Unsafe sex among youths, sexual exploitation worsening HIV sprea

Some harmful practices among young people under the guise of ‘hookup girls and coded runs’ which contribute to the risk of contracting HIV infections as many of them engage in unprotected sex have been found to be increasing cases of HIV infections among teenagers. SODIQ OJUROUNGBE writes on how the new trend is fuelling new HIV infection in Nigeria

It was a dark and rainy night in the Magboro area of Ogun State. A popular club around the vicinity was dimly lit, and the music was pounding.

 A young woman was spotted at the bar, dressed in a tight, revealing dress. She was dancing suggestively to get the attention of men.

Joy as she simply identified herself started out as a waitress in a local bar. She was poorly paid and desired to earn more to be able to support her struggling family.

She said she was hoping to find a job and a better life when she left Akwa Ibom State for Lagos State but ended up in a club in Ogun State.

While carrying out her duty one night, Joy, 19, overheard the discussions of four young girls that visited the club about how coded runs secretly yield money for young girls without anyone mistaking their activities for prostitution.

Sharing her coded runs experience with PUNCH Healthwise, Joy recounted, “After listening to their discussion; I developed interest in the practice and worked up to the girls to help me get into the practice.

“They told me that with hookup, nobody will know that I am doing business with my body. They told me that I will be getting a lot of rich  men as clients who are ready to pay heavily to have unprotected sex with young girls  because they  love having it raw rather than using condoms. I was told that rich men love to patronise young girls than older women because the older women will not allow them to have sex with them without the use of a condom. So, they love to go to teenage girls who will not make things difficult for them.”

“So, that same night, they were able to hook me up with a rich guy who paid me handsomely after we had it flesh to flesh.”

Joy claimed that she was initially angry at the client’s demand but had to yield to it to enable her shoulder family responsibility before her.

“I know that coded runs have their own risk especially if the man has an infection like HIV.  But I have no other choice because all I am looking for is survival. It is not like I am into prostitution. It’s all about hooking up with men who love to have sex raw  and are ready to pay anything to have it ”, she said.

Joy  told our correspondent that after her encounter with those girls, she  started doing  hookup which she claimed pays better than her waitress job.

Stories of struggle and misery

In the shadow of modern skyscrapers, young women like Joy are becoming trapped in a web of deceit and desperation. Beneath the bustle, stories of struggle and misery abound, with women and girls frequently being the most vulnerable due to poverty, violence, and opportunity gaps.

This is the story of some women’s journey from despair to hope, from the depths of hardship to the promise of a better future, and how they get caught up in the cycle of poverty and exploitation by ‘sex-hungry’ men.

Runs, hookups are street lingual in Lagos and many other popular cities across Nigeria.  The term is used to refer to a form of prostitution in which young women and girls are paid for sexual favours. It is also used to describe the casual sexual encounters that are common in this context.

However, the reality of these encounters is often far from casual, as they are often coerced and exploitative.

Findings by PUNCH Healthwise showed that many of these young women come from poor backgrounds, and they have little education and economic opportunities.

It was discovered that their desperation to look for a way to support themselves or their families has continued to put them at risk of engaging in unprotected sex which is reportedly contributing to the cases of new HIV infection in the country.

Discrimination continues

According to data from the World Health Organisation, sex workers face an increased burden of sexually transmitted infections  and blood-borne infections.

WHO revealed that female sex workers globally are estimated to be 30 times more likely to be living with HIV than other women of reproductive age.

In 2019, the Joint United Nations Programme on HIV/AIDS estimated a mean HIV prevalence of 36 per cent among sex workers. The average reported prevalence of active syphilis among sex workers is 10.8 per cent (range 5.8 per cent to 30.3 per cent).

While less is known about the prevalence or incidence of other STIs and viral hepatitis infections among sex workers, increased rates have been documented in different contexts around the globe.

The global health organisation lamented that sex workers face high levels of stigma and criminalization almost everywhere.

Citing modeling studies, WHO stressed that decriminalizing sex work could lead to a 46 per cent reduction in new HIV infections in sex workers over 10 years, while eliminating sexual violence against sex workers could lead to a 20 per cent reduction in new HIV infections.

Making difficult choices

Amina was only 18 years old when she started working as a hookup girl. She had just dropped out of school and was struggling to make ends meet. She knew that she could make money by having sex with men, but she didn’t realize the risks she was taking.

One night, she met a man at a club who was willing to pay her a lot of money for sex. She went back to his hotel room, and that’s when everything changed. He refused to use a condom, and she was too afraid to say no.

After that night, Amina started to notice that many of the men she met were willing to pay more for unprotected sex. She knew it was risky, but she was desperate for the money. She thought about the dangers of HIV and other sexually transmitted diseases, but she needed to make enough money to survive. So she started having unprotected sex with more and more men.

 She soon learned that many other women were doing the same thing. They were desperate for money, and they were willing to take the risks. But they didn’t have any access to information about HIV prevention or treatment, and they didn’t have anyone to help them.

They all had to make a difficult choice – continue to have unprotected sex to make money, or stop and risk losing everything. For many of them, the choice was clear. They had no other options, and they had to keep going.

From discussions with more than four of these young ladies between the ages of 18 and 24, they claimed men pay as little as 25,000 per night to have unprotected intercourse with them.

