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Abidjan-Lagos: the road bringing trade, HIV

Agence France-Presse - December 1, 2007
Isabelle Ligner

COME, Benin, Dec 1, 2007 (AFP) - Kofivi, a Beninese of 45, has spent all his working life in the various ports of the West African coast, from Abidjan to Lagos, a major route both for trade and for the spread of HIV-AIDS.

This former migrant worker used to send a chunk of his salary back to the village every month to help his subsistance farmer relatives eke out a living.

They kicked him out a year ago and he was taken in by an association here that helps people living with HIV-AIDS.

"This is a densely-populated corridor, more than 1,000 kilometres long crossing five countries," said Lise Adjahi Pourteau, coordinator of Medecins du Monde (MDM, Doctors of the World) in Benin.

"It's an essential road axis for the region and brings with it a high risk of the spread of HIV," she added.

In the countries concerned prevalence rates around this road are far higher than the national average.

Around Come and Ouidah for example, a zone to the west of Cotonou, which is right on the route, prevalence rates run at around 5 percent: more than double the national average.

This is one of the reasons why MDM started running a prevention, detection and care programme there, said Adhahi Pourteau.

Since 2005, as part of this programme, MDM have tested 20,000 people, of whom 2,200 have been declared HIV-positive. Some 500 of those who are HIV-positive are today receiving anti-retroviral drugs.

Kofivi is one of them. He found out he was HIV-positive in 1989. He has a wife and children now aged 10 and eight in Abidjan, whom he left to come and get treatment in Benin.

"I travelled a lot in Ivory Coast, in Ghana, Togo, Benin and Nigeria," he murmured, visibly weakened by his illness. "And I had the sort of lifestyle that goes with that."

The Abidjan-Lagos corridor association (Ocal), based in the commercial capital Cotonou, also carries out prevention and medical care along this whole stretch. It targets the border towns and the most vulnerable sections of society - lorry and taxi drivers, sex workers and traders.

Francois is one of the people trained up by local organisations to work in sensitising local people.

Although he has kept his regular job as a taxi driver, his new role is to turn conversations with clients or colleagues as often as possible to the risks of HIV-AIDS.

"It's not so much a case of encouraging people to change their lifestyles but rather of encouraging them to go for tests and to use protection," he said.

"Around here, people tend to spend weeks at a time away from home and a lot of them succumb to sexual temptation on the roads, notably with prostitution," explained Corneille Houangni, a local official in charge of the fight against HIV-AIDS.

Associations of people living with HIV-AIDS are trying to get local communities to stop stigmatising and rejecting AIDS-sufferers, Nicolas Ahouansou, the head of the Come association, told AFP.

It is this fear of being stigmatised in the region that stops many of those who suspect they have HIV from going for testing and counselling.

For the same reason, mothers who suspect -- or even know -- that they are HIV positive do not refrain from breastfeeding their infants, for fear of being of their condition being recognised.

And it accounts at least partly for the fate of people like Kofivi. whose family threw him out. When he became too sick to work he went back to his village outside Come.

"After my second bout of tuberculosis, last year, the family told me I had to leave, that I was just another mouth to feed," he said, his cheeks emaciated, his eyes sunken.

After a life spent going from port to port, all he longs for now, he admits, is to die at home, surrounded by his family.

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