Lagos State, Nigeria - Family Health International

Lagos State, Nigeria 

Report of the In-Depth Assessment 

of the HIV/AIDS Situation 

Assessment Team: 

Prof. Adewale Oke 

Dr. Laide Adedokun 

Mr. Ogunlade 

Dr. Fola Soretire 

Mr.Biodun Adetoro 

Dr. Olufemi Faweya 

FAMILY HEALTH INTERNATIONAL • FEBRUARY 2001

In-Depth Assessment Report 

Table of Contents 

Acronyms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5 

Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6 

1. Introduction/Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7 

2. Sociodemographic Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8 

3. Response to the HIV/AIDS Epidemic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9 

3.1 National . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9 

3.2 Non-governmental organisations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9 

3.3 International donors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9 

3.4 Lagos State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9 

4. Methodology for the In-Depth Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10 

4.1 Purpose of the assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10 

4.2 Intended uses of assessment information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10 

4.3 Researchers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10 

4.4 Selection of consultants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 

4.5 Pre-training activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 

4.6 Tool development workshop . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 

4.7 Training of core research group/team members . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 

4.8 Intensive training for stakeholders and research assistants . . . . . . . . . . . . . . . . . . . . . . . . . . .11 

4.9 Data collection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 

5. Findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13 

5.1 Ojo Local Government Area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13 

5.1.1 Research sites . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13 

5.1.2 Site inventory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13 

5.2 Health services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14 

5.3 Condom outlets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14 

5.4 Ethnographic overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14 

5.5 Identification of vulnerable populations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15 

5.5.1 Female sex workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15 

5.5.2 Truckers/bus drivers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15 

5.5.3 In-school youth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16 

5.5.4 Out-of-school youth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16 

5.5.5 Other vulnerable populations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17 

5.5.6 Non-governmental organisations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17 

5.7 Major HIV/AIDS activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17 

5.8 Ethnographic account . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18 

5.9 Community leaders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18 

5.10 Care and support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18 

5.11 Medical care/counselling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18 

5.12 Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19 

5.13 Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19 

2 

PAGE

3 

Lagos State 

6. Lagos Mainland LGA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20 

6.1 Research sites . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20 

6.2 Site inventory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20 




6.4.2 Truckers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22 





6.7 Major HIV/AIDS activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23 


6.9 Community leaders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24 


6.11 Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25 

7. Ajeromi-Ifelodun LGA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26 

7.1 Research site . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26 











7.7 Non-governmental organisations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30 



7.10 Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31 

8. Ikeja LGA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32 

8.1 Research site . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32 











8.7.1 Ikeja Central . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36 

8.7.2 Ogba . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36 

8.7.3 Onigbagbo/Barracks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36 

8.7.4 Ojodu/Berger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36 

8.7.5 Onilekere . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37 


8.9 Recommendation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37


9. Epe LGA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38 

9.1 Research sites . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38 












9.7.1 Aiyetoro . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43 

9.7.2 Papa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43 

9.7.3 Marina . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43 

9.8 Conclusion and recommendation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44 

10. State Summary and Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45 

11. Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .47 

Appendices 

Appendix I Researchers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .48 

Appendix II Life History of a Sex Worker . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49 

Appendix III Interviewees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .50 

Appendix IV Assessed Organisations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52 

4

Acronyms 

AIDS Acquired Immune Deficiency Syndrome 

AIDSCAP AIDS Control and Prevention Program 

AIDSTECH AIDS Technology Program 

ARV Antiretroviral drug 

CHEW Community Health Extension Worker 

CHO Community Health Officer 

FP Family planning 

FHI Family Health International 

FSW Female sex worker 

IMPACT Implementing AIDS Prevention and Care Project 

LACA Local Government Action Committee on AIDS 

LGA Local Government Area/Authority 

LLO Life Link Organisation 

LSHAF Lagos State HIV/AIDS Foundation 

MOE Ministry of Education 

MOH Ministry of Health 

MTCT Mother-to-child transmission 

NACA National Action Committee on AIDS 

NERDC National Educational Research and Development Council 

NGO Non-governmental organisation 

NISER Nigerian Institute for Social and Economic Research 

NLC Nigeria Labour Congress 

NMA Nigeria Medical Association 

NUBIFIE National Union of Banks, Insurance and Financial Institutions Employees 

NURTW National Union of Road Transport Workers 

NUT Nigerian Union of Teachers 

OVC Orphans and vulnerable children 

PHC & DC Primary health care and disease control 

PLHA Person/people living with HIV/AIDS 

PPFN Planned Parenthood Federation of Nigeria 

RAPAC The Redeemed AIDS Program Action Committee (of RCCG) 

RCCG The Redeemed Christian Church of God 

SAPC State AIDS Program Coordinator 

SACA State Action Committee on AIDS 

STI/D Sexually transmitted infection/disease 

SWAAN Society for Women and AIDS in Africa, Nigeria Chapter 

TB Tuberculosis 

TBA Traditional birth attendant 

UNFPA United Nations Fund for Population Activities 

UNICEF United Nations Children’s Fund 

USAID United States Agency for International Development 

VCT Voluntary counseling and testing 

VHW Volunteer health worker 

WHO World Health Organisation 

YMCA Young Men’s Christian Association 

5 

Lagos State


Executive Summary 

Family Health International (FHI)/ Nigeria conducted an 

in-depth assessment in Lagos State as part of its redesign 

of the ongoing Implementing Aids Intervention and Care 

(IMPACT) project, funded by the United States Agency for 

International Development (USAID). The overall goal of 

the redesign is the development of comprehensive programs 

for prevention and care in high- risk and vulnerable 

populations. Five Local Government Areas (LGAs) – 

Lagos Mainland, Ojo, Epe, Ikeja and Ajeromi Ifelodun – 

were studied. 

The fieldwork for the assessment was conducted 15-21 

February 2001, with the following objectives: 

• Identify STI/HIV/AIDS risk factors and prevention 

and care opportunities in the selected LGAs. 

• Develop a standard assessment tool/methodology that 

other planners can use to evaluate risk, identify prevention 

and care opportunities and design effective 

state/LGA level Sexually Transmitted Infections/ 

Human Immunovirus (STI/HIV) prevention and care 

initiatives. 

• Obtain data to help design a plan for STI/HIV/AIDS 

prevention and care initiatives in priority communities 

and LGAs. 

The in-depth assessment was carried out by FHI in collaboration 

with 40 stakeholder representatives in Lagos 

State. Multiple data collection methods were used to triangulate 

the information. These included: 

• Site mapping 

• Site inventory 

• Key informants’ interviews 

• Structured questionnaires for collection of information 

on care and support facilities and activities 

• Structured organisational assessment and community 

leaders questionnaire 

• Focus group discussions with Female Sex Workers 

(FSW)s and Persons Living with HIV/AIDS (PLHA) 

• Ethnographic survey 

Information was collected from a wide range of sources 

including public officials, operators of private health facilities, 

Non-Governmental Organisation (NGO) executives, 

community leaders and representatives of high-risk and 

vulnerable groups. 

6 

Major Findings: 

1. There appears to be a high prevalence of HIV in 

Lagos State – possibly greater than the official 6.7 

percent. 

2. FSW located in hotels, brothels or other settlements 

are a high-risk group for HIV transmission in the general 

population, although most sex workers interviewed 

reported condom use. 

3. Condom use appears to be insignificant among truckers/bus 

drivers, who are more likely to involve in multiple- 

sex and thus enhance the spread of the disease. 

4. Sexually active youths (in- and out-of- school) rarely 

use condoms and are thus at risk of HIV infection. 

5. Respected, trusted and influential community leaders 

could help fight the epidemic if they were actively 

involved in the campaign against HIV/AIDS. 

6. There are minimal care and support activities, except 

Mainland LGA ongoing care and support activities. 

Recommendations: 

• The three focal LGAs are commercial centers and represent 

high-risk settings with populations that exhibit 

high-risk behaviors. 

• There should be a focus on the FSWs and, by extension, 

their clients. 

• Condom-use promotion should be intensified and 

efforts made to provide quality products. 

• Specific interventions targeting youths in- and out-ofschool 

are needed. 

• Men with multiple sex partners and petty traders/ 

low-income women should be reached, since they are 

not likely to use condoms and therefore constitute a 

population at risk. 

• Truckers/bus drivers, “okada” operators (commercial 

motorcycle riders), mechanics and other artisans 

should be targeted. 

• Condom-friendly hotel owners and FSW chairladies 

should be encouraged to participate in any HIV/AIDS 

intervention focusing on sex workers. 

• Community leaders and organisations that can reach 

local residents with HIV/AIDS information should be 

involved in the implementation of projects. 

• Conscious efforts should be made to enhance the 

capabilities of health facilities and health care 

providers to offer improved services. 

• Identified PLHA should be encouraged to form/join a 

support group. 

• Voluntary counselling and testing centres should be 

established.

1. Introduction/Background 

A situation assessment of HIV/AIDS in Nigeria reveals an 

estimated sero-prevalence rate of 5.4 percent in the country 

(FHI, A Desk Review, 2000). This prompted the federal 

government to establish the National Action Committee 

on AIDS (NACA), charged with the responsibility of 

ensuring that an HIV program is undertaken within the 

context of a multi-sectoral approach. 

Family Health International/Nigeria (FHI), is funded 

mainly by the United States Agency for International 

Development (USAID). FHI is committed to supporting 

NACA’s efforts by incorporating a comprehensive program 

approach in two areas (described in FHI, 2001): 

1. Working with LGAs to perform HIV/AIDS strategic 

assessment and planning to implement a high-risk 

strategy 

2. Developing prevention and care interventions focusing 

on priority communities – (high-risk and vulnerable 

populations in selected LGAs) 

FHI/IMPACT is designed specifically to help USAID missions 

and bureaus implement effective interventions and 

increase the capacity of local organisations – both public 

and private – to assume responsibility for their own 

HIV/AIDS programs. Interventions are designed to reflect 

local and cultural context, geographical spread/diversities 

and stages of the epidemics. 

The HIV program will simultaneously work at multiple 

levels on the following activities: 

a. Influencing individual and societal norms 

b. Improving the health infrastructure 

c. Alleviating structural and environmental constraints 

A desk review of existing data was carried out in May 

2000 to facilitate the impact assessment. The review 

focused on risk-assessment studies, risk-support services 

and behaviour-change interventions in priority communities 

within the country. The document serves as a guide 

for preparing the instrument/protocol for the impact 

assessment. 

7 



2. Sociodemographic Overview 

Lagos State was created 27 May 1967. It covers 

14,712.32 sq.km; the current population is about 10.6 

million (See Lagos Rapid Assessment, November 2000). 

This makes Lagos the most populous state in the 

Federation. Until 12 December 1991, Lagos City was the 

national capital. In economic terms, Lagos is the most 

diversified city in the nation. In 1975, more than 55 percent 

of Nigeria’s industrial establishments were located in 

the metropolitan area and they, in turn, contributed 70 

percent of the national gross industrial output. 

Lagos is the focal point of Nigeria’s international trade: 

three-quarters of the total import and export trade 

(excluding petroleum) passes through its ports. It is the 

headquarters of the nation’s largest commercial establishments; 

major banks and the only stock exchange are located 

in Lagos City (ibid). Its economic opportunities have 

brought in a heavy concentration of Nigeria’s most talented 

and highly educated citizens. Earnings for both professionals 

and skilled workers – and perhaps wageemployer 

workers, aside from Abuja – are the highest in 

the country. 

But the economic and occupational advantages are 

unevenly distributed. Half the working population is classified 

as informally employed, some (mainly women) by 

choice, but many others by necessity. These workers are 

usually petty traders, street hawkers or day laborers. 

Employment insecurity is intensified by the fact that residents 

cannot rely on agriculture to supplement earnings in 

bad times, nor can they quickly receive help from the kin 

group as they did in their native homes (ibid). Work is 

basically individual in a contemporary urban area such as 

Lagos, unlike the traditional setting. 

Barnes (op. cit) reported a sharp division between the elite 

and the common citizen in both numbers and income. 

High-ranking managers, civil servants and professionals 

constituted only about six percent of the metropolitan 

area population, yet earn more than thirty times a small 

business worker’s wages. The vast majority of the working 

force (82.5 percent) is comprised of petty traders, 

craftsmen, laborers and transporters. 

