The Associated Press; 50 Rockefeller Plaza, New York, NY 10020 - Saturday, November 8, 1997; 11:31 a.m. EST
Karin Davies, Associated Press Writer

They share intimacies, child-care duties, and meals and money when one needs a hand the other can give.

Hawa Chelangat, 34, and Hadija Chemutai, 31, also share what to them is a blessing in their otherwise cursed lives -- they are apparently immune to the deadly AIDS virus.

"Because my blood has remained clean, I just feel it is God who has been good to me," said Chelangat, a devout Muslim. "It's luck, and God has been so good."

As a prostitute for 14 years on a continent where more than half the world's 23 million HIV-infected people live, she is, indeed, lucky to be free of the AIDS virus. Since AIDS appeared in Kenya in the early 1980s, the sexually transmitted disease has infected 95 percent of the prostitutes who work in the Majengo slum on the outskirts of Nairobi.

The cousins are among just 60 women out of 1,864 who have visited the Majengo clinic for prostitutes since 1985 and remained HIV-negative for three or more years.

"We think they are immune to HIV," said Dr. Frank Plummer, a University of Manitoba physician who is principal researcher at the clinic. "We are calling it resistant -- we are not calling it immune -- but we have a lot of evidence that their immune systems are able to recognize and kill HIV."

If the source of the prostitutes' protection can be identified, it could yield new clues for creating a vaccine against AIDS, Plummer and researchers not involved with the clinic said.

That Chelangat and Chemutai are cousins is important. Researchers have strong evidