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Abstract
A cow dies with grass in it’s mouth” – Fishermen’s response to “zero grazing” in Kisumu, Kenya
A. Sharma1, E. Bukusi1, Z. Kwena1, A. Buffardi2, B. Agot1, C. Muga1, K. Holmes2
1Kenya Medical Research Institute, Centre for Microbiology Research, Nairobi, Kenya, 2University of Washington, School of Medicine, Seattle, United States
Background: Kenya, a high HIV prevalence country, receives funds to improve access to basic services and livelihoods for those HIV-infected. For those uninfected, funds are often limited to HIV prevention through abstinence, being faithful and condom use (ABC). We examined the relevance of this donor policy for fishermen along Lake Victoria, Kisumu in Nyanza Province. Nyanza bears half the Kenyan HIV/AIDS burden.
Methods: We discussed the daily routines of fishermen in12 focus groups of 8-12 fishermen and clarified findings with12 key informants.
Results: Organizational structures and inequitable access to resources influence fishermen’s sexual behavior. Multiple relationships of jaboya (priority buyers and sellers) ensure constant local movement of fish in an industry threatened by international canneries. Some fishermen and female fishmongers, often widows from other beaches, seal their jaboya relationship with sex. Immigrant fishermen may unknowingly “cleanse” a widow for inheritance through ritual sex. Without fixed routine, location or crew membership on fishing boats, fishermen have relative freedom to spend their daily earnings on alcohol and sex. Boat owners buy intoxicants for nighttime fishermen to combat the chill and their fear of seeing she-demons. Though cognizant of the risk posed by their sexual partnerships often with impaired judgment, some fishermen do not adopt ABC accepting that just as “a cow dies with grass in its mouth,” they will die of HIV/AIDS while continuing to have sex. Commensurate with these reports, separately, we found a HIV prevalence of 29.4% in a representative sample of this population of fishermen.
Conclusions: Resources are needed for STI/HIV risk reduction through changes in the structures that influence highly localized sexual behavior. Changes in how business is transacted and provision of livelihood programmes and basic health and social services, particularly for widows and single mothers, could prevent new infections and may eventually, save on funds required for treatment and comprehensive care.
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