8 

Living arrangements reflect these different social classes or 

social categories. The elite live almost exclusively in luxury 

housing located in separate estates or ‘reservations’ in 

municipal Lagos, suburban Ikeja, Ilupeju, Ikoyi and 

Victoria Island. For the ordinary people, Lagos City is a 

social melting pot. The metropolitan area houses one of 

the more heterogeneous concentrations of people in 

Nigeria. Houses and neighborhoods reflect this, except 

for the Hausa, who often live in fairly homogeneous 

enclaves. Otherwise, the many linguistic and cultural 

groups represented in Lagos are spread throughout the 

metropolis. The impact assessment was carried out among 

the ordinary people. 

The Yoruba make up about 70 percent of the population. 

Other ethnic groups include the Igbo (15 percent), Edo 

(Bini), Hausa, Efik, Ijaw, Nupe, Urhobo, Igbira, Ibibio, 

Isoko, Tiv and a significant number of non-Nigerians 

from African and European countries (ibid). Key demographic 

statistics for Lagos (FHI, 2000) reveal a literacy 

rate of 82 percent, 56.8 percent economically active, 

infant mortality rate 60, total fertility rate of 5.4 percent, 

mean age at child -bearing 29.6 and life expectancy of 

61.5 years. 

References: 

Family Health International. Lagos State, Nigeria: Report 

of Rapid Assessment in Slected LGAs. FHI/Nigeria: 

November 2000 

Barnel, 1986

3. Response to the HIV/AIDS Epidemic 

3.1 National 

In response to the epidemic, the Federal Ministry of 

Health (FMOH) has taken various measures to prevent 

the transmission of HIV. Several committees have been 

established, including the National Expert Advisory 

Committee established in 1986. This group has emphasized 

prevention through safe blood transfusions. 

However, due to the declining economy and low political 

commitment, many measures have not been sustained. 

After the transition to civilian government, the President 

of Nigeria, Olusegun Obasanjo inaugurated the National 

Action Committee on AIDS (NACA) within his office to 

coordinate a multi-sectoral approach to all activities to 

control the epidemic. Similar structures, State Action 

Committees on AIDS (SACAs) and Local Action Committees 

on AIDS (LACAs), were to be established in the states and 

LGAs. NACA, with support from international organisations 

and donor agencies programming in Nigeria, developed 

a three-year HIV/AIDS Emergency Action Plan 

(HEAP). 

3.2 Non-Governmental Organisations 

Nigerian NGOs have responded to the challenges of 

HIV/AIDS. The National AIDS and STD Control Program 

(NASCP) and major international bilateral and multilateral 

agencies have continued to encourage this effort. Many 

NGOs have developed technical and managerial skills to 

implement AIDS prevention activities through training 

workshops supported by various donor agencies. 

However, considering the population size and rate of 

spread of the epidemic, more NGOs must be involved, 

especially in rural areas. 

3.3 International Donors 

The government and people of Nigeria have received support 

and collaboration from the international community 

since the beginning of the epidemic. Prominent among 

these are the United States Agency for International 

Development (USAID), Department for International 

Development (DFID), Ford Foundation, World Health 

Organisation (WHO) and other bilateral and multilateral 

organisations. Due to the present political developments 

of transition into democracy, several bilateral and multilateral 

agencies have increased their support to the country, 

expanding program activities in the country. 

9 

3.4 Lagos State 


The official prevalence rate for HIV/AIDS in Lagos is 6.7 

percent, higher than the national figure of 5.4 percent. 

Nonetheless, an epidemic in the state is possible, due to its 

highly urbanized nature. Lagos State Government appreciates 

the seriousness of the issue and has taken measures 

to combat it. For instance, the governor, Senator Bola 

Tinubu, inaugurated the Lagos State HIV/AIDS 

Foundation – now the Lagos State HIV/AIDS Control 

Agency (LASACA) – on 1 December 1999. This agency 

has a mandate to handle all matters relating to HIV/AIDS 

in the state. 

Data collected from two hospitals between January 1996 

and September 1998 showed a prevalence rate of 6.06 

percent, a result similar to that of the 1999 National 

HIV/AIDS sentinel survey. Hospital patients testing positive 

after screening for HIV increased from 14 percent in 

1997 to 18 percent in 1998 – thus, nearly one of every five 

patients tested positive. The major route of transmission 

of the virus in the state is through unprotected sexual 

intercourse (85 percent) whilst mother to child transmission 

is about 6.5 percent. Identified factors influencing 

the spread of the virus include poverty, unprotected sex 

and inadequate prevention, diagnosis and management of 

Sexually Transmitted Diseases (STDs). 

To fight the epidemic, the agency developed a work plan 

involving various stakeholders. Strategies included advocacy 

to policymakers to help them better understand their 

role and commitment in the fight. To implement the developed 

workplan, the agency will continuously mobilize 

local governments to establish their own LACAs, which 

can be strengthened to implement various HIV/AIDS prevention 

and care activities. 

The following issues to be addressed or earmarked for 

implementation are similar to FHI- adopted strategies to 

curtail the epidemic: 

• Development of VCT centers 

• Establishment of support groups 

• Care for orphans and vulnerable children 

• Confidentiality 

FHI, collaborating with Local State AIDS Action 

Committees (LASACA) in Lagos State, will ensure that the 

above activities and others will be considered in future 

program design.


4. Methodology for the In-Depth Assessment 

4.1 Purpose of the Assessment 

Information gathered in a successful rapid assessment in 

selected states and LGAs (Anambra, Nassarawa, Kano and 

Lagos) provided the basis for an in-depth assessment to: 

• Identify STI/HIV/AIDS risk factors and prevention 

and care opportunities in these states 

• Develop a standard assessment tool/methodology that 

other planners can use to evaluate risk, identify prevention 

and care opportunities and design effective 

State/LGA level STI/HIV prevention and care initiative 

• Obtain data for designing STI/HIV/AIDS prevention 

and care initiatives in priority communities and LGAs 

in the four states 

4.2 Intended Use of Assessment Information 

Data collected from the in-depth assessment will be used 

to develop comprehensive prevention and care programs 

in identified risk areas and vulnerable populations. This 

will involve working with selected LGAs to develop strategic 

plans of action for these high-risk groups. In each 

selected risk area, FHI intends to work with a variety of 

partners to reach the identified high- risk and vulnerable 

groups with prevention and care programs. As much as 

possible, activities will be linked to those of national 

organisations and structures such as the military, police, 

unions and schools. In other words, the data generated 

will provide information to prepare a protocol for an 

intervention program. 

10 

4.3 Researchers 

The research team consisted of three FHI/Nigeria staff 

including the Resident Advisor, four consultants (three 

sociologists and a medical doctor), and eleven research 

assistants (holders of at least 1st degree from various universities 

and similar field experiences). Other members 

represented the State Hospital Management Board, ministries 

of Health, Education and Youth and LGA representatives 

such as AIDS Action Managers and NGO partners, 

all totaling 40 persons. (See Appendix I).

4.4 Selection of Consultants 

Before training began, sociologists from various Nigerian 

universities were asked to submit their curriculum vitae. 

Nine consultants were selected from the submitted applications; 

these included specialists in medical sociology, 

demography and epidemiology. Two consultants represented 

the Federal Ministry of Health. 

4.5 Pre-Training Activities 

Eight different instruments were sent to these consultants 

for review. These papers also served as working documents 

during the training. 

4.6 Tool Development Workshop 

An in-depth assessment pre-planning meeting to finalize 

the tools was held 5 - 11 February 2001. Participants in 

the workshop reviewed tools from similar surveys in 

Togo, Nigeria and Rwanda. They worked in small group 

sessions and made presentations in plenary. At the end of 

two days, semi-structured guidelines were developed and 

adopted for use during the assessment. The following 

guidelines were developed: site inventories, mapping 

guide, ethnographic observations/analysis, care and support, 

and organisation assessment guidelines for line ministries, 

partner NGOs, and community leaders. 

4.7 Training of Core Research Group/ Team Members 

Training was conducted for the core research team members, 

including consultants, FHI/ Nigeria staff and a representative 

from the Federal Ministry of Health (NASCP). A 

participatory approach was used. The international consultant, 

FHI/Arlington and London, provided technical 

assistance and facilitated sessions on care and support for 

people living with HIV. Lectures and basic information 

about HIV/AIDS/STIs were given. The Report of Rapid 

Assessment was used as a working document to familiarise 

team members with the initial findings from various states. 

The team was trained in conducting key informant interviews, 

ethnographic analysis and observations. The developed 

tools were pre-tested in groups similar to the intended 

populations. Materials were then reviewed to incorporate 

findings from this pre-test to produce the final tools. 

11 

4.8. Intensive Training for Stakeholders 

and Research Assistants 


A three-day intensive training, conducted by the trained 

FHI staff and consultants, was held for selected NGOs, 

representatives from states and LGAs and research assistants 

12-14 February 2001 at the Excellence Hotel, Ogba 

in Lagos. The course involved a series of lectures on basic 

STI/HIV/AIDS information. Participatory method was 

adopted using the principles of adult education and experiential 

learning theory, with emphasis on content and 

process of conducting the in-depth assessment. Formal 

and informal learning methods, including peer reviews, 

role plays and simulation exercises, were also used to train 

on questionnaire administration. Study sites were selected 

during the training sessions and facilitated by the consultant 

on sites with the highest concentration of groups in the 

community at risk of contracting HIV/AIDS. 

4.9 Data Collection 

Various data collection methods involving communityderived 

participatory approaches and structured assessment 

tools were used to gather information for development of 

the intervention programs. Informants and/or respondents 

were selected using a convenient sampling method. Other 

criteria included local involvement/ownership and suitability 

for possible interventions. Each of the five LGAs fulfilled 

the criteria of both ‘risk groups’ and ‘risk setting’. 

Data gathering began immediately after the training. It continued 

for six days, with a team of 10 persons per LGA working 

15-21 February 2001. At least 10 field workers, including 

a coordinator, were assigned to each LGA, with two overall 

team facilitators. Multiple data collection methods were used 

to ensure that all required information was collected from different 

target groups and stakeholders. This also served for 

data triangulation. The following methods were used: 

1. Site inventories 

2. Key informant interviews 

3. Target group in-depth interviews 

4. Ethnographic observations/analysis 

5. Mapping exercises 

6. Structured questionnaire on care support


Field assistants collected data on items in which they had 

some expertise, experience or were relatively comfortable. 

For example, those with social-sciences background gathered 

ethnographic data from informant interviews, focus 

group discussions and mapping exercises; those in health 

sectors collected information on care and support. At the 

end of each day’s activities, a short team meeting was held. 

Field assistants in various subgroups presented detailed 

reports, with all sources of information triangulated. If 

there were major discrepancies, assistants returned to the 

sites for more observations/interviews and/or analysis 

12

5. Findings 

5.1 Ojo Local Government Area 

5.1.1 Research Sites 

Field research and data collection were undertaken in nine 

sites in five LGAs 

LGA Ojo Local Government 

Site 1 Site 2 Site 3 Site 4 Site 5 Site 6 

Sites 

Ojo 

Okoko- 

Maiko 

Ajangbadi 

Alaba 

International 

The research team collected information in the nine sites 

enumerated above (Ojo, Okokomaiko, Ajangbadi, Alaba 

International, Military Cantonment, Ijanikin, Vespa, 

Iyana Iba and Volkswagen). The LGA population is estimated 

at 875,990, but only half that number live here. 

The others are traders and reside elsewhere. It is thus not 

possible to estimate the population of different sites, nor 

is it possible to segregate the population into target groups 

per site. The information given here, therefore, is applicable 

only to the LGA as a whole. 

5.1.2 Site Inventory 

The inventory listed below represents the data derived 

from the nine sites. 

LGA 

SITE 

Sex workers 

Truckers 

Uniformed sector 

Formally employed 

Informally employed 

Petty traders 

In-school youth 

Out-of-school youth 

Health facilities 

Condom outlets 

Ojo 

ALL 9 SITES (#) 

3,050 

No information on exact # 

“ 

“ 

“ 

“ 

53,240 

10,000 

56 

100 

13 

Military 

Cantonment 

Ijanikin 

Site 7 

Vespa 


Approximately 3,050 sex workers were identified in the 

two sites where sex workers are located. Two thousand 

are permanent sex workers; 1050 are classified as visiting 

sex workers. 

The exact number of truckers could not be ascertained but 

the major companies involved are: 

1. Trans Motor Company (TMC) 

2. Dangote Transport 

3. Ohonba Line, Benin 

4. The Young Shall Grow 

Site 8 

Iyanaiba 

Site 9 

Volkswagen 

The first two operate trucks, while the last two are luxurious 

bus passenger companies. Because of its proximity to 

Mazamaza Bus Station in Mile 2 Amuwo-Odofin (a centre 

for long-distance bus companies in Lagos), many companies 

do not maintain offices here. However, drivers stay 

two to three days in guesthouses, hotels and brothels in 

the sites.


