns that many of those who are HIV-positive go on to spread it when they are released.

However, calls to distribute condoms in prisons have been suppressed by state health authorities.