Prostitution facilitates the spread of all sexually transmitted microbial agents. There is no doubt that it played a crucial role in the dissemination of HIV-1 in many parts of the world, including during the first few decades of the emerging epidemic in central Africa. In this chapter, we will review what is known about the development of prostitution (or sex work, as some prefer to call it) in the burgeoning cities located close to the natural habitat of the P.t. troglodytes source of SIVcpz/HIV-1, a process that was intimately related to the urbanisation we have just examined.

The core group

Immediately after the African HIV epidemic was recognised in the mid-1980s, prostitutes and their clients were identified in many countries as the core group within which the virus is exponentially transmitted in the early stages, a process facilitated by the extraordinary prevalence of STDs among these women, which increase the efficacy of heterosexual HIV transmission. Eventually, male clients infect their subsequent female partners not involved in the sex trade, enabling the virus to move out of the core group and into the general adult population. From a concentrated epidemic, it becomes a generalised one.