Official statistics on sex workers and HIV in Costa Rica are scant. We only have data that indicate that the infection rate among sex workers increased from 0.4% in 1992 to 0.6% in 1994 to 0.8% in 1995.143
The last report revealed that the infection rate is less than 5%. Nevertheless, this data is based on registered prostitutes from very low socioeconomic background. According to this report, there were 141 Costa Rica. Epidemiological Fact Sheets on HIV/Aids and Sexually Transmitted Infections, UNAIDS, 2004, P.2.
142 Tico Times, Feb 27, 2004
143 Epidemiological Fact Sheets on HIV/AIDS and Sexually Transmitted Infections Costa Rica 2002 Update, UNAIDS 2002.
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3,920 new infections during 2003, of which 523 were female and 72 belong to sex workers (13.8%).144
The number of HIV-infected sex workers who work for the tourist industry is unknown.
In a small country such as Costa Rica given the evidence we have on unsafe sex in the sex industry, 100 sex workers who are HIV positive can have a large impact on the monger population. These men repeatedly share the same sex workers who do not always use condoms. Despite this threat many of the
―experts‖ on HIV and Costa Rica‘s monger community -such as Prolijo- still think that AIDS is not a major concern. Prolijo thinks the articles on HIV and sex work in Central America are rather pessimistic:
I don't want to gloss over this report because AIDS is serious business, but I would like to point out a few
ameliorating factors and some tips. First, the current 0.55% HIV/AIDS infection rate is still very low compared
to many other countries... Second, notice the subgroups with the highest rates of infection - gays, prisoners
(presumably due to gay sex), the Afro-Caribbean groups, street Children and yes also CSW's. My guess is that,
as in the US, this problem is more serious among the lower class sex workers such as street walkers, which most
of us don't frequent, and lower class brothels, which some of us do…The reason I am guessing it is also more
prevalent in the lower class brothels is that they are frequented more heavily by men who are not as educated
about the perils of AIDS or refuse to wear them as part of their culture (ie brothels that cater more to Ticos). So
my advice is don't use street walkers or local brothels. There is also overlap of gays, Afro-Carib and CSW in the
Caribbean port towns of Limon and Puerto Viejo and I am sure the AIDS/HIV rate is highest in that part of
CR, bringing up the country's average rate. So my second piece of advice is don't go to the Atlantic coast for
sex. I realize that there are also some among us who go to the local brothels or who still go bare for genital to
genital sex, so we still shouldn't ignore this problem, but I think the risk is far less amongst the BM girls most of
whom see only 1-2 clients per day if that and who, although they provide BBBJ's, usually insist on a condom
for the actual deed…
This article just fits into the alarmist campaign of the CR government and US religious groups against the sex
trade. Perhaps, I am sticking my head into the sand on this issue, but I think distinctions must be made between
various subgroups within the sex market. We are not all pedophiles, or gay or go with IV drug-using
streetwalkers, or high-volume low rent local brothels.145
Others, such as Kotigre, think there are no STIs to worry about in Costa Rica: ―I never use a condom and I never heard of any STDs in CR so I wouldn‘t worry. By the way, I've got these perpetual blisters that keep coming back on and around my lips. Anybody knows if it's because I'm not getting enough sun and vitamin C?‖ 146
Depending on the source, we have two different stories on STI statistics. The number of new STI, according to the official reports of the Ministry of Health, is increasing but not an alarming rate. The number of gonorrhea cases, for example, rose from 1,278 in 2001 to 1,847 in 2003. Syphilis, on the other hand, remains stable and urethriti s of the non-gonorrhea type shows a light increase from 2001 to 2003. The number of AIDS‘ new cases in 2003 is almost half of the number in the year 2000. (Tables 23-24)
If we only relied on the Ministry of Health‘s reports for our HIV information, the picture of the epidemic seems very optimistic. There are fewer AIDS‘ new cases and the epidemic seems to be in decline since the year 2000. Nevertheless, another picture arises from the hospitals‘ data. This information is more reliable because it comes from the diagnosis made at the places where most Costa 144 Costa Rica. Epidemiological Fact Sheets on HIV/Aids and Sexually Transmitted Infections, UNAIDS, 2004, P.2.
145 http://www.costaricaticas.com/phpbb2/viewtopic.php?t=718
146 http://www.costaricaticas.com/phpbb2/viewtopic.php?t=3928
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Ricans are treated and not from a bureaucratic department that requires doctors to report the new HIV
cases.
Hospitals report four times more new AIDS cases than the Ministry of Health. This means more than 450 new AIDS cases a year.
The difference in numbers can be explained by the fear many doctors at public hospitals have of reporting the true diagnosis to the Ministry, a practice that makes perfect sense in a society with little tradition of confidentiality.
If we add to this number the AIDS‘ patients treated in private clinics and hospitals, the reality of the AIDS epidemic in Costa Rica might look very different and perhaps duplicates the one suggested by the public hospitals.
The situation in the hospitals is a drastic increase in STIs and HIV among the general population and among sex workers.147 The country‘s HIV infection rate is becoming similar to Thailand‘s since the data indicates 1% cero prevalence among the heterosexual population, 6% among homosexuals and 8%
cero prevalence among bisexuals.
Congenital syphilis shows a progressive increase from 1994 to 2001.
Between 1993 and 2002, there are 98 new cases of congenital syphilis per year.
7 of each 100 heterosexuals has syphilis and one has HIV
7 of each homosexual men have syphilis and 6 are HIV+
9 of 100 bisexual men have syphilis and 8 are HIV+
55 of 100 registered sex workers have bacterial vaginosis
Contrary to some of the mongers‘ optimism about HIV in Costa Rica, this data suggests that the epidemic is a serious threat to both the American and the Costa Rican communities.
147 The Tico Times, Weekly Edition: Vol. VIII, No. 131, August 27 2004.
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6.