Women on the Edge

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Sex work is one of the most diversified industries in the Middle East and North Africa,offering a wide array of services to a vast range of clients at a variety of prices. Malika,a woman living with HIV from Oran in Algeria, is just one face of this booming trade.Married at 20, her union was a disaster from the start. “I was beaten and cursed by [myhusband] all the time. He couldn’t talk to me without fighting. Life became unbearable withhim.” After fits and starts of separation and reconciliation, Malika eventually divorced, andmoved back home.

In her mid-twenties, like many young people, through friends, she got to know the city’snightlife. “I was impressed with their world and dresses,” she said. “Especially after I wasdeprived of everything.” So Malika took off her hijab, and entered the sex trade. The moneywas relatively good, by local standards—around 2,000-3,000 Algerian Dinar (around USD25-40) a “pass”—and it was quickly spent. While her family depends on Malika’s income,its real source is not something that she has disclosed. “I explained to my family that I workin the information technology field, and that I do some business deals which allow me tomake some extra money.”

A couple of years ago, Malika’s health began to falter, with dramatic weight loss and othersymptoms. She suspected it might be HIV, having had unprotected sex with a boyfriendwho suffered the same signs. Nonetheless, her test results were a shock. “Since I knew Iam infected with the virus, my life totally changed and my view of life changed too. WhenI was married, I suffered from poverty and the treatment of my husband to me. I thoughtthat the meaning of life is money,” she said. “But now I understand life very well. I wouldadvise women to be close to God Almighty, and don’t follow their whims.”

As study after study in countries across the region shows, Malika’s experience is far fromunique.1 Poverty—often brought on by divorce and the need to support kids familyinstability, including a history of domestic violence; abuse by clients, pimps and police; andpoor access to reproductive, sexual and other healthcare services—are realities for femalesex workers.

Like most women in MENA, knowledge of HIV and STIs among female sex workers isgenerally limited. Multiple clients a day is generally the rule and condom use varies, froma low of 25% of female sex workers in Egypt reporting condom use with their last client, tomore than half in Morocco claiming protected sex. A number of economic, legal and socioculturalconsiderations conspire to make women agree to unprotected sex, even when theyknow the dangers.