5.2 Health Services 

LGA/Site 

Ojo LGA 

All sites 

5.3 Condom Outlets 

LGA SITE 

Ojo LGA 

Public Health Services 

Health facility 

PHC – 3 

Chest clinic - 1 

*It is estimated that 10,000 condoms are sold monthly. 

Data did not differentiate between public and private 

sources. Given the urban nature of the sites, condoms 

enter the area through several sources such as traders, 

LGA health workers and various health facilities. 

5.4 Ethnographic Overview 

LGA/Site 

Ojo 

All sites 

Population, Location 

875,990 

Public and Private* 

100 

Lagos State (Ojo LGA) Nigeria 

Ojo has the second largest concentration of FSWs (next to 

Ajeromi-Ifelodun). A relationship between the high concentration 

of truckers, in- and out-of-school youths, major 

markets and FSWs can be established. 

14 

Private Health Services 

Nursing homes - 10 

Private hospitals - 12 

Health clinics - 20 

Pharmacies (patent med.) - 30 

It is not possible to state precisely the number of petty 

traders or those involved in formal and informal employment 

in this report. Nonetheless, the research team 

noticed quite a large number of petty traders. There were 

also many youths-in-school (53,240) and youths-out-ofschool 

(10,000). The number of available health facilities 

is substantial (56) and adequately patronized. Condoms 

can be purchased in most health facilities and in market 

places. 

Ethnographic Summary 

3,050 sex workers including 2000 permanent and 1,050 visiting 

sex workers 

High number of truckers 

High number of in-school and out-of-school youth 

Major markets – petty and commercial traders

5.5 Identification of Vulnerable Populations 

5.5.1 Female Sex Workers 

LGA/Site 

Ojo 

(All sites) 

Major Clients 

Occupations 

Traders, truck drivers, long distance drivers, 

garage boys, artisans (mechanics) youths, 

affluent older men, married men, students 

Geographic Area 

1. Cassidy Bus Stop, Okoko 

2. Olojo Drive 

3. LASU/Badagry Expressway 

4. Oba Daudu Street, Ojo 

5. Ajangbadi/Alaba Int. Road 

Collective Attributes 

Mostly from West African Coast and other 

states within the Federation 

Long-distance traders, drivers, businessmen 

Clients are a diverse group, notably truckers/bus drivers, 

affluent older men, married men and students from tertiary 

institutions. Others are from West African Coast and 

other states within the Federation. Charges vary from 

N50 – N300 per round and N500 per night. Major sexual 

partners are sex workers and students. Students are 

usually casual and engage in the trade to subsidize their 

incomes. 

5.5.2 Truckers/Bus Drivers 

LGA/Site 

Ojo 

(All sites) 

Major Companies 

1. Trans Motor Company 

(TMC) 

2. Dangote Transport 

3. Ohonba Line, Benin 


15 

Charges 

Major Sexual Partners 

• Sex workers 

• Students 

Round N50 – N300 

(depending on client’s status) 

Night (overnight) N500.00 (minimum 

Major Areas Frequented 

Okokomaiko 

Ajangbadi 

Ojo 

Ijanikin 



5.5.3 In-School Youth 

LGA/Site 

Ojo 

(All sites) 

Primary Schools Names 

1. Aganju Aka Pry. Schl. I 

2. Aganju Aka Pry. Schl. II 

3. Araworo Pry. Schl 

4. Ang. Pry. Schl. I, Ojo Ijanikin 

5. Ang. Pry. Schl. II, Ojo 

Ijanikin 

6. Army Barracks Pry. Schl. 

7. Army Cantonment Pry. Schl. 

8. Army Children Pry. Schl. 

9. Army Demon. Pry. Schl. 

10. Army Model Pry. Schl. 

11. Brigade Pry. Schl. 

12. Comm. Pry. Schl. Ajangbadi 

13. Comm. Pry. Schl. Ponpoku 

14. Estate Pry. Schl. Iba 

The large number of schools in the LGA is a reflection of 

the many youths here – particularly the presence of Lagos 

State University (LASU) and other tertiary institutions – is 

an important issue in the present campaign. 

5.5.4 Out-Of-School Youth 

LGA/Site 

Ojo 

(All sites) 

Major Out-of-School 

Youth Areas 

Locations throughout the 

LGA, including marketplaces, 

hotels and public areas such 

as parks and cinema houses 

Similar to the observation in respect to youths-in-school, 

youths-out-of-school are numerous here (10,000). Many 

are clients of the sex workers and pose a special threat 

because of their lifestyles: they are associated with hotels, 

marketplaces, cinema houses. Some live under the bridges. 

Secondary Schools Names 

1. Ajangbadi High Schl, Aja 

2. Army Cont. Boys Sec. 

Schl. Ojo 

3. Army Cont. Girls Sec. 

Schl, Ojo 

4. Awori College, Ojo. 

5. Comm. Sec. Schl. Ojo 

6. Govt. College, Ojo 

7. Fed Govt. Coll, Ijanikin 

8. Govt. Sec. Schl. Otta, Ijanikin 

9. Iba Thony Est. Sec. Schl. Iba 

10. Ojo High Sch. Ojo 

11. Jubilee College kokomaiko 

Estimated Number of 

Out-of-School Youth 

16 

10,000 

Tertiary Names 

1. Adeniran Ogunsanya College 

of Education, Ijanikin 

2. LASU, Ojo 

3. National PG Medical 

Schl, Ijanikin 

4. NAISA 

5. Ojo LGA Voc. Schl. Igbede 


Structures 

Public and private structures 

Recreational facilities 

Hide-outs such as under the 

bridges

5.5.5 Other Vulnerable Populations 

Ojo LGA (All sites) 

1. Uniformed services 

2. Other government/civil servants 

3. Construction workers 

4. Petty traders 

5. Fishermen 

Numbers 

Although vulnerable groups cut across social categories, 

the most vulnerable are usually found in low social or 

occupational groups. 


LGA/Site 

Ojo 

All sites 

NGO 

National Council of Women Societies 

Red Cross 

Only two NGOs are located in the sites. They provide 

humanitarian services, including public enlightenment 

programs. 

5.7 Major HIV/AIDS Activities 

LGA/Site 

Ojo 

All sites 

AIDS Activities 

AIDS activities are limited in scope, mostly enlightenment 

programs to raise awareness and thus help prevent 

HIV/AIDS. 

Exact number could not be ascertained 

Enlightenment programs – basic knowledge 

about the causes and prevention of HIV/AIDS 

17 

Summary Description 


Seminars, fund raising for charity 

Honorary awards for those who have contributed 

to the development of children, particularly 

in Ojo community 

Humanitarian services 


Seminars/workshops, Radio and television 

programs to raise awareness/preventive 

measures


5.8 Ethnographic Account 

Ojo LGA, with headquarters at Ojo, was established in 

October 1966. It has an estimated population of 875,990. 

The LGA is located at the western part of Lagos State, 

bounded on the north by Alimosho LGA, to the east by 

Amuwo-Odofin LGA, to the south by the Lagoon and 

Atlantic Ocean, to the west by Ologe Lagoon and Badagry 

LGA/Ogun State. The topography is partly riverine and 

dry land; 40 percent of the area is water, accessible only 

through the Lagoon. As the host of a major international 

electronic market in Nigeria, Ojo LGA attracts all ethnic 

groups. Although Yoruba and Ibo are the leading ethnic 

groups, the Awori-Yoruba are the real indigenes. The two 

national religions, Christianity and Islam, are widely practised 

in churches and mosques throughout the LGA. 

There are also some adherents of traditional religion. 

To facilitate primary health care, the LGA has divided sex 

workers into different categories – including students of 

secondary school and tertiary institutions trying to supplement 

their allowance with the income from sex trade. 

5.9 Community Leaders 

Community leaders are well-respected; they range in age 

from 51 to 80 years and they have lived in the community 

between five and 80 years. The leaders have varied 

influence over such community activities as building of 

roads, toilets, town halls and schools, digging of wells, 

donation of property for government projects, immunization, 

sports, counseling and marriage guidance for youths. 

They have mobilized people for environmental sanitation 

activities, PHC and enlightenment programs on health 

issues. However, they have never been involved in 

HIV/AIDS programs except in condom distribution. They 

did not see HIV/AIDS as a major health problem in the 

community – rather they consider malaria, typhoid fever, 

gonorrhea, yellow fever and malnutrition as their health 

problems. Only three of the seven men interviewed have 

ever known some one who died of AIDS; two mentioned 

the late popular musician, Fela Anikulapo-Kuti. 

There is no community-based NGO working on HIV/AIDS 

but the leaders indicated that some religious groups, through 

their sermons, discuss it. They agreed that enlightenment 

campaigns would be a good way to make people understand 

the risk of HIV/AIDS. Other methods mentioned are provision 

of screening centers in LGA, inclusion of HIV/AIDS 

messages in sermons in churches and mosques and school 

clinics. The leaders are interested in initiating or expanding 

HIV/AIDS services in the LGA; they are ready to spearhead 

these activities if given the necessary information. They 

18 

would like to be involved in mobilisation, enlightenment 

campaigns, health talks and provision of land to safe HIV 

screening centers. Some are ready to participate in caring for 

people already infected with HIV in their communities. It is 

believed that the community can be encouraged to identify 

PLHA and provide support for them. 

5.10 Care and Support 

Political commitment to HIV/AIDS is certainly not a major priority 

here. The few programs organised have basically targeted 

preventive activities. School youths and artisans should be 

reached. Little or no care and support activities are ongoing. 

5.11 Medical Care / Counselling 

The chest clinic in Ojo is the major provider of TB care in 

the public sector. Directly Observed Therapy, Short-course 

(DOTS) is not being practiced because of distance from the 

facilities. TB patients are routinely tested for HIV at the 

Mainland Hospital. Other services include medical management 

of HIV/AIDS, counselling by nurses who – though 

not trained specifically in HIV matters – provide both preand 

post-test counselling to literate patients. Routine care 

for HIV/AIDS patients without TB is provided. 

The PHC, which is headed by a Chief Nursing Officer, has 

not handled cases of HIV/AIDS. Private health care 

providers, however, seem to be more active in the area of 

care, with slightly more than one percent of admissions in 

one facility due to HIV-related illnesses in the past two 

years. Clinics see about five to 10 cases of AIDS- related 

illness per month. Rapid tests for HIV are provided. ARV 

is not used, but strong analgesics are occasionally given. 

Preventive therapy for illnesses of HIV-positive people is 

uncommon. When referrals are made to teaching hospitals, 

there is little or no feedback. 

Only one patient was treated for TB over the past three 

years in the two private hospitals considered. STD treatment 

is, however, very common, using clinical diagnosis. 

Home-based care and nutritional supplementation are not 

provided. None of the guidelines provided by the FMOH 

is available in these clinics. No training has been done for 

most care providers in this sector. Facilities claim to offer 

pre- and post-counselling, though none of the staff has 

been trained. Awareness about Mother to Child 

Transmission of HIV/AIDS (MTCT) interventions is low. 

Routine tests for pregnant women are provided in many 

centers – but if positive, the women are not allowed to 

deliver in the clinic and are not told the results of the test. 

Socio-economic support and community involvement in 

care and support is minimal.

5.12 Conclusions 

It is obvious from the above that Ojo LGA will benefit 

greatly from any programme aimed at preventing and coping 

with STI/HIV/AIDS. Aside from sex workers who are 

mostly found in brothels/local hotels, more focus should 

be on the following groups: 

1. In- and out-of-school youth with special attention to 

students from secondary schools and the university, 

particularly LASU 

2. People with multiple sex partners, who are unlikely to 

use condoms since they do not consider the effect on 

their casual sex partners 

3. Petty traders (women) who engage in casual sex to 

subsidize low incomes 

5.13 Recommendations 

1. Truck/bus drivers, okada operators, mechanics and 

other artisans should benefit in an intervention program. 

2. Enlightenment programs aimed at prevention and coping 

should be organized/encouraged at community levels 

with local participation. 

3. Efforts should be intensified to discourage sex workers. 

Possibility of an alternative trade could be 

explored through the LGA/community or charity 

organisations. 

4. Condom use should be further encouraged, with a 

quality product appropriately distributed and free, if 

possible. 

