FOR most people, Majengo may not mean much, but to some medical researchers, the name of this Nairobi slum rings with hope.

Majengo is a Swahili word referring to buildings but to many in Nairobi, it is a place synonymous with sex.

With brothels all over the place, it does not even look close to a medical haven, not with its lacing of rusted shacks and haphazardly-arranged mud-brick huts, its open-air market, salons, hawkers pitching second-hand clothes and women selling sex for the equivalent of pennies, while children go to school...one cannot tell what really goes on there.

But it is here that, in 1986, a handful of HIV-resistant prostitutes were found to be in good health.

A group of prostitutes in this area have remained HIV-negative despite long exposure to HIV-positive men and scientists studying this group of women are hoping to discover what has kept the women HIV-negative and use their findings to develop an HIV and AIDS vaccine.

For more than 15 years, researchers have worked with the Majengo prostitutes.
But recently a group of prostitutes thought to be immune to HIV became infected, causing dismay to scientists hoping to develop an AIDS vaccine.

It was thought that exposure to HIV on a regular basis created immunity, but six Kenyan women previously thought to be resistant are now HIV-positive. The women are all former prostitutes who have since left the business.

Scientists now think immunity may be reliant on continued exposure - once regular contact with HIV stops, immunity is lost.

University of Nairobi, maternity child heath (MCH) clinic research physician Dr Francis Nyamiobo has been involved in this research and explains where it stands at the moment.
"We don't have much now but we are still hopeful that something positive might come out of this," he says.

Dr Nyamiobo says the research at the clinic has been going on for some time now.
One of the prostitutes at Majengo clinic, Hidaya, 27 says she got into prostitution nine years ago and is still in the business.

She says she is HIV positive and is on antiretroviral treatment.
"I was married and I have three children that I had with my late husband who died from HIV related illnesses. He knew I was in the profession and he used to send me because that's how I used to feed the family when he was down and sick," she says.

Hidaya says she always tells her clients about her HIV status but some do not believe her and refuse to use condom.

"I tell them but if they refuse then there is nothing that I can do, at least I have done my part," she says.
Jane is a retired commercial sex worker in her 40s and says she started prostitution in 1995.

She says she came from the village and started working in a salon where she was getting peanuts.

"I had a sister who was already in the profession and that's how she advised me to join them and see how much money I would get. It was a difficult choice to make. The first day I started, I made 900 shillings that was in 1995 and it was a lot of money at that time and when you are new in the business, you have a lot of clients so I would like have 12 clients a day," she says "The older ones taught me how to protect myself (use condoms). We used to rent and share a room which had about five beds...five and we would be having sex there, it was more like a brothel and customers used to come there."

Jane says she has two children - a son and a daughter and they did not know what she was doing as they thought that she was working in a salon.

She says she was later diagnosed with HIV and is currently on ARVs.

Jane says with prostitution, there is no planning.
"You enter with nothing and leave with nothing because when you have money, you spend it and don't think about tomorrow. Sometimes you tell a guy to put on a condom, he puts it on but tears the front and you know he has done this because you are the one that removes the condom. And another thing, he pays you before the act but then some men, after the act will start beating you, asking for their money back because they claim they are not happy with the service," she says.

She says she has now stopped because she is old and her children are big now and it would not look good for a woman of her age to be sleeping with men for money.

Nursing sister in charge at Majengo clinic Elizabeth Wibo says there are about 3000 enrolled prostitutes. Some have passed on, some who have moved out, some who have stopped the profession so the number keeps changing.

Wibo says there are between 700 and 1,000 commercial sex workers who are still actively going to the clinic.

She says if a sex worker who is HIV negative goes to them, they do not consider them HIV resistant until they stay with them for some time.

"After a long time, then we consider them as one of the those who are HIV resistant but we have some at the moment who we consider HIV resistant,' says Wibo.

But make no mistake; this is not the reason why this place is perceived to be important.
The research being carried out in Majengo is just one part of a worldwide effort to find a vaccine or drug that will protect people from AIDS.

In September, a vaccine that was on trial in Thailand was found to reduce the risk of contracting HIV - the virus that leads to AIDS - by nearly a third.