They asserted that they charged some of the men according to their appearance, adding that on some days, they ended up with individuals who would pay more than 25,000 just for two rounds of unprotected sex.

Spreading HIV ‘unknowingly’

In addition to the personal health risks associated with prostitution, there is also the risk of spreading HIV.

It was discovered during different interactions with some of the young girls that many prostitutes don’t have access to information about HIV prevention, and they don’t have the means to protect themselves.

Investigation revealed that some of these girls are at a higher risk of contracting the virus. And when they do, they often pass it on to their clients, who in turn pass it on to their partners. This cycle of infection continues to spread HIV.

Some of the girls confirmed to our correspondent that many men who visit them are married. This indicated that when those men go home to their wives, they risk infecting them with HIV.

The lack of awareness about HIV is a major problem in Nigeria, especially among young people. Many people don’t know the facts about HIV transmission, and they don’t know how to protect themselves. This lack of knowledge is leading to an increase in new HIV infections, especially among young women.

Findings by PUNCH Healthwise also showed that many young men believe that sex without a condom is more enjoyable, and they are willing to pay more for it. But they don’t understand the risks they are taking, and they don’t care about the consequences. They are willing to put the lives of young women at risk for their own pleasure.

According to a research institute, Lancet,  national HIV prevalence was 2.1 per cent (95 per cent CI: 1.5–2.7 per cent) among adults aged 15–49 years in Nigeria, which corresponds to approximately two million people living with HIV, compared to previous national HIV prevalence estimates of 1.4 per cent from the 2018 NAIIS and UNAIDS estimation and projection package PLHIV estimation of 1.8 million in 2022.

Drug resistance HIV on the rise

In recent years, there has been an increase in the number of cases of HIV that are resistant to antiretroviral therapy.

According to the Centers for Disease Control and Prevention, antiretroviral therapy or ART involves taking medicine as prescribed by a health care provider. HIV treatment reduces the amount of HIV in the body and helps to stay healthy. There is no cure for HIV, but it can be controlled with HIV treatment.

Health experts are warning that drug-resistant HIV is on the rise in Nigeria, posing a serious threat to the country’s HIV treatment programmes.

The experts attributed this increase to several factors, including inadequate monitoring of patients on ART, and poor adherence to treatment.

In addition to the growing problem of drug-resistant HIV in Nigeria, experts are also concerned about the spread of the infection through unprotected sex with ‘hookup’ girls.

A Retired Chief Research Fellow at the Nigerian Institute of Medical Research, Yaba-Lagos, Dr Dan Onwujekwe said there is a risk of transmission of HIV among the young population, especially those who practice unprotected sex.

While affirming that most men are not ready to use condoms during sexual intercourse, the researcher said this mindset could jeopardize the 2030 goal of eradicating HIV infections.

“But the added risk is that what they will be transmitting, many of them may be on drugs and they are not taking their drugs appropriately. So they will be transmitting drug-resistant HIV.

“So from the beginning, somebody who gets infected and patronizes these hookup people might actually be like somebody who looks heavy, but he is actually on drugs. And they won’t tell you that they have HIV and they are on drugs, but they will not be getting the drugs appropriately and they will have resistance strains. That is another added risk that we have to factor in.

“So what can we do? We can only work by spreading awareness. We need to rejig our campaigns to carry these messages that look, it is not only HIV but could be drug resistance rate and there are many of them because people don’t take their drugs appropriately.

“Risky behaviour is more risky now than at the beginning of the HIV pandemic. People should get this awareness in their heads,” he noted.

The researcher revealed that many young people with HIV in the country are having drug resistance because of their risky behaviour.

He added. “If they choose to continue with their risky behavior, they should know what is coming. So this is the message I would like because this thing you pointed out is a fact.

“When I was speaking with our paediatricians and who handles adolescent issues. The paediatrician confided in me that a lot of people, almost half of all adolescents with HIV, have drug resistance. They are not taking their drugs well and they have drug resistance.

“Drug resistance to HIV is high among the adolescents and younger generation of HIV-infected people. So a lot of their treatment has failed. They are transmitting drug-resistant HIV while doing these hookups among their age mates and colleagues and so on.”

Unprotected sex, more HIV risk

Similarly, an infectious disease specialist, Dr. Emeka Okoro warned that the increasing practice of unprotected sex with commercial sex workers in Nigeria is contributing to the spread of HIV with serious implications for the health of the population.

He stressed the need for increased education and prevention efforts, as well as improved access to HIV treatment.

The infectious specialist also highlighted the need for a more compassionate and empathetic approach to working with commercial sex workers, who are often marginalised and stigmatised.

 According to him, the key to addressing this problem is to recognize that commercial sex workers are human beings who deserve to be treated with dignity and respect.

He further said, “This is a serious problem that needs to be addressed urgently, or we risk undoing all the progress that has been made in the fight against HIV in Nigeria.

“Sleeping with hookup girls is not only dangerous, but it also perpetuates the cycle of poverty and disease.

“These women are often unaware of their HIV status and may be more likely to engage in high-risk behaviors, such as unprotected sex. They may also be less likely to access ART, making them more vulnerable to developing drug-resistant strains of HIV.

“We are seeing a growing problem of drug-resistant HIV in Nigeria, and this is likely being fueled in part by the increasing practice of unprotected sex with commercial sex workers.”