19 



6. Lagos Mainland LGA 

6.1 Research Sites 

Field research and data collection was undertaken at nine 

sites in five LGAs 

LGA Ojo Local Government 

Site 1 

Site 2 

Site 3 

Site 4 

Sites 

Otto 

Data collection were carried out in six sites as indicated 

above (Otto, Iddo Motor Park, Oyingbo, Ebute Metta, 

Sabo and Jibowu) 

6.2 Site Inventory Overview 

Target groups 

Sex workers 

Truckers 


(police) 

Sawmillers 

Fishermen 

Petty traders 



Formal employment 

Iddo Park 

Estimated Population 

(All 6 sites) 

1,210 

750 

1,200 

1,950 

560 

4,150 

13,456 

3,460 

5,788 

Oyingbo 

Large numbers of youth, in and out of school, and a substantial 

number of FSW, have important implications on 

the spread of HIV/AIDS. 

20 

Ebute Metta 

Site 5 

Sabo 

Site 6 

Jibowu


Lagos Mainland 

All sites 



LGA/Site 


(All Sites) 

Population, Location 

Pop. 341,834 

Location – Lagos State 

This is a typical urban population with a high concentration 

of FSWs. We noticed a well- organized transportation 

network and fairly adequate provision of social and 

recreational facilities. 

Major Clients 

Occupations 

Businessmen, long-distance drivers, area boys 

and young boys 


Mostly resident in Marywood/Batula, Iddo, 

Oyingbo (White Sand), Otto but visiting sex 

workers come from neighbouring LGAs 


Prefer truck drivers because they tend to pay 

more Resident FSW do not like outside 

engagements 

Those who patronise sex workers in the LGA are, as 

usual, truckers in addition to businessmen and area boys. 

Charges vary from N100 to N500 per round to N1200 

overnight. Sex workers seem to prefer truck drivers, who 

will spend substantial amount of money. 

Key Features 

21 

Charges 

• Per round – N100 

• Overnight – N500 – 600 

Iddo Area 

• Per round N500 

• Overnight 


• Highly urbanized 

• Well organized resident FSW 

• High number of women engaged in concealed sex work 

• Heavy transportation network – truckers/luxury bus drivers 

• Motor parks, hotels and bars promoting sexual activities



LGA/Site 


Major Companies 

• Kanuri Motors 

• Ifesinachi Motors 

• ABC Motors 

• Young Shall Grow 

• Ekene Dili Chukwu 

• Chisco Motors 

• Salisu Adamu 

• E. E Ekeson 

• C. N Okoli 

• P. N. Emerah 

• Edegbe Line 

• Edo Line 

• Eagle Line 

• Early Birds 

• Road Mark 

• Oha Motors 

• Caleb Motors 

The truckers’ sexual partners are mostly FSWs, but students 

from tertiary institutions are sought after by those 

who can offer more money. 


Lagos Mainland Area 

All sites 

Primary Schools 

56 * 

(*See appendix for list of schools) The presence of five 

tertiary institutions brings in many youths, with important 

implications for HIV/AIDS campaigns. 


• Residential and visiting FSW 

• Students 

• Petty traders 

22 

Secondary Schools 

39 * 


Otto 

Iddo Park 

Oyingbo (White Sand area) 

Batula 

Jibowu 

Tertiary Institutions 

1.Yaba College of Technology 

2. University of Lagos 

3. Federal College of Education 

4. School of Health Technology 

5. Fed.Technical College


Lagos Mainland LGA 

All sites 

Major Out-of-School Youth Areas 

• Otto 

• Evans Square 

• Foot of the 3rd Mainland Bridge 

The number of out-of-school youths in this table may be an 

underestimation, considering the large numbers in neighbouring 

LGAs. 


Lagos Mainland LGA 

All sites 


LGA/Sites 


(All Sites) 

6.7 Major HIV/AIDS Activities 

LGA/Sites 


(All Sites) 


Tertiary – 1 (LUTH) 

General –3 

Health facilities - 6 

PHC – 15 

Public and Private* 

There are numerous outlets, but there is no information 

on their precise number. 

HIV/AIDS Activities 

Public enlightenment and awareness programs 

Activities focus on enlightenment programs and behavioural 

change as it affects sexual practices. 

23 

Estimated Number of Out-of-School Youth 


Private hospitals - 60 


10,000 

Could not be estimated because condoms are available in almost all stores 


Focus on prevention – behavioural change on 

sexual activities 

Provision of basic facts on HIV/AIDS 

Coping measures for PLHA



Lagos Mainland LGA is one of the oldest in the state, with 

a 1998-projected population of 341,834, mostly urban 

with very few rural settlements (Makoko and Iwaya). 

Shomolu LGA bounds the Mainland LGA in the north, 

Carter Bridge (Lagos Lagoon) in the south, Surulere LGA 

in the west and the 3rd Mainland Bridge in the east. The 

LGA includes many built-up areas, commercial centers 

housing both corporate and residential buildings. 

Nigerians here have diverse cultural backgrounds, with 

mostly Islamic, Christian and traditional religions. 

Many features make the LGA unique, such as the 

Nigerian Railway headquarters and rail line terminating 

at Iddo, military bases and military referral hospitals and 

motor parks for luxurious buses. The LGA has 39 secondary 

schools, 56 primary schools and five tertiary institutions. 

The LGA administers its public service through 

42 functional Community-Based Development 

Associations (CDAs), which work with the LGA authorities 

to formulate and complement policies that affect residents. 

The CDA is a key agent of socialization and public 

administration. 

Residents are predominantly low-income earners, petty 

traders and market women. Several market sites sell 

motorcycles, spare parts, electronic/electrical products 

and other goods. Iddo and Otto parks house more expensive 

sales outlets and restaurants, bars and joints. The 

LGA can be divided into areas of high population density 

(such as Makoko, Ebute Metta, Iwaya, Akoka, Ijora and 

Otto) and low population density (such as Yaba, Jibowu 

and Sabo). 

6.9 Community Leaders 

Community leaders are highly respected – they have at 

one time or the other been involved in mobilizing the communities 

for various political and health programs. These 

leaders have been in the community for an average of 18 

years but have not been involved in any STI/HIV/AIDS 

programs except the distribution of condoms, which was 

done at the insistence of the LGA. Some leaders complained 

that distribution would encourage promiscuity. 

They favoured promoting abstinence. 

All leaders were interested in working on STI/HIV/AIDS 

implementation programs – though several felt that diseases 

like malaria and cholera are greater health problems 

that should be addressed in the community. The large 

presence of FSWs and out-of-school youths (‘area boys’) 

were also identified as problems. Programs have been put 

in place to keep the youths busy by organizing football 

matches within the local government. 

24 

The leaders are well -informed and knowledgeable about 

HIV/AIDS but their attitudes varied from willingness to be 

involved in the care and support of PLHA to unwillingness 

to be associated with the individuals so identified. 

Leaders indicated that information about infected individuals 

should not be divulged. One religious leader heads an 

NGO that promotes safe blood transfusion by collecting 

blood donations that are screened and kept for use in local 

blood banks. All the men interviewed are influential and 

highly placed, and have successfully mobilized their community 

members to participate in solving various issues in 

the community – FHI and related organisations can build 

upon their strength to reach the community in implementation 

programs. 


Lagos Mainland’s local government recently launched its 

own LACA, with eight members from the health, education, 

agriculture and accounts sectors. Care for PLHA is 

regarded as one of the major priorities in the LGA. 

Though facilities for their clinical care abound in the 

LGA, most AIDS cases are referred to the Lagos 

University Teaching Hospital (LUTH). The LGA has a 

budget line for HIV/AIDS: about N140, 000 was released 

out of N500, 000 allocated for 1999/2000. 

The NRC and Mainland hospitals provide care for the 

general populace, while the Military Hospital serves military 

personnel and their families. Cases of HIV and AIDS 

were first seen in the mid-1980s at the Mainland Hospital, 

in the early 1990s at the Military Hospital. No written 

guideline on care exists in any of the centres. Only the 

Military Hospital provides medical management of 

HIV/AIDS, ARV therapy and provision of VCT in addition 

to counselling, medical care for TB and palliative care 

– which all the others also provide. Bed occupancy rates 

vary from 43 percent (NRC) to 75 percent (Military 

Hospital). The proportion of HIV –related cases in the 

MH has increased to 1:10 in 2000 from the previous 1:20 

in 1998. Presently, the MH routinely admits patients with 

AIDS for treatment, while other hospitals almost always 

refer such patients to LUTH. Feedback mechanism from 

LUTH is poor: no report is sent back to the referring hospital. 

Rapid screening tests are performed in all hospitals, but 

only the Military Hospital provides ELISA and Western 

Blot confirmation as well. Symptomatic treatment for 

common HIV-related illnesses is generally given in the 

hospitals. 

Mainland Hospital provides specialist care for TB cases – 

an average of 43 patients per month. TB cases are seen in 

the other hospitals as well, but DOTS is not practiced in

any of them because of drugs and personnel logistics. STD 

treatments are based on etiologic diagnosis – alone or 

combined with clinical diagnosis, even though doctors 

have some knowledge of syndromic management. 

Clinical management and care training sessions have been 

held for physicians in the Mainland Hospital and NRC. 

The Mainland and Military hospitals have trained counselors; 

the Railway Hospital physician provides counselling. 

Counselling is still not popular at the Mainland 

Hospital, despite the presence of trained counselors there. 

MTCT and VCT measures are yet to be fully used in any 

of the hospitals. Counselling, clinical care and social support 

for PLHA are recognized as priority areas of focus to 

ensure comprehensive care across a continuum. 

Ajayi Memorial Hospital (AMC) and Ireti Hospital were 

the private hospitals visited. Little information was 

obtained from Ireti Hospital. AMC sees an average of one 

to two HIV/AIDS patients each month. Rapid HIV testing 

is done. Common HIV-related illnesses like cough and 

diarrhea are attended to. Most AIDS patients, however, 

request discharge because of stigma. TB is also treated at 

the facility. STD treatment is based on a combination of 

etiologic and clinical diagnosis. No training on syndromic 

management or HIV clinical management has been held 

for hospital staff. 

25 

6.11 Recommendations 


Lagos Mainland LGA will benefit from a mini-comprehensive 

program for selected high-risk groups in the LGA: 

Iddo/Otto and Oyingbo communities. The program 

should also include the Batula community within the 

Olaleye area. Such a plan could reach all risk groups. The 

following specific recommendations are offered: 

1. Use specific strategies, such as organized football 

matches, for out-of-school youths. 

2. Strengthen hospitals’ counselling units by training 

more personnel. Encourage identified PLHA from 

Mainland Hospital to form a support group. 

3. Utilize community leaders’ and community development 

associations’ ability to reach the public with 

information during program implementation. 

4. Establish condom-friendly hotels by targeting hotel 

owners and associations; discuss programming with 

FSW chairladies. FSW should also be encouraged to 

use condoms with clients. 

5. Encourage Luxurious Bus Association and National 

Union of Road Transport Workers to provide behaviour-change 

communications for their members. 

6. Reach tertiary institution students to reduce high-risk 

sexual behaviours.


7. Ajeromi – Ifelodun LGA 


LGA Ajeromi – Iffelodun 

Site 1 

Site 2 

Site 3 

Sites 

Boundary 

Information was collected separately in the four sites enumerated, 

but data were then compiled together. 

Therefore, rather than describing each sub-site, we will 

refer to the four as a whole. 

7.2 Site Inventory 

Alaba-Suru 

The inventory listed below is a summation of the information 

gathered from all sites. 

LGA 

Site 

Sex workers* 


Truckers 

Formal employment 

Informal employment 

Petty traders 





Street youth/Area boys 

Ajeromi-Ifelodun 

Population 

5,000 

244 

*Sex workers are not categorized into permanent/visiting. 

Note that the LGA has the highest concentration of FSWs 

in the state. 

6 

8,562 

421 

581 

47,243 

3,462 

21 

200 

2,106 

26 

Akere 

Site 4 

Alafia


LGA/Site 


(All Sites) 

High concentration of urban poor. The heterogeneous 

nature of the population contributes to the large number 

of brothels and FSW. 



LGA/Site 


(All Sites) 

Details 

Major Clients 

Occupations 

Businessmen and traders, travelers, okada 

operators, bus drivers/conductors, mechanics, 

vulcanizers (especially senior apprentices and 

journeymen) 

Bankers, civil servants, soldiers 


Alaba Market, Suru-Alaba 


• High level of promiscuity among clients 

• Mostly young men who work at Apapa Port 

• Low-income civil servants 

Client categories are similar to those observed in Ojo and 

Lagos Mainland: truckers/bus drivers, businessmen, 

bankers, and civil servants. Charges are based on social 

classification. 