The vaccine - a combination of two earlier experimental vaccines - was given to 16,000 people in Thailand, in the largest ever such vaccine trial.

It has been hailed as a significant, scientific breakthrough, but a global vaccine is still some way off.
The study was carried out by the US army and the Thai government over seven years on volunteers - all HIV-negative men and women aged between 18 and 30 - in parts of Thailand.

In Zambia and South Africa studies have also been carried out.

In Zambia in 2006, the Zambia Emory HIV Research Project (ZEHRP), the International AIDS Vaccine Initiative (IAVI) and Targeted Genetics Corporation (Nasdaq: TGEN) announced the initiation of a clinical trial in Zambia to test the safety and immunogenicity of tgAAC09, a preventive HIV vaccine.

This was the first preventive HIV vaccine conducted in Zambia with Dr. Elwyn Chomba acting as the Principal Investigator even though no results on the same have not been released to date.

In October, 2005, the Zambian government announced the commencement of trials of three indigenous HIV and AIDS herbal remedies namely the Sondashi formulation, made by former works and supply minister Ludwig Sondashi; the Mailacin formulation, made by a school teacher; and the Mayeyanin formulation.

However, after the trials, it was found that the treatments were not effective cures for the disease as was claimed by the three traditionalists.

The Kenya study is taking place at Pumwani Maternity Hospital and Majengo clinic and is being done by the University of Nairobi and another university in Manitoba, Canada.

Dr Nyamiobo, who operates from Pumwani Maternity Hospital, says there is still hope that something positive might come out of the trial being conducted in Majengo.

Dr Nyamiobo says currently the university is doing two research studies, one is a telephone research study and the other one is the study into the prostitutes, which focuses on examining the properties of the cervix to see if the causes for resistance could lie there.

"There is another clinic in Majengo which mainly deals with sex workers who have shown some form of resistance to HIV and the clinic is trying to use another group of women here at the Pumwani clinic to see if there is any difference in the cervix that makes the sex workers more resistant to HIV," he says

He says not much has been gathered so far and cannot give much to the public.

"As the study goes on, things keep changing so we have to finalise the study and that is when we will be able to say what we have found," he says.
Dr Nyamiobo says there are 20 women on the study at the clinic.

He explains that the women are identified and spoken to in a group and they can pull out any time.
He explains that they get a sample from the cervix and tell them to abstain from sex for two weeks.
However, he says the women are compensated for this, to make sure their spouses are taken care of.

Dr Nyamiobo explains that when the clinic started, they took HIV negative women and have been following them up over time.

He says the aim was to see the ones that might turn out HIV positive and check if there is any change in the immunity compared to those who are not becoming HIV positive.

"But basically, the ones we are using here are HIV negative women who are married and the other side (at Majengo) we have HIV negative sex workers," he said

He says naturally, sex workers are exposed to HIV in their line of duty.

"We have HIV negative people who are not sex workers but are part of the programme and we are trying to see if there is a difference in the cervix of the sex workers and that of the other HIV negative women," he says.

He says some of the commercial sex workers have become positive over time so the issue of them being resistant is debatable.

Dr Nyamiobo says they are trying to see why some are taking long.

" You see some have been in the profession for 30, 25 years and they are still negative so we are trying to see if there is anything we can see in the cervix that actually protects them," he said.

He admits that it is also not possible to know if the men the women are sleeping with have HIV but a woman sleeping with 10 clients a day is likely to sleep with an HIV positive man along the way.

"When you go to Majengo, you will realise that some of them are sleeping with 10 clients a day and if you look at a woman who has been in the profession for 30 years, it means she was having unprotected sex before the messages of condoms use came in. Ideally this is someone who should have become infected along the way, having 10 clients a day for 30 years so along the way one of your clients must have been HIV positive," he said.

He says until conclusive findings are made speculation will continue.

"Because for women the point of entry is the cervix and if some women are resistant and are exposed so there must be something in the cervix so we have several hypothesis and until maybe we prove something, then maybe. So for now we are just trying. We are hoping," he says.

Dr Nyamiobo says the first stage may be completed in the next two years and is hopeful that something will be found.