Public health programs get a lot of the credit. But so do religion -- and personal behavior. Fred de Sam Lazaro.
FRED DE SAM LAZARO: Senegal has the kind of profile typical of African countries staggering under AIDS. Most of its people are poor, [with] an annual per capita income of just $600, and two-thirds are illiterate. Yet, on a continent where AIDS has infected up to 30% of the population, Senegal's rate is barely one percent.
The imams in Senegal's mosques say there's one important statistic: the country is 95% Muslim, and they are devout. Homosexuality is outlawed by the Qur'an, they note, as is marital infidelity. AIDS in Africa is primarily a disease of heterosexuals.
Voice of Dr. Antoine Mahe: Islam is a religion that prohibits sexual deviance -- it does not allow taking liberties with your sex life. As a Muslim, you are obligated to choose your wife and stay with her.
DE SAM LAZARO: There's no question that Senegal's mosques are filled on Fridays, and life comes to a stand still each day during the calls to prayer.
However, this former French colony also has a thriving commercial sex industry. Prostitution is tolerated -- the only condition being that it keep a low profile. Senegal is alone among African nations to not only acknowledge the sex trade, but it's also taken elaborate steps to regulate it.
In a program that was started way back in 1969 to control sexually transmitted diseases, Senegal began requiring its commercial sex workers, or prostitutes, to register in places like the poly-clinic here in Dakar, and to come in for regular medical checkups. That program is now key to monitoring the spread of HIV in the country.
About 1,000 women are registered at this clinic in the Senegalese capital, Dakar.
Every month, she has to come here for examination, and if its okay, she has a stamp on her carnet. If the police goes to her, at a place of prostitution, she has to show her card, and the policeman checks the regularity of her visits.
If she does test positive for HIV, she can continue to work, using condoms, it is hoped. Across the world, the sex trade is often the source of sexually transmitted diseases, so public health officials say the surveillance has been invaluable.
DR. SULEYMAN MBOUP (AIDS researcher): I am [a] military [man] by training, I am [a] colonel in the Army, and I think that even in any war, you need to know first your enemy. Knowing the current situation, you can adapt to what you are doing.
DE SAM LAZARO: Mama Bambera became a sex worker eight years ago. She says the registration program has been a huge help, both in health care services and information.
MAMA BAMBERA: This is a really good thing. I've learned how to protect myself. I didn't know anything about AIDS. Now, I am able to get information and to pass it on to people with whom I work and my family members.
DE SAM LAZARO: Professor Suleyman Mboup has studied sex workers in Senegal for 15 years. He says the awareness campaigns have paid off. The infection rate among registered prostitutes is a relatively low 15% and hasn't increased since the early '90s.
PROFESSOR MBOUP: We was able to document very high knowledge of this population and some behavior change, [such as] very high rate of usage of condom[s]. While when you go to non-registered prostitutes, you have [an] increase of this incidence rate of SDI, and you have [a] lower rate of knowledge and usage of condom, and also HIV. And so, I think this has been very important factor.
AHMED MANDAME NDIAYE (Louga imam): When I meet someone who rejects people with AIDS, I remind them that they cannot be sure that the person contracted it by cheating on his wife. There are many other ways to catch AIDS, so we have to be careful. We also have to take into account that, according to the Qur'an, God is most merciful. If a person repents, God will forgive, so who are we to not give assistance to such a person?