27 

Charges 

Category A: Low income 

Per round N80-200 

Overnight N700-1000 

Category B: Sophisticated FSW 

Per round N200-400 

Overnight N1,500-2000 


Population: 1.7 million 

• Urban, low-income, high density 

• Heterogeneous population 

Location: Lagos State (Ajeromi- • Highest concentration of hotels and brothels for sex work 

Ifelodun) 

(120) 

Distance: 25km from Ikeja 

• Large concentration



LGA/Site 


(All Sites) 

Major Companies* 


2. Ifesinachi Motors 

3. ABC Motors 

4. Dandolla 

5. C.N. Okoli Transport 

*No truck companies were identified. All those named are 

(luxurious) bus companies. Truck drivers are major customers 

of FSWs and frequent brothels and hotels where 

they reside. 



All sites 

Primary School *74 

Oladipo Pry. Schl. I 

Oladipo Pry. Schl. II 

Alakoto Pry. Schl. 

L.A. Pry. Schl., Ago 

Christ Ass. Pry Schl. 

*There are 74 primary schools, 20 public and seven private 

secondary schools. The above list includes examples 

of these schools. . 


LGA/Site 



Youth Areas 

The estimated number of youths-out-of-school is very 

large, which may contribute to the presence of so many 

FSWs, since these youths are ready customers. 

— 


1. Young school drop-outs 

(some in vocational training, 

17-24 years of age) 

2. Tertiary and secondary 

students 

Secondary School* 

Awodi Ora Sec. Schl. 

AJIF High Schl. 

Cardoso High Schl. 

Gaskiya College 

Alakoto High Schl. 

28 

Estimated Number of 


3,462 


1. Alaba Oro Road, Amukoko. 

2. Mosafejo, Amukoko 

3. Achakpo Road Ajegunle 

4. Achakpo and Ajegunle 

5. Goriola Street Ajegunle 

6. Mobil Road Ajegunle 

Tertiary 

Tertiary 

Major Out-of-School Structures 

—


LGA/Site 


(All Site) 

Vulnerable populations 

1. Uniformed services 

2. Government/civil servants 

3. Construction workers* 


5. Fishermen* 

6. Religious denominations 

7. Professional/trade associations 

8. Major community groups 

*No information is available about the exact number of 

these men. However, petty traders/low-income women are 

conspicuous – this pattern persists in all the sites. 


LGA/Site 


(All Sites) 


General 1 

PHCs 6 

The services identified are mostly owned by individuals or 

private groups (67 percent). This pattern is common and 

supports the suggestion that private health services may be 

more effective or accessible in providing services. 


LGA/Sites 


(All Sites) 

Public Outlets* # 

Pharmacies 

Drugstores 

*Two hundred public and private outlets were identified. 

Aside from the cost, there should be no problem securing 

the commodity in LGA. 

29 

Private Outlets* # 

Pharmacies 

Chemists/drugstores 

Numbers 

581 

20 

4 

3 

2 


Nursing home 1 

Private hospitals 13 




LGA/Site 


(All Sites) 

NGO 

War Against AIDS Spread (WAAS) Foundation 

Ajegunle CPH 

Amukoko CPH 

Life Link Organisation 

Four NGOs/organisations were identified but only two of 

them, War Against AIDS Spread (WAAS) and Life Link 

Organisation, focus on HIV/AIDS-related activities. 


Ajeromi-Ifelodun LGA was carved out of the old Apapa 

LGA in 1996. It covers an area of 2,485 hectares and has 

a population of not less than 1.7 million people. It is 

mostly urban, high density. Dwellings range from wellbuilt 

houses containing flats to poorer ones with individual 

rooms of the type commonly called “Face-Me-I-Face- 

You”. Low density areas include Awodiora Housing 

Estate, Mba Street, Old Ojo Road and some areas of Tolu 

in the Olodi-Apapa area. The remainder of Amukoko and 

Ajegunle and Olodi-Apapa is a high-density area. 

Commercial activities are high virtually everywhere in the 

Boundary area – Akerele Areo by Kirikiri axis etc. Several 

thousand retail shops – both large and small – are located 

in all the commercial centres. The LGA is very heterogeneous, 

made up largely of Igbos, Yorubas, Efiks and a 

heavy concentration of Hausas in Sabo. Most of the population 

can be classified as low-income, although there are 

some medium-income earners. 

The LGA has one of the highest concentrations of hotels, 

brothels, nightclubs and bars – more than 120; about 75 

(62.5percent) are brothels for sex work. Typical brothels 

include night bars with many obscene pictures. There is 

music, dancing, smoking and drinking – typically from 8 

p.m. till midnight. Young men who come to drink and 

dance at the club patronize the residential sex workers. 

Virtually all hotels, even those not harboring sex workers, 

30 


• Registered as a non-profit NGO with 

Corporate Affairs Commission, Abuja 

• Objectives: Stop the spread of HIV/AIDS 

Encourage development of anti-HIV 

herbs/vaccine to suppress the virus 

• Both organisations register with the 

Corporate Affairs Commission 

• Promote environmental sanitation 

• Focus on child survival 

• Creates HIV/AIDS awareness 

operate either short-time schedules for sexual intercourse 

or are lodging hotels, especially the more dignified ones 

where more affluent men meet their sex partners. 

The LGA’s high population is largely Igbo and Efiks with 

little education or income. This young and very virile 

group, together with many poorly educated Muslim 

Yoruba, tend to have many wives and large numbers of 

children. 

It is estimated that more than 5,000 female sex workers 

live in Ajegunle and Amukoko; some freelance from their 

homes, others live in brothels. Many reported that they 

are often derided as ‘Asewo’ (prostitute) “useless girls” ’. 

Nevertheless, many men patronise them.


Though HIV care has been recognized as a priority area in 

AJIF LGA, activities so far have been targeted only 

towards public enlightenment and condom distribution. A 

budget of N500, 000 was provided for HIV programs in 

1999/2000, but nothing was released. A LACA has been 

proposed, to be staffed by the LGA health, agriculture, 

education and information units. HIV care has never been 

discussed at Health Department meetings, but a workshop 

on HIV/AIDS prevention was held in the year 2000. 

Care provision in the LGA is essentially limited to 

HIV/AIDS diagnosis. If a positive diagnosis is made, both 

public and private hospitals refer a patient to LUTH or 

Mainland Hospital. 

The first cases of AIDS were reported at the GH Ajegunle 

when it began HIV screening in 1999, with rapid HIV 

testing being done. Results are disclosed by the laboratory 

technologist, who is not trained in HIV counselling. 

Only palliative care is given. STD treatment is based on 

clinical diagnoses. TB cases are referred to LUTH and the 

IDH. 

Screening is available in most of the private hospitals visited, 

and they see an average four to 10 AIDS–related illnesses 

per month. Most of the facilities say they have no 

provision to deal with care of PLHA. Only one doctor had 

received training in HIV care organized by the Association 

of Private and General Medical Practitioners of Nigeria 

and the State Ministry of Health in 1999. TB patients who 

become positive for HIV are referred to teaching hospitals. 

STDs are treated mainly on the basis of etiologic and clinical 

diagnosis. Feedback from teaching hospitals to referring 

facilities is weak. 

Counselling is provided by some doctors and nurses, 

though none has been trained on HIV counseling specifically. 

WAAS foundation is the NGO recognized to be involved 

in the provision of HIV care in the LGA. It counsells about 

eight persons each month. One WAAS member received 

training by SFH in 1998. The NGO also provides homebased 

care for about 16 PLHA. These people have set up 

a support group, but have received no external aid since 

the organisation was founded five years ago. 

31 

7.10 Conclusion 


Ajeromi-Ifelodun is the undisputed centre for sex workers, 

and information supports the general assumption 

about the relationship between sex workers and the 

spread of STI/HIV/AID. Any intervention program aimed 

at curbing the spread of these diseases here should focus 

on sex workers and, by extension, their clients – including 

men with multiple sex partners, truck/bus drivers, okada 

operators, mechanics, civil servants and soldiers.


8. Ikeja LGA 


LGA 

Sites 

Site 1 

Ikeja Central 

Fieldwork was conducted in five sites in the LGA. 

8.2 Site Inventory Overview* 

Site 2 

Ogba 

Ikeja 

Site 3 

Onigbongbo/ 

Barracks 

LGA Ikeja 

Inventory 

Sex workers 

Truckers 




Petty traders 





No. of primary schools 

No. of secondary schools 

Street youth / Area youth 

Employed out-of-school 

youth 

Visiting sex workers 

No. of private primary 

schools 

No. of private sec. 

schools 

No. of NGOs 

Site 1 

Ikeja 

158 

None 

600 

1087 

250 

5 

29 

13 

5 

104 

10 

21 

Site 2 

Ojodu/Berger 

150 

300 

1000 

800 

100 

50 

1 

2 

300 

32 

Site 3 

Onigbogbo/ 

Barracks # 

15 

300 

1800 

12,844 

200 

10 

12 

6 

4 

30 

500 

50 

Site 4 

Ojodu/Berger 

Site 4 

Ogba 

57 

65 

3000 

850 

6507 

600 

85 

74 

2 

2 

200 

Site 5 

Onilekere 

Site 1 

Onilekere 

None 

None 

920 

300 

250 

628 

1000 

8 

None 

1 

None 

120


LGA/Site 

1. Ikeja Central 

2. Ogba 

3. Onigbongbo 

4. Ojodu/Berger 

5.Onilekere 

Details 

Location: Lagos State 

Distance from centre: 4km 


Distance – 3km 






The LGA is described as an urban informal sector, but has 

some characteristics of a suburban setting. Heavy concentration 

of FSW noticed. Presence of major motor 

garage and Army barracks might have promoted sex 

work. Two sub-sites, Onigbongbo and Onilekere, are 

headed by traditional rulers (Baale). 


33 


Wage employment –urban informal sector economic activities 

FSW concentrated in Ipodo 

PHC, near private hospital 

Mixed community in terms of residential and commercial 

activities 

Truck/bus drivers major SW clients 

Nigerian Army Barracks situated here, traditional community 

headed by a Baale 

Residential area 

Major motor vehicle garage 

Numerous transport workers 

Sex work 

Focal point for truck/ bus drivers 

Traditional community headed by a Baale 

Various religious groups prominent




LGA/Site 

Ikeja 

(All Sites) 

Major Clients 

Occupations 

Truck/bus drivers, policemen, soldiers, dockworkers, 

businessmen, okada operators, bus 

conductors 


Shonola Street, Ogba Agenda Road, Acadian, 

Onigbongbo, Charity, Ojodu, Dengbo Hotel, 

African Hotel, Seaside Hotel 


Typical urban center in size, density and heterogeneity 

Tremendous infrastructural benefits and facilities 

Sex workers are patronised by truck/bus drivers, a pattern 

observed in all sites. More policemen, soldiers and dockworkers 

are regular customers than in other LGAs. 

Charges are moderate, N250 per round and N500 

overnight. 


LGA/Site 

Ikeja 

All sites 


Truckers were seen in Shonola Street and Ogba Agenda 

Road. FSW are their major sex partners, including visiting 

sex workers. 

*The groups were adequately identified but no information 

is available on exact numbers. As earlier observed, 

they are usually of low social class – in terms of both education 

and occupation. 

— 

34 

Charges 


Female sex workers 

Visiting sex workers 

Round: N250.00 

Night: N500.00 


Shonola Street 

Ogba Agenda Road.


LGA/Site 

1. Ikeja central 

2. Ogba 

3. Onigbongbo 

4. Ojodu/Berger 

5. Onilekre 


LGA/Site 

Ikeja 

(All Sites) 

8.5 Health Services* 

LGA/Site 

Ikeja and Ogba 

Vulnerable populations 

1. Uniformed men 

2. Other government/civil servants 

3. Construction workers 


5. Fishermen 

6. Tailors 

7. Vulcanizers 

8. Carpenters 

9. Plumbers 


Tertiary – 

PHC – 1 

*The three other sites, Onigbongbo, Ojodu/Berger and 

Onilekere, lack health facilities. 

8.6 Condom Outlets* 

LGA/Site 

Ogba 

Public Outlets 

Primary 

*There is virtually no information on this item except for Ogba. 

