Twenty-four-year old male sex worker Doudou (not his real name) was forced to turn to Senegal's leading gay NGO when his family members threw him out for being a homosexual.
When he discovered he was HIV-positive a year later, Doudou was faced with a double whammy: gay and HIV-positive in a predominantly Muslim country where homosexuality is illegal.
"A serious car accident in May 2003, that claimed the life of my companion, was what started it all," he recalled. The accident caused multiple fractures to his legs, causing him to use crutches for nearly one year.
Stuck and immobilized at home with his family, he realised that they would never accept his sexual orientation. "My half brothers and half sisters kicked me out of the house while I was still struggling with crutches ... I could not bear their verbal daily abuse."
GAYS SIDELINED IN HIV/AIDS PROGRAMMES
Using his meagre savings, Doudou rented a room in the Senegalese capital, Dakar, and turned to an NGO called 'And Ligeey' (Work Together in Wolof a local dialect) - which offers support services for men who have sex with men (MSM) and regular information campaigns on HIV/AIDS.
It was while attending a workshop for MSM that Doudou got tested for HIV. The workshop was part of a survey trying to assess the HIV/AIDS prevalence rate among MSM in the country.
The study, undertaken between April and August 2004, revealed that 21.5 percent of MSM in Senegal were HIV positive. According to the 2005 National Survey on Demographic and Health, 0.7 percent of the country's total population is living with HIV/AIDS.
Senegal has one of Africa's lowest HIV prevalence rates, thanks in part to efficient campaigning, testing and prevention encouraged by the government, but the gay community has been sidelined from AIDS programmes since homosexual sex is technically a crime.
Doudou has not told his family about his positive status. "With what my family made me go through only during the period that my legs were broken, I can only imagine how much worse it would be if bedridden with AIDS," he commented.
Without an education, Doudou has never managed to have a permanent job. Before his car accident, he relied on his sexual partners for financial support.
"I can say I was addicted to prostitution, I had no regular jobs but earned lots of money from my partners," he said.
His partner, who later got killed in the car accident, was married to a woman. "He used to say that he married her only to have children," explained Doudou.
Because of the social stigma attached to homosexuality, some members of the gay community live a double life as married men with children. According to the 2004 study, more than 94 percent of men having sex with men in Senegal also have sexual relations with women.
Doudou admitted never having practiced safe sex before discovering his positive status.
"Now that I know I am HIV positive, I protect myself by asking my partners to wear condoms because I cannot [afford to] contract the virus twice," he said.
Since August 2005, Doudou has been receiving antiretrovirals (ARVs) from the Red Cross centre in Dakar free of charge.
SEX WORK TO SURVIVE
Despite the free access to this service, Doudou has been finding it difficult to get by, especially after his accident and his family's rejection.
After having spent all his savings, he left his rented room and found temporary shelter with a friend in the suburbs of Dakar. He now lives in Mbour, a seaside locality 80 km south of the capital.
"Doudou told me that a friend offered him a job in Mbour, but I found out later he was prostituting himself to live," noted a member of the 'And Ligeey' association.
According to Doudou, homosexual men find it difficult to get jobs, because "when people realize we are MSM, they will not employ us or make sure we are sacked from the job we have."
Two years after his accident, Doudou continues to be plagued by his car-accident injuries, resulting in costly medical follow ups, well beyond his means even with the help from his 'And Ligeey' friends.
"A week ago, Doudou asked me for 100 CFA (US $2) to pay for the trip to get his ARV treatment. He has nothing left, he even sold his cell phone," commented one of the members of 'And Ligeey', who asked not be named.