Promoting AIDS awareness and treatment in Senegal, where 20 percent of sex workers and men who have sex with men (MSM) are HIV-positive, runs up quickly against harsh anti-gay laws and attitudes.
"We face verbal and physical aggression in the streets if people know we are MSM," said Lamine, secretary-general of a group organized to persuade men to learn about safe sex and HIV testing.
Efforts by Lamine's group, Xam Xamle ("teaching knowledge"), have been largely unsuccessful in this predominantly Muslim West African nation. The sub-Saharan region is home to about two-thirds of the estimated 33 million people worldwide who are HIV-positive.
Prevention efforts by governmental and non-governmental organizations alike often are unpopular in Senegal, said Dr. Bara Ndiaye, project leader for Enda Sante, an NGO involved in HIV prevention and treatment. "This society is very hostile toward homosexuals."
For women over 21, prostitution is legal in Senegal. Registered sex workers can access health care, health information, and condoms. However, estimates suggest only 20 percent of the sex workers are registered, in part due to stigma.
"We are sometimes rejected by our own kids," said Ndeye, an HIV-positive female sex worker and spokesperson for the support group Karlene. "If the community finds out you are a sex worker, your opinion will no longer mean anything."