5 

Numerous 

6 

10 

1 

— 

35 

Secondary 

1 Public 

Numerous 

4 

2 Public 

None 

Population 


Private Hospital - 12 

Private Outlets 

85 (Pharmacies) 

Tertiary 


Nigerian Institute of Journalism



Ikeja LGA, one of the 20 LGAs in Lagos State, is uniquely 

located in the heart of Lagos metropolis. It is one of the 

most populous and urban parts of Nigeria, with a truly 

heterogeneous population. Indigenes are Awori, a Yoruba 

subgroup. There are fairly defined communities such as 

Onigbongbo, Ipodo, Ogba, Ojodu, Onilekere and part of 

Ojota. 

The LGA is a typical urban centre in terms of size, density 

and heterogeneity. It has derived tremendous infrastructural 

benefits from the past political and administrative 

facilities – notably roads, pipe-borne water, telecommunications, 

health and educational facilities. Five subsites 

were selected for the study: Ikeja Central, Ogba, 

Onigbongbo, Ojodu/Berger and Onilekere. 

8.7.1 Ikeja Central 

The site includes the GRA and Ipodo/Isale Awori, about 

4km from the state capital (Alausa). There are five public 

primary schools and one public secondary school. 

Residential characteristics vary sharply from the very 

dense and congested areas of Ipodo to the low density of 

the GRA. Female sex workers are concentrated in Ipodo, 

where there are large numbers of low-class brothels, hotels 

and hostels for their operation. Visiting FSW are also 

found in Allen Avenue, Mandarin Casino and the Country 

Club. The Ikeja bus stop is a major traffic route for small 

and large buses carrying commuters to other parts of the 

metropolis. 

The General Hospital is the most visible public health 

facility. A secondary facility has been recently converted 

to a teaching hospital for LASU medical school. There are 

a number of primary healthcare centres and large private 

hospitals. The diverse characteristics of the permanent 

and transient population – in terms of economic status, 

occupations, religions and ethnicity – give rise to a complex 

socio-economic/socio-cultural environment in which 

the active players are employees, informal sectors, soldiers, 

FSWs, transporters and low-income earners. 

36 

8.7.2 Ogba 

Ogba is a mixed community of residential and commercial 

activities. A large number of public primary schools, secondary 

schools and the Nigerian Institute of Journalism (a 

post-secondary institution) are located here. Shonola and 

Ogba/Aguda roads are notorious for sex trade. FSW are 

found in the Aimasiko hostels. They also operate in the 

evening in Maru Gruel House in Ogba, charging N200 

per round and N500 overnight. Healthcare facilities 

include PHC, private hospitals, pharmacies and drug 

stores scattered throughout the community. These also 

provide outlets for condoms (about 85 such outlets were 

identified). 

8.7.3 Onigbongbo/Barracks 

The community, largely residential except for the Nigerian 

Army Barracks, is about 6km from the state capital. It is 

a traditional community headed by a 78-year-old Baale. 

There are six primary schools and many religious institutions. 

It is striking to note that there are no permanent 

FSW in the community; the leadership has successfully 

outlawed them. A few, however, sneak in at night and 

operate in Lasiyet Hotel, Mammy Market in the barracks, 

NICA and other hotels. Drivers and concealed sex workers 

meet in Mosafejo Park, where an average of 30 trucks 

and buses park overnight. These FSW also sell food, 

drinks and illegal drugs. The drivers also frequent 

Acadian Hotel and Orelope food canteen for sexual entertainment. 

8.7.4 Ojodu/Berger 

This community, 3km from the state capital, is largely residential 

with a major motor garage (Berger) linking directly 

to the expressway between Lagos and other parts of the 

country. Hundreds of transport workers are found here 

and sex work thrives. The National Union of Road 

Transport Workers has a strong foothold in Berger 

because it serves as a focal point for truck, bus and taxi 

drivers. Sex workers are found as permanent residents in 

Crown Hotel, Africana Hotel and Seaside Hotel. Other 

bars and guest houses frequented by bus and truck drivers 

are Charity Hotel, Acadian House, Mojoyin Restaurant, 

Alubarikaloju and Denglo hotels. Out-of-school youths 

can be seen performing menial jobs around the garage, or 

simply roaming and picking pockets.

8.7.5 Onilekere 

Like Onigbongbo/Barracks, Onilekere is a traditional 

community headed by a Baale. It has many religious 

groups, but virtually no educational facility except a primary 

school. There are few community development, 

youth or ethnic-group oriented women’s associations. It is 

a medium-density area with no visible transport workers, 

hotels or bars. Out-of-school youths engage in the informal 

sectors as vulcanizers, mechanics, seasonal petrol sellers 

and food hawkers. 


The SAPC office is responsible for policy formulation, 

coordination, supervision and implementation of all state 

HIV activities. Priority areas being addressed include 

VCT, IEC, safe blood transfusion and VCT. A Lagos State 

HIV/AIDS Foundation is the multi-sectoral coordinating 

body in charge of HIV/AIDS in the state. Clinical care, 

counselling and NGO social-support schemes are available, 

but home-based care and support for orphans and 

vulnerable children is rudimentary. 

Hope-Worldwide and the Salvation Army are two of the 

notable NGOs providing psychological support for people 

diagnosed with HIV/AIDS in government hospitals in the 

state. Many of these hospitals, however, refer HIV/AIDS 

cases to either LUTH or GH Ikeja. There are not enough 

trained counsellors. The state has an HIV/AIDS budget, 

from which five million naira were released by the 

Commissioner for Health in 1999/2000. International 

donors also help fund some programs. Training has been 

given to tutors of the schools of nursing and midwifery in 

the state as well as secondary school teachers. 

The Ikeja LGA has a 10-member AIDS Action Committee. 

The group is multi-sectoral and works with the Lagos State 

HIV/AIDS Foundation to plan for HIV/AIDS intervention 

in the state and LGAs. But there is presently no set budget 

for HIV/AIDS activities; 1999 was the last year such a 

budget was set. However, money from the general PHC 

vote is used to carry out programs and send staff to workshops, 

seminars, etc. Public enlightenment is the major 

focus of the LGA campaign. Cooperation of LGA political 

officials is needed to ensure government commitment. 

The GH and private hospitals in the LGA provide medical 

care for people with AIDS. An increasing number of 

AIDS-related illnesses are seen: one HIV patient in every 

20-30 admissions. More counsellors are needed. ARV 

supplements symptomatic management of PLHAs in only 

one private hospital. This facility also provides preventive 

and Cotrimoxazole therapy. DOTS is offered for TB care 

only in the GH. 

37 


STD treatment is based on activity (clinical diagnoses). 

Two trained HIV counsellors are available in the GH. 

However, supplies required for observing universal precautions 

are in short supply. A wide range of counselling 

services is provided, with test results disclosed by doctors 

or trained counsellors. They attempt to ensure confidentiality. 

Despite widespread enthusiasm for prevention of motherto-child 

transmission (MTCT) of HIV, only one private 

hospital offers ARV (pre- and antenatal), Caesarean section 

for HIV-positive mothers and avoidance of breastfeeding. 

Protective clothing is worn in the GH. PLHA are 

referred to collaborating NGOs for psychosocial support. 

8.7 Recommendation 

It is apparent that although FSW still constitute a major 

risk population, attention should also be focused on their 

clients – in Ikeja, they include truck/bus drivers, policemen, 

soldiers, dock workers, okada operators and businessmen. 

All these men have multiple sex partners and 

rarely use condoms.


9. Epe LGA 


LGA 

Sites 

Site 1 

Aiyetoro 

Fieldwork was performed in the three LGA sub-sites as 

indicated in the above table. 

9.2 Site Inventory Overview 

Epe 

Site 2 

Papa 

LGA Epe 

Site 

Site 1 

Sex workers 

Truckers 




Petty traders 





300 

Only 350 FSWs were identified in the two sites (Aiyetoro 

and Papa) – 330 of them (85.7 percent) in Aiyetoro. We 

also noticed a large number of petty traders (2000) and 

out-of-school youth (3,500) in Aiyetoro. 

80 

100 

2000 

- 

2000 

500 

3500 

16 

15 

38 

Site 2 

50 

30 

20 

1800 

- 

400 

3000 

2500 

9 

10 

Site 3 

Marina 

Site 3 

15 

50 

30 

40 

500 

- 

2000 

500 

none 

10


LGA/State EPE 

Aiyetoro 

Papa 

Marina 

Details 

Population – 28,000 

Location - Lagos State (Epe 

LGA) 

Distance from center – 145km 



(Epe LGA) 



Location – Lagos State (Epe 

LGA) 


Aiyetoro is the most important site in terms of the 

research focus; it is the centre of commercial and social 

activities and the major home of the FSW. Note the heavy 

concentration of non-indigenes in Marina. 


39 


Commercial center of the LGA – most popular markets, garages 

FSW mostly in the brothels on permanent basis 

A few visiting SW 

Diversified occupations: farmers, fishermen, construction 

workers, uniformed government workers 

Community development associations 

Diverse ethnic groups with non-indigenes concentrated in 

the site SW mostly in brothels




LGA/Site 

Aiyetoro 

Papa 

Marina 

Major Clients 

Occupations 

Motorcyclists (okada), bus drivers, mechanics, 

barbers, fishermen, timber merchants, 

plywood workers. 


Aiyetoro Market. Akinsola Street behind the 

Total Filling Station 


Commercial activities 

Occupations 

Timber merchants, plywood workers, 

motorcyclists (okada), bus drivers, police 


Near Lagos State University (LASU) campus 


Youths of various social categories including 

in- and out-of- school and ‘area boys’ 

Occupations 

Motorcyclists, okada, mechanics, bus/taxi 

drivers, fishermen, timber merchants 


Very close to Aiyetoro, share same boundary 


Multi-ethnic groups 

Clients are generally in low occupational categories in 

terms of prestige and substance. Charges are low, from 

N100 per round to N600 overnight. 

40 

Charges 

Round – N100 

Night – N500 – N600 


Night – N400 – 500 


Night – N400 - 500


LGA/Site 

EPE (All sites) 


Buses/taxis privately owned 

Truckers/bus drivers patronise FSWs. Since this is a small 

community, it is much easier to meet sex workers, whose 

charges are affordable. 



Epe LGA Site 

Aiyetoro 

Papa 

Primary Schools 11 

1. St. Michael Pry. School 

2. Adegbesan Pry. School 

1. Luyepo Pry. Schl. Papa 

2. Lupetoro Pry. Schl. Papa 

3. Zumratul Pry. Schl. Papa 

4. Morning Star Pry. Schl. 

5. Ewe-nla Pry. Schl. Papa 

6. Eddy Standard Pry. Schl. Papa 

7. Dabasco Pry. Schl. Papa 

8. Jolayemi Pry. Schl. Papa 

9. Opeolu Pry. Schl. Papa 


LGA Epe 

Site 

Aiyetoro 

Uniformed men 

Other government officials 

Construction workers 

Fishermen 

Petty traders 

Petty traders are regarded as the most vulnerable group in 

Epe, about 95 percent of them of those so identified in 

Aiyetoro 

50 

40 

120 

2000 

The number of higher schools is relatively low, not surprising 

in a suburban community. Because of lack of adequate 

facilities, many students might leave for secondary 

and tertiary education in Lagos City. 

41 


FSWs located mostly in Lagbade, Lacoom and Gamson brothels 

Secondary School 2 

— 

Papa 

100 

150 

250 

— 

— 

1. Ogunmodede College Papa 

2. Epe Girls High School, Papa 

Tertiary 

Marina 

15 

5,000 

—



LGA Epe 

Site 

Major Out-of-School Areas Estimated Number of Outof-School 

Youth 

Aiyetoro 

Papa 

Marina 

Aiyetoro Market 

Aiyetoro Market 

Fishermen’s Market 

Not very evident 

The number of out-of-school-youth is extremely high even 

for a rural community. Most were found in Aiyetoro 

Market; others in filling station, motor garage and seaside. 

These are the youths that patronise the sex workers. 


LGA Epe 

All Sites 

Number of Public Health 

Services 1 

Papa 

9.6 Condom Outlets* 

LGA 

Site 

Aiyetoro 

Papa 

Marina 

Tertiary 

General 1 

Maternity 

Health facility 

*The number shown is less than the actual, since various 

channels/outlets in the sites were not included in the fieldwork. 

