A unified front in the fight against AIDS along the Corridor in West Africa

Preventing HIV along the truck routes of the Gulf of Guinea

Many people in West Africa question the existence of AIDS. Some say, "That is the disease of homosexuals. We don't have homosexuality in Africa," or "The West invented AIDS for population control; they are afraid that Africa will grow too strong." These sentiments are conspicuous in many regions of West Africa. It is surprising that until now only a few research groups have dedicated themselves to studying the effect of these attitudes and beliefs on the epidemic's regional growth.

The Corridor Project has worked diligently to shed light on the social and economic motives behind these attitudes through large-scale scientific studies. The project is bringing together the efforts of five countries to arrest the spread of AIDS along what is both a shipping corridor between Nigeria and the Ivory Coast and a corridor for HIV transmission in the subregion. The project has worked together with hundreds of local nongovernmental organizations to gather information and analyze the results of their programs, with the goal of eventually creating a sound, fact-based policy for HIV/AIDS along an especially vulnerable coastline.

Be wise, use a condom: Nigerian HIV prevention campaign poster

The work has already proven critical. In the past 15 years of the fight against HIV/AIDS in West Africa, there has been a general lack of knowledge and a weak understanding of the sexual behaviors of the groups who are most likely to transmit the disease. Accordingly, these groups of people have remained the most vulnerable to contracting and transmitting HIV/AIDS. For years, organizations working in the field just watched from the sidelines, curious about whether individuals were absorbing and understanding their HIV/AIDS prevention messages.

Before the Corridor Project began to gather and publish their findings, the general lack of understanding about what was and wasn't working was causing some people that work within the field of HIV/AIDS to question the value of prevention and awareness programs in general. One representative from an international organization in Cotonou, Benin, stated, "What is all of this money doing? We see money pouring in, checks being cashed, but where are the results? What has changed?"

Before the launch of the Corridor Project in 2004, hundreds of organizations worked in isolation. There was little guidance or coordination. Many organizations operated programs that were completely off the mark. The Corridor Project is bringing people together for the first time to respond in a unified front against the problem of HIV along shipping corridors in West Africa. When they started, they immediately recognized why their role was important. "What we immediately found when we started was that there were no programs along the borders. Nongovernmental organizations preferred to set up in big cities. This created a door for the infection," stated Agapit Yao Akolatse, Evaluation Expert for the Corridor Project.

Even for organizations with the insight to set up HIV/AIDS programs along the borders, the impact of these programs on the fast-moving population of the corridor was hard to determine. Perhaps their programs had impact, perhaps they did not. Gathering the data to define their impact would have been a daunting task for any one organization.

It's your right to stay alive

As a result, the 14,000,000 yearly travelers, migrants, and workers who are recognized as being very vulnerable to contracting HIV were consistently overlooked by statistics, while all the time lacking services to minimize their vulnerability.

For the individuals on the ground along the numerous border checkpoints scattered along the Gulf of Guinea, the need for HIV/AIDS programs has always been clear. "Truck drivers are far away from their families and have extra money to spend, while the young girls who sell goods at the truck stops are generally in need of money," said a representative of Red Cross on the border between Togo and Benin. This situation has obvious results. However, only a few people in the local communities or governmental and health agencies seemed aware of the extent of the problem. In many places along this well-traveled road from Lagos in Nigeria, across Benin, Togo, and Ghana, up to Abidjan in the Ivory Coast, services were not available.

To convince the public of the need for HIV/AIDS programs, a baseline study was conducted by the Corridor Project in 2004 to identify HIV/AIDS prevalence in the Corridor and to put a system in place to monitor risky behavior trends. The goal of the study was to gather the necessary information to steer the programming of the hundreds of collaborating NGOs in the region. During the study, uniformed border agents, truck drivers, young people, and commercial sex workers were questioned on their sexual practices.

When the results were revealed, they confirmed suspicions and highlighted the urgent need for services. Most importantly, they stressed an urgent need to target young women. The general demographic profile of these young ladies reveals why they are vulnerable: 85% are less than 35 years old, 23% are uneducated, 78% use alcohol, 9% do not believe in the existence of AIDS, and 39% have never taken an HIV test. More specifically, the results highlighted that most of these young ladies are still engaging in dangerous sexual practices. Four out of five young women surveyed reported that they had had sex in exchange for money in the preceding twelve months, and only 62% of commercial sex workers declared that they used condoms systematically. Agapit Yao Akolatse states that "Statistically, women along the corridor are young. They have not gone to school. They have no information. They do not have the power to resist in the face of opportunities to sell themselves for sex."

Outreach materials produced for the Corridor Project are eye-catching

One of the most surprising results of the baseline study revealed that three percent of those questioned admitted to engaging in homosexual activity. The main reasons given for homosexual sex included that it was generally more pleasurable and that there were economic motivations. The general rate of homosexual activity is equivalent to the percentage in many Western nations. A finding such as this one can help to convince those who refuse to believe that Africans engage in homosexual acts. This is encouraging because organizations can begin to change basic public conceptions about sexuality and discrimination by referring to evidence.

One of the main goals of the Corridor Project is to help organizations understand whether their HIV/AIDS programs are actually helping to change behaviors of high-risk groups on a regional scale. In October 2005, a team of interviewers surveyed thousands of travelers and workers along the Corridor. Individuals were pulled aside as they waited in customs and immigration lines to complete a ten-minute survey. Among demographic questions about nationality and age, there were also questions about border and checkpoint procedures and sexual history. The results of these surveys will be analyzed and compared with the baseline data to determine whether organizations have been successful at increasing people’s knowledge about HIV/AIDS in the past two years.

Before the project commenced, there was simply not enough information for policy makers and programmers to act swiftly and constructively to combat the threat of AIDS. Today, Africans crossing the borders between Nigeria and Ivory Coast are being systematically targeted with HIV/AIDS prevention messages, directed to local clinics that treat STIs, offered counseling, and referred (in the case of young women) to programs in nearby communities that may help them to overcome their poverty without exploiting themselves sexually. The Corridor Project has brought a new credibility to the efforts of nongovernmental, public, and private agencies working to reduce the HIV transmission rate in West Africa.

In December, a team from the Corridor Project attended the International HIV/AIDS and STIs Conference in Abuja, Nigeria, to present preliminary findings for the project. Among the most important achievements reported to the international health community were the establishment of eight border control AIDS committees, setting up a Corridor radio network, and the implementation of a regional AIDS policy among five governments.

Some of the preliminary findings of the follow-up study were also revealed. Condom sales at the borders had increased by 50% since the start of the project, and 15,000 drivers and 238,000 passengers were reached with HIV prevention messages. The Executive Secretary of the Corridor Project, Dr. Justin Koffi, was encouraged by these findings and announced that "The involvements of five countries, several partners, stakeholders and the target population from diverse background in the formulation and implementation of programmes have given [our program] a hybrid vigour. We are confident that together we will make [our program] a reference for other developmental projects that are bound to be supra-national to succeed."

To learn more about the Corridor Project, please refer to their website at www.corridor-aids.org.


Cotonou: Nights Under a Streetlamp
What Does your Thirteen-Year-Old Carpenter Know About AIDS?