Biology Reference
In-Depth Information
aroused concern, as well as scientific interest as to whether their immunity was
waning. A key finding in this study was that the women's seroconversion was cor-
related with a reduction in sex work: that is, a break in sex work was associated
with a loss of the immune responses which were protecting them against the HIV
virus. The study therefore drew some important conclusions for vaccine develop-
ment (Kaul et al.
2001b
: 3). Attention shifted to the factors that led to seroconver-
sion and what could be learned from this for vaccine development (Kaul et al.
2001c
). Subsequent studies on the long-term survivors have suggested new direc-
tions in HIV research (Fang et al.
2004
: 697).
Other studies, which used the women's genetic samples, have focused on
genetic variation in order to determine susceptibility to HIV-1 infection (Ji et al.
2004
). Genetic studies have provided new insights with regard to the factors asso-
ciated with resistance to infection by HIV-1
22
and more studies are under way,
which could contribute to the development of a vaccine against HIV.
Follow-up studies of 850 women in Majengo are currently being conducted as
part of the ongoing collaborative project by researchers from the universities of
Nairobi and Manitoba.
5.3.2 The Research Participants
The sex workers who live and work in Majengo often have no other income or
support, live in small tin shacks, work well into middle age and have dozens of cli-
ents every day, as the payment from each is very low (Lavery et al.
2010
: 1; Carlin
2003
). In addition to poverty, social circumstances such as the loss of parents to
HIV/AIDS, domestic violence or the need to provide for extended families may
force them into sex work.
As sex work is illegal in Kenya, the women are not organized in brothels and
usually work independently and compete with one another. Remnants of colo-
nial policies, 'when sex workers were imported into Kenya from Tanzania by the
British government for its soldiers' (Bandewar et al.
2010
: 3), still lead to racial
divisions today.
The women's extreme socio-economic disadvantage, in conjunction with the
poorly funded health care system, means that they are unable to access quality
health care in any other way than through involvement in the research clinic.
As for benefit sharing, the original, routine issues of negotiation and decision-
making related to the Majengo research studies only involved researchers and adminis-
trators from the relevant universities and institutions. There was no formal inclusion of
representatives of the sex workers. The volunteer (sex worker) participants themselves
22
For example: 'This study adds IRF-1, a transcriptional immunoregulatory gene, to the list of
genetic correlates of altered susceptibility to HIV-1. This is the first report suggesting that a viral
transcriptional regulator might contribute to resistance to HIV-1' (Ball et al.
2007
: 1091).