42 

3,500 

2,500 

— 


Structure 

Motor garage 

Filling station 

Motor garage 

Seaside 

Number of Private Health 

Services 1 

Nursing home 

Surgery 

Private hospital 1 

Epe 

Public and Private 

15 

10 

Various pharmaceutical and medicine stores 

—


Epe, the “fish basket” of Lagos State, is located on longitude 

4oE and latitude 6.31oN. Epe Town, the LGA headquarters, 

could be described as riverine, located on a slightly 

elevated land rising between 30 to 60 metres above sea 

level. It borders the shores of Lagos Lagoon and the sheltered 

Lekki Lagoon surrounded by mangrove swamp forest. 

The LGA is bounded on the east by Ijebu-East and 

Ijebu-South LGAs of Ogun State along Imobi and Iwopin, 

where it crosses the Lekki Lagoon further south terminating 

at Aboreji seacoast end. It shares a boundary with 

Ikorodu LGA in the west and Imota across Ikorodu/Epe 

Road. It is bounded in the north by Odogbolu LGA of 

Ogun State and Ijebu-Lekki LGA in the south. 

EpeTown, where most fieldwork was carried out, is about 

140km. east of Ikeja, the capital city of Lagos. The LGA 

includes a number of isolated villages or settlements occupied 

by the Ijebus, a Yoruba sub-ethnic group. The population 

is estimated at between 200,000 and 250,000. 

The people are predominantly farmers. Fish farming is 

important in the riverine areas; many of the Ilaje from 

Ondo State participate in this activity. Civil servants, uniformed 

security personnel, bus/taxi drivers, motorcyclists 

(okada), mechanics and petty traders (women) who dominate 

the main open markets. Commercial female sex 

workers operate mostly in the brothels. 

The first settlers probably migrated to the present locale in 

the 15th and 16th centuries. Others arrived as late as 

19th Century. According to tradition or oral history, the 

earliest settler came directly from Ile-Ife, the cradle of the 

Yoruba race, followed perhaps by migrants from Ijebu- 

Ode, Sagamu and Lagos. Some inhabitants of the riverine 

villages moved from Epe Town. Yoruba, with Ijebu 

dialect, is spoken but most inhabitants are also fluent in 

English. 

Epe has fairly adequate social facilities for a Nigerian suburban 

community: pipe-borne tap water and constant or 

at least predictable electricity (NEPA). The road network 

is impressive and general sanitation is satisfactory. 

Educational facilities include a campus of Lagos State 

University (LASU), Lagos State College of Primary 

Education, and many primary and secondary schools. 

There is a general hospital and many private hospitals, 

health centres and clinics and pharmaceutical and drug 

stores. Recreational facilities include open fields and 

halls, motels, bars and clubhouses. The five major markets 

provide entertainment as well as commercial activities. 

In addition to their religious roles, churches and 

mosques also offer some recreation and entertainment. 

43 


9.7.1 Aiyetoro 

Aiyetoro, with a population of about 28,000, is the commercial 

nerve centre of the LGA. There are no secondary 

schools in the area, but much commercial activity. 

Aiyetoro Market, the most popular in Epe, is located here. 

The two main motor garages, hotels and brothels are 

important features of Aiyetoro. The area also has many 

retail shops, hawkers, food vendors, petty traders, private 

clinics and patent medicine stores. Female sex workers – 

both permanent and visiting SW –occupy the brothels. 

FSW are mostly located in Akinsola Street behind the 

Total Filling Station. Visiting sex workers are found in 

Satolu and Prestige Hotels. 

9.7.2 Papa 

Papa is a relatively small community of about 15,000 

inhabitants. Residents include farm workers, fishermen, 

construction workers, uniformed government workers 

and female sex workers. Papa is very close to the LASU 

campus and Epe, and has two secondary schools –all factors 

that make Papa very relevant to the research interest. 

In addition, the site hosts young people of various social 

categories: in- and out-of-school youths, ‘area boys’, 

motorcyclists, bus conductors, taxi drivers, petty traders 

and their female apprentices. 

9.7.3 Marina 

Marina (population 12,000) is, in many ways, similar to 

Papa, except that there is only one primary school and 

only one church in the community. There are, however, 

various community groups or associations such as Isoko 

Community Association, Ibo Association and Itshekiri 

Association. Non-indigenes are concentrated in the 

Marina area. Sex workers are mostly located in Baba 

Sahear brothel very close to Aiyetoro. Araromi Market is 

a major commercial centre that also provides other social 

activities.


9.8 Conclusion and Recommendation 

Epe is a sexually active and well-informed community 

with a high level of awareness of STIs and/AIDS. Condom 

use is acceptable – at least in principle – and actually utilized 

by sex workers. It is also apparent that the youths 

are the main victims of unprotected sexual intercourse and 

the most vulnerable to STIs, HIV/AIDS in the community. 

Unlike sex workers, the youths engage in unprotected 

(without the use of condom) sexual intercourse with adult 

men with multiple partners for exchange of gifts, money 

or other favours. 

The literature has established and identified the most vulnerable 

segment of a society to STIs, HIV/AIDS. 

Although sex workers usually top the list, information 

from Epe suggests that they may not present the real problem. 

FSW seem to have accepted the reality of STIs and 

HIV/AIDS and are very conscious of the dangers. These 

women seem to know how to care for themselves and 

take all known precautions to avoid infection. Perhaps 

the real danger zone, the most vulnerable groups, are the 

youths followed by men with multiple partners and petty 

traders/low income women. These segments have something 

in common: unprotected, chanced sexual intercourse. 

As indicated, the youths are the worst. They have 

the most sexual partners who cut across social categories 

and indulge in indiscriminate and unprotected sexual 

intercourse. 

A thorough analysis of the youths’ sexual behaviours in 

various communities is needed. What we have observed 

in Epe is not likely to be different from any other community, 

particularly in our society. We recommend that any 

program on prevention and management of STIs, 

HIV/AIDS should focus essentially on youth. 

44

10. State Summary and Conclusion 

The study was carried out in five Lagos LGAs (Ojo, Lagos 

Mainland, Ajeromi-Ifelodun, Ikeja and Epe) 15 - 21 

February 2001. Each LGA fulfilled the criteria of both 

“risk groups” and “risk setting”. 

Data collection methods included community-derived participatory 

approaches and structured assessment tools. 

Multiple collection methods were used. Informants or 

respondents were selected purposefully. Fieldwork was 

conducted simultaneously in all selected LGAs/sites. 

The researchers were FHI/Nigeria staff, consultants, 

research assistants, stakeholder representatives (State 

Hospital Management Board; ministries of Health, 

Education and Youth, the LGA and others such as the 

AIDS Action Manager and NGO partners). 

Major Findings From the Five 

Local Government Areas: 

HIV/AIDS Epidemic 

The in-depth assessment confirms high prevalence of 

HIV/AIDS in Lagos State – the official figure of 6.7 percent 

may in fact be lower than the actual rate. This suggestion 

is based on our observation and/or information 

gathered from informants about the risk-group. In Ojo 

LGA, for example, over 3000 sex workers were identified 

in the study sites alone; these women are actively patronised 

by various segments of the population. 

Female Sex Workers 

Sex workers were found in strategic locations throughout 

the state – usually in hotels and brothels as permanent or 

temporary workers. Very poor FSWs were located mainly 

in the brothels. Charges range from N50 to N300 per 

round with a minimum of N1200 per night, depending on 

a client’s status and the level of sophistication/attractiveness 

of the sex worker. 

An estimated 9000 FSWs were identified in four of the five 

LGAs sites (excluding Ikeja) – this figure does not include 

casual sex workers such as students or low income women 

(petty traders) or men with multiple sex partners. 

It is interesting to note that Ojo and Ajeromi/Ifelodun 

LGAs are responsible for about 90 percent of sex workers 

reported in the Lagos State sites. It should be pointed out, 

however, that the high concentration of sex workers in 

Lagos is partly due to the state’s heterogeneous nature in 

45 


terms of ethnicity and the attendance sexual permissiveness 

characteristics of an urban setting. For instance, Epe, 

more of a rural setting, recorded only 300 sex workers 

(3.3 percent). In addition, many of the FSWs are actually 

not indigenes of the state; they are mostly from West 

African Coast and other states within the Federation. 

Truckers/Bus Drivers 

Truckers are evident throughout the state. Bus drivers 

operate luxurious buses owned by individuals, groups, 

companies or organisations. 

Their major sexual partners are FSWs and students from tertiary 

institutions. They also have ‘girl-friends,’ usually petty 

traders who are readily available. These girl-friends also 

provide accommodation when truckers cannot afford hotels. 

Vulnerable Populations 

Other vulnerable populations identified include uniformed 

men, civil servants, construction workers and 

petty traders. Most engage in casual unprotected sexual 

intercourse. Their exact number cannot be ascertained – 

but they are many. In Ajeromi-Ifelodun alone, 590 were 

identified; another 500 were found in the relatively small 

community of Epe. 

In-School Youth 

Education is a major industry in Lagos State – a reflection 

of the large number of youths here. In Ojo LGA, for 

example, there are 39 primary schools in the study sites, 

14 secondary and five tertiary institutions. A similar pattern 

exists in Lagos Mainland LGA: 56 primary schools, 

39 secondary and five tertiary. 

Lagos State is one of the most densely populated – if not 

the most densely populated – in terms of youths in school. 

This has many implications for HIV/AIDS intervention 

programs.



The study reveals that a large number of youth in the state 

do not attend school. In the study sites alone, nearly 

20,000 youth are estimated out-of-school — 10,000 from 

Ojo, 6,000 from Epe. 

Most of these youths are in the streets; some form gangs 

such as ‘area boys’, others are touts or the much-talkedabout 

“undesirable element” found in cult activities and 

illegal drug distribution. Others are bus conductors or 

street hawkers. A few of the out-of-school youth are 

apprentices, mostly in mechanics and related trades. 

Major attention must be given to these youths in order to 

curb the menace of HIV/AIDS, since many have been associated 

with reckless sexual activities. 

Condom Outlets 

Outlets are numerous throughout the state. In Ojo alone, 

100 outlets were identified, with reports that 10,000 condoms 

are sold monthly. In Ajeromi-Ifelodun, 200 outlets 

were found. The number could be even greater, given the 

urban nature of Lagos State and the fact that condoms 

enter the sites through various inconspicuous sources. 

Non-Governmental Organisations 

Only a few NGOs are located in the sites, mostly in Ojo 

and Ajeromi-Ifelodun. However, we were able to identify 

20 NGOs throughout the state (see appendix). NGOs 

have demonstrated or expressed interest in programs 

aimed at preventing or managing HIV/AIDS. They can be 

of great help to FHI/Nigeria initiatives. 

46 

Community Leaders 

Community leaders are generally well informed and 

knowledgeable about HIV/AIDS. They are respected and 

command a lot of influence – they have mobilised their 

communities to promote health-related and socio-economic 

activities from which the people have benefited tremendously. 

Their activities and influence are most noticeable in 

Ojo and Lagos Mainland, where some of them double as 

traditional rulers or ‘Baale’. They are willing to cooperate 

and be involved in mobilisation and enlightenment activities. 

They will donate land/space for screen centres if 

needed. FHI could enlist their support and channel their 

assets appropriately to enhance its programs. 

Care and Support 

Most care and support activities are located in the 

Mainland LGA sites. When this LGA’s LACA was 

launched, it attracted a budget of half a million naira. 

Other organisations such as NRC and Mainland hospitals 

provide specialized services including TB care, HIV/AIDS 

management, ARV therapy and provision of VCT.

11. Recommendations 

Lagos State will benefit greatly from a mini-comprehensive 

program targeting the high-risk groups selected in the 

state: Ojo LGA, Lagos Mainland LGA, and Ajeromi- 

Ifelodun LGA. It is hoped that other high-risk LGAs initially 

identified, namely Ikeja and Epe, will also benefit 

from the program – as will the entire state in the long run. 

Meanwhile, we offer the following 

specific recommendations: 

1. Focus more on sex workers and, by extension, their 

clients. They still constitute a major danger of spreading 

STI, HIV/AIDS in Lagos State. 

2. Encourage and strengthen condom use – but products 

should be of high quality and distribution should be 

free (if possible). 

3. Discourage sex workers – possibly explore alternative 

trades through the LGA/community or charity organisations. 

4. Reach in- and out-of-school youth to reduce their high 

risk sexual behaviour. Give special attention to students 

from secondary schools and universities, particularly 

LASU. 

5. Reach men with multiple sex partners and petty 

traders/low-income women. They constitute a great 

risk because they are not likely to use condoms. 

6. Find ways for program to benefit truckers/bus drivers, 

okada operators, mechanics and other artisans. 

47 


7. Establish condom-friendly hotels by targeting hotel 

owners’ associations and FSW chairladies for programming. 

8. Utilise community leaders and community development 

associations with the ability to provide their 

publics with information during program planning 

and implementation. 

9. Strengthen hospital counselling units of the hospitals 

by training more personnel. Identified PLHA should 

be encouraged to form support groups. 

10. Carry out a thorough analysis of youths’ sexual 

behaviours in various communities. What we have 

observed in Lagos is probably applicable to other 

communities, particularly in our society.


Appendix I: Researchers 

Ikeja LGA 

COORDINATOR 

Dr. Adedokun 

STATE 

Mrs. A.I. Akinola 

SAPC MOH 

LGA 

1. Mrs. O.O. Oyenuga 

AIDS Action Mgr. 

2. A.A. Oshodi 

RAs 

Lagos 

TEAM FACILITATORS 

DR. OKE 

BIODUN ADETORO 

Com. Dev. Insp. 

1. F. Osungbure 

2. Joseph Oke 

NGO PARTNERS 

Laide Adenuga 

RCCG 

Mr. S.K. Idowu 

NUT 

Aderemi Oginni 

NURTW 

Maureen Onyia 

NLC 

Ajeromi/Ifelodun 

COORDINATOR 

Ogunlade 

STATE 

Mr.A.K. Agbodji 

LGA Admin. 

LGA 

1. Mr. L. Akinyombo 


2. Mrs. R.T. Imam 

Com. Dev. Insp. 

RAs 

1. Ajayi 

2. Adeboje 

NGO PARTNERS 

Rasaq Awosola 

LLO 

Maj.Abigail Omolola 

SA 

Christy Nwanguma 

CRH 

Mrs.Ola Kukoyi 

SWAAN 

Mainland 

COORDINATOR 

Dr. (Mrs.) Faweya 

STATE 

1. Mrs. Kemi Adeoye 

LGA Admin. 

2.Mr. Babs Ayoade 

LGA 

Min. of Educ. 

1. Mrs. A.U. Aina 


2.Miss B.O. Adeniyi 

Agric. Social Welfare 

Dept. 

RAs 

1. O. Babatunde 

2. Adedayo 

NGO PARTNERS 

Nnodim Florence 

SWAAN 

Udung Moses 

LLO 

Femi Ogbaro 

AHI 

48 

Ojo 

COORDINATOR 

Adetoro 

STATE 

1. Yemi Adegite 

Min. of Youth 

RAs 

1. Ogunmekan 

2. Ibrahim 

3. Chilwa 

NGO PARTNERS 

A. Atobatele 

RCCG 

Bede Eziefule 

CRH 

E.O. Eniayewu 

AHI 

Care & Support 

Dr. Soretire 

Dr. Faweya 

Epe LGA 

COORDINATOR 

Prof. Oke 

STATE 

Mrs. C.A. Oresanya 

Hosp. Mgt. Board, Min 

of Health 

LGA 

LGA 

1. Mrs. A.M. Moronkeji 1. Dr. T.A. Ameho 


M O H 

2. Mrs. E.O. Akonye 2. Mrs. A.A. Ogidan 

Chief Instructor, 

Comm. Develop 

LG Voc. Centre 

Inspector 

RAs 

1. Akintimi 

2. Omotosho 

NGO PARTNERS 

Kunle Balogun 

CHIEF 

Johnson Oguntade 

NURTW 

Sunday Jim 

Sal Army 

Tiamiyu Christopher 

NUT

Appendix II: Life History of a Sex Worker 

Angela Ayus was born in a city in the south 30 years ago. 

While in secondary school, she had a boyfriend whom she 

intended to marry. They engaged in sexual intercourse 

without the use of a condom whenever they wanted to do 

so. At age 15, she discovered that she was pregnant and 

the two decided to get married. Although the young man 

was from a neighbouring state and different ethnic group, 

these differences presented no problem. He worked in the 

university and earned enough to take care of the family. 

Angela had her first child (a boy now 15 years of age) a few 

months after the wedding. Since then, she has had another 

child, a girl. The boy is now in SSI; the girl has just started 

JSSI. Her husband was a member of several local associations 

including his home-based ethnic group association. 

Their meetings often became festive occasions. 

One day her husband told Angela that it was his turn to 

host the association “and in a big way.” She prepared 

everything needed, with help from friends and relatives. 

The meeting turned into an all-day affair. When almost 

everybody had left, Angela noticed a younger woman – 

much younger than herself – who made herself very much 

at home. When Angela confronted her husband, his relatives 

told her that the young woman was her husband’s new 

wife, from their own ethnic group, even his own village. 

Angela was shocked, but kept quiet. She decided to accept 

the new wife after some people talked to her. But things 

were never the same again. Her husband paid no attention 

to Angela or their children. Whenever she asked for 

money for food, he would tell her to go to the younger 

wife. What this means, according to the informant, is that 

he had rejected Angela as a wife. She had no money to 

feed herself and the children. She decided to move out and 

stay with a cousin. She sent the children to her mother. 

Even then, the husband didn’t look after them. With the 

help of her cousin, she started trading (petty) but could 

not get enough money to take care of herself or the children. 

When her mother died, Angela moved the children 

to a relative. She was desperate and needed money to 

feed the children and send them to school. Although the 

other wife had never had a child, her husband did not care 

about Angela’s children and visited them infrequently, giving 

them little. 

49 


A friend advised Angela to move to Epe and engage in sex 

work. Angela accepted the offer – she felt she had no 

choice. Despite the fact that business is dull in Epe, she 

has enough to take care of herself and children. She goes 

home every Christmas but will never tell anybody what 

she does, nor will she allow anyone – including her children 

– to visit her. They don’t know that she is in Epe; 

they think she is working in Lagos. Angela feels ashamed 

of being a sex worker, and says she will quit as soon as she 

has enough money to start a decent business. She is aware 

of STIs and HIV/AIDS. Angela examines all her clients for 

STIs and will not allow sex without a condom. She gives 

each client two, in case one bursts or tears and uses antibiotics 

regularly to prevent or cure STIs. She thinks she is 

taking good care of herself and should not have STIs. 

Angela’s main fear is HIV/AIDS. She does not want to die, 

but wants to take care of her children, and wants them to 

become a responsible and respected gentleman and lady. 

She would like to start a business in future, never to be a 

sex worker again. She asked: How can I know that a man 

has been infected by HIV? Without waiting for an 

answer, she told the researcher that a man, a potential 

client, came to her the other day for business. The man 

looked so thin. She thought it might be a case of AIDS 

and told him she could not have him. He begged, telling 

her that that is his normal size, nothing is wrong with him. 

He wanted to add to normal charge (N100) because he 

was so pressed. Nevertheless, she didn’t accept him. 

At 30 years of age, Angela is still pretty and looks healthy. 

She believes that if she can escape HIV, there is a bright 

future for her and her children.


Appendix III: Interviewees 

S/N 

1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

Respondents 

Oba M. Afolabi Ashafa 

JP, MFR 

Oba Elder A.I. 

Olugbogi JP 

Alh. Ahmed 

Ibrahim Rufai 

Ven (Dr) A.A. Akinade 

Mrs. J.O. Ojikutu 

Mrs. E.A. Omilani 

Alhaja Bamigbola Ajayi 

Glory 

Kemi 

Tokunbo 

Kemi 

Busola 

Wumi Faderin 

Chibuso Okomma 

Monica Ologunwa 

Title 

Aladi Onijanikin 

of Ijanikin 

Oloto of Oto-Awori 

Chief imam 

Archdeacon 

Deputy principal 

Principal 

Women leader 

Manager 

Sex worker 

Sex worker 

Manager 

Sex worker 

Sex worker 

Student 

Student 

Student 

Student 

Student 

Student 

Student 

Student 

Organisation 

Ijanikin 

Oto-Awori 

Islamic Leader, Ojo 

LGA 

Anglican Church, Ojo 

Archdeaconry 

Awori College, Ojo 

Jubilee College, 

Okoko 

NCWS, Agbelowowa 

City Hotel 

50 

“ 

“ 

New Era Hotel 

Awori College, Ojo 

Awori College 

Adeniran Ogunsanya 

College of Education 

Jubilee College 



LASU 

Target Group 

Community Leader 

Sex worker 


Tool 

Community leader 

& Ethnographic 

guide 

Ethnographic 

guides

Appendix III Cont. 

S/N 

22 

23 

24 

25 

26 

27 

28 

29 

30 

31 

32 

33 

34 

35 

36 

37 

38 

39 

40 

Respondents 

Tunde 

Moses 

Chinedu 

Nwachukwu 

Chief Faderin 

Peter 

Elosa 

Alhaji Fasasi 

Malbau Yakubu 

Mrs. 

Mrs. 

Mrs. 

Dr. Obi 

Mrs. Benson 

Dr. V.A. Kiladejo 

Mrs. F.M. Beyioku 

Dr. Odufunwa 

Mrs. A.M. Moronkeji 

Title 

Student 

Transport Manager 

Driver 

Driver 

NUPENG official 

Driver 

PCMS 

Medical Director 

Senior Nursing Sister 

Lab Technician 

Medical Director 

Chief Nursing Officer 

Medical Officer of 

Health 


Organisation 

LASU 

Trans Continental 

Nigeria (TCN) 

Ohomba Line 

TCN 

TCN 

Chest Clinic, Ojo 

Graceland Medical 

Center 

Kiladejo Hospital 

Ojo PHC Center 

PHC Dept., Ojo LGA 

Ojo Local Government 

51 

Target Group 

Out-of-school 

youth 

Transport workers 

Health worker 

Tool 

C & S Section 

2 - 10 

LACA 


Section 1 C & S + 

LACA


Appendix IV: Assessed Organisations 

Organisation 

1. Lagos State HIV/AIDS Foundation 

2. Hope Worldwide 

3. Health Matters Incorporated 

4. National Council of Women Societies 

5. Community Health Information 

Education Forum 

6. National Union of Road Transport Workers 

7. Nigeria Labour Congress 

8. Society for Women and AIDS in Africa 

9. Centre for the Right to Health 

10. Life Link Organisation 

11. The Redeemed Christian Church of God/The 

Redeemed AIDS Programme Action Committees 

12. Nigeria Union of Teachers Lagos State Wing 

13. Youth AIDS 

14. WAAS Foundation 

15. Ajegunle Community Partners for Health 

16. Amukoko Community Partners for Health 

17. Ajegunle Community Project 

18. The Nigerian Red Cross Society 

19. War Against Indiscipline Brigade 

20. Nigeria AIDS Alliance 

52 

Address 

Flowel House, G.N. Lagos, Broad Street, opp. Western 

Avenue 

256 Herbert Macaulay Street, Yaba, Lagos 

Youth Centre, 7B Appolo, Makoko 

16 Surulere Street, Ojo Town 

C.H.I.E.F., Cornerstone Complex, 6 Bayetinlo Court, Gbara 

Community, off Lagos Epe Expressway, Lekki Pennisula, 

Eti Osa 

52 Sule Street, Idi Mangoro, Agege, Lagos 

29 Olajuwon Street, off Ojuelegba Road, Yaba 

12 Apena Street, off Cole Street, Ojuelegba, Surulere 

3 Obanile-aro Street, Ilupeju 

13 Commercial Road, Apapa 

Km. 46, Lagos – Ibadan Expressway 

24 Coker Road, Ilupeju, Mushin 

39 Akinbowale Street, New Oko-Oba, Ifako-Ijaye 

10 Baale Street, 1st Floor, Ajegunle, Apapa 

202, Ojo Road, Ajegunle 

ACPH Secretariat 13 Sanni Street, Amukoko 

67/68 Kirikiri Road, Ajegunle 

Ajeromi-Ifelodun Division, c/o L.A. Primary School, Ajo- 

Hausa, Ajegunle 

Ajeromi-Ifelodun LG, Baale Street, Ajegunle 

5th Floor, 24/26 Macarthy Street, Onikan, Lagos

Notes 

53 



Notes 

54

Notes 

55 


Family Health International implements the USAID IMPACT Project 

in partnership with the Institute of Tropical Medicine, Management Sciences for Health, 

Population Services International, Program for Appropriate Technology in Health 

and the University of North Carolina at Chapel Hill 

Family Health International 

Institute for HIV/AIDS 

2101 Wilson Blvd., Suite 700 

Arlington, VA 22201 USA 

www.fhi.org

Lagos State, Nigeria - Family Health International

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