Aurélie is a transvestite sex worker in Cameroon’s largest city, Douala. Last month, after a condom he was using broke during sex, he went to a public hospital to ask for post-exposure prophylaxis (antiretroviral drugs that provide protection against the virus if taken within 72 hours). He was turned away. "The nurse told me that it is the risk of my job," says the 28-year-old. "She told me to go to a private clinic in order to spend the money I earn through prostitution."
Aurélie’s experience is not unusual. Prostitution is prohibited and punished in Cameroon. While formal prosecution is not common, male sex workers are frequently targeted by police. To compound this, as in most African countries, homosexuality is illegal and men who have sex with men (MSM) face endemic political, religious and social hostility.
The Cameroonian penal code punishes "sexual relations with a person of the same sex" with imprisonment of between six months and five years and a fine of up to 200,000 CAF francs ($410) – a huge sum in a country where the average monthly wage is around 50,000 CAF francs.
According to popular beliefs, homosexuality is either a spell put over people to bewitch them, a cult or a perversion. In public discourse, the French word homosexuel has come to mean all things evil, according to a 2010 Human Rights Watch report on rights abuses of the gay community in Cameroon.
Being a male sex worker is like a double curse. Stigma, violence and detention are widely reported. As a result, male sex workers operate in secrecy and their male clients are also forced underground. Some, like Aurélie, dress up as women and work on the streets. But many keep their masculine appearance. They seek their clients in snack bars and strip clubs.
"Fleur", 32, a sex worker, says he’s bisexual with a preference for men. "Sometimes the police come to arrest us," he says. "Girls are quickly freed but the treatment of men is different. The police beat us. They say it is to remove the demon of homosexuality in us. They make us sleep on the floor in the cells and only free us after tough negotiations." As he tells his story, tears spill down his cheeks. "This hatred makes me sad. But I feel worse because discrimination is felt even in our families and in places such as schools and hospitals."
"When we go to state hospitals, we have to lie to get treatment," says Cyril, another sex worker. He says nowadays doctors are less likely to report them to the police but they ask their receptionists turn them away. "I’ve had this experience and many people I know have too," he says.
In Cameroon, as in many African states, the government does not recognise men who have sex with men as a risk group. HIV in Africa was originally thought to be transmitted mainly through heterosexual intercourse but there is growing evidence that transmission through MSM is a significant problem.
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