KATUNA, 15 October 2008 (IRIN) - Said*, a long-distance trucker from the Democratic Republic of Congo, is married with six children. His work keeps him on the road for weeks at a time, and on those long, lonely nights he turns to his girlfriend, who lives in town of Malaba on the Kenya-Uganda border.

"I decided to have one girlfriend, because if you go out with so many women then you risk getting HIV or other diseases," he told IRIN/PlusNews. "I have been married for 13 years and have had this girlfriend for about nine years."

Said sees his girlfriend and their two children about once a month. On the surface he may seem to have made the right choice, sidestepping the risk of HIV through indiscriminate sex, but according to residents in the Uganda-Rwanda border town of Katuna, he should not feel so safe.

"Many women here have at least three boyfriends, each of whom thinks he is the only man in their lives," said Hope Tumuhimbise, a sex worker in Katuna, Uganda. "The women even have friends in several towns, who can tell them when one tucker is in a nearby town so they can get rid of another one and pretend they are alone."

Said admits that he has never gone for an HIV test and has no real way of knowing whether he is the only man his girlfriend is sleeping with. "I have told both her and my wife that if they sleep around and give me HIV, then they are killing themselves, because who will provide for them and the children if I am not around?"

Brian Atuhire, site coordinator for an HIV programme in Katuna, run by the NGO, Family Health International (FHI), http://www.fhi.org/en/index.htm said these "girlfriends" were more difficult to categorise as sex workers, and the truckers often did not see them as such.

A 2008 study of condom use among female workers along highways in Uganda http://www.ncbi.nlm.nih.gov/pubmed/18665445 found that they used condoms 74 percent of the time on average, but this dropped to 50 percent with regular clients; just 19 percent of sex workers reported 100 percent condom use.

"If it is a sex worker whom they meet in a bar and pay for sex once, then the truckers know they should use a condom – to them that's obvious. The challenge comes with these so-called wives or girlfriends," Atuhire told IRIN/PlusNews.

"The truckers pay rent, start businesses for these women, and feel more of a connection; they believe they are cleaner, so they don't bother with condoms for these women."

Crossing the border a risky business

The HIV risk is high in these towns; according to voluntary counselling and testing (VCT) records in Katuna's largest health centre, prevalence is about 11 percent, compared with a national average of 6.4 percent; according to antenatal clinic surveillance in 2007, Gatuna town, on the Rwandan side in the northern province of Byumba, has an HIV prevalence of over six percent, about twice the national average.

Some women cross the border from the Rwandan town of Gatuna to buy food cheaply in Katuna, Uganda, and then ask truckers to smuggle the food back to Rwanda where the women sell it; payment for this risky deal is usually in the form of sex.

Tumuhimbise, known informally as the "chairwoman" of Katuna's sex workers, said most women in the town were engaged in sex work.

"There are those who stay in the bars and drink with the men, or those who go shouting that they are selling sex after they have smoked bhang [marijuana] – those ones are the malayas [sex workers]," she said. "But if a woman has her own home and business, and the men come to her house, then it's difficult to call her a sex worker."

She runs a restaurant in Katuna, and had several Congolese "boyfriends" before she discovered she was HIV-positive in 2007. Today, Tumuhimbise encourages local women and truckers to use condoms.

FHI also works with low-income sex workers in the area to give them skills in agriculture, commerce and information technology so they are able to find work or start businesses without having to resort to sex work, but Atuhire admitted that it was tough to compete with the truckers, who gave the women as much as US$100 every time they came to town.

In conjunction with the local truckers union in Katuna, FHI runs a SafeT Stop where truckers can relax, watch cable TV, play pool and learn about HIV. A "moonlight" VCT operation runs once a week, with counsellors shouting from the centre's balcony for truckers and others to come and find out what their HIV status is.

"After a while the message is routine – the truckers have heard it all before and know everything they need to know," Atuhire said. "We emphasise that they must always use condoms with all their sexual partners, and hopefully the messages will eventually get through."

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