CAPE VERDE: Tourism boom carries hidden cost of increasing HIV

The white sandy beaches, inland salt formations and volcanic landscapes of Sal island, in the Cape Verde archipelago, off the coast of Senegal in West Africa, have been drawing in tourists from across the world, but experts warn that it has become vulnerable to the spread of HIV/AIDS.

The boom in Sal's tourism industry, fed by an international airport that used to be the only one in the island chain until a few years ago, has been the backbone of the country's sturdy economic growth of around seven percent per year.

Charter flights and package deals make access even easier for tourists, mainly from Europe, who flock to stay in the picturesque beachside town of Santa Maria, where widespread construction is further proof of increasing confidence in the economy.

When Cape Verde, a cluster of 10 islands and five islets with a population of less than half a million, gained independence from Portugal in 1975, many questioned the country's economic viability without the colonial power, but over time it has prospered.

"At the moment, the key sector is tourism," the country's president, Pedro Pires, told IRIN/PlusNews. "Cape Verde has become an interesting tourist destination for lots of other countries, European nationals in particular. In accord with these demands, the tourism sector in Cape Verde is being developed."

Although Cape Verde's capital city, Praia, is situated on Santiago Island, Sal is the wealthiest island - unemployment is at 12 percent compared to the national average of around 24 percent - with a relatively low rate of poverty.

Cape Verdians as well as foreigners are lured to Sal by the promise of work and business opportunities, prompting annual population growth estimated by local officials at 6.7 percent, against a 1.5 percent natural increase.

"With the tourism and construction boom, we are importing poor people from other islands. We also have immigration from [West] Africa and Europe," said Jorge Figueiredo, president of Sal's local government administration and a medical doctor.

Low prevalence, high risk

Unlike its continental neighbours, Cape Verde's average HIV prevalence rate is less than one percent and so far has been spared an epidemic of the disease. Statistics from the Praia-based Committee of Coordination and Combating AIDS (CCS-Sida), the national anti-AIDS body, indicate that Sal is one of the least-affected islands.

In 2005, 16 new cases were reported in Sal, compared to 32 on the island of Sao Vicente and 165 on Santiago, the main island. Some 223 new cases were reported in Cape Verde as a whole.

But Sal is among the islands most at risk of the spread of HIV, along with Boa Vista and Sao Vicente, where international airports will open this year. Sal's at-risk populations, particularly in Santa Maria, where most tourists stay, include commercial sex workers, drug users and vulnerable children.

"We receive around 160,000 tourists per year in Sal. As we know, HIV is linked directly to sexual behaviour. So, naturally, the danger of transmission grows with this flow of tourists," said Figueiredo. "Sal is extremely vulnerable, even if statistics don't show it."

Prevention is better than cure

Of the people known to be living with HIV in Sal, some are foreigners and one is a child, infected by mother to child transmission. Four people, all adults, are receiving antiretroviral treatment, which is provided free to anyone who needs it, including those in country illegally.

Carla Andrade, a medical doctor and the local government's health delegate, says efforts in Sal are focused on the prevention of mother to child transmission, sensitising the population and encouraging people, especially pregnant women, to be tested.

"We would like to increase the number of tests we carry out. The rate of testing among pregnant women is good but we would like 100 percent of pregnant women to be tested," she said.

National data in 2005 showed that over 70 percent of men and around 45 percent of women used condoms when they had high-risk sex, but Andrade said condoms were not always used, many people had multiple partners, and the virus was still mostly spread by sexual contact.

"We can say between 80 to 85 percent of HIV-positive people are infected through sexual transmission ... We speak about prevention, about using condoms, but we see that often people don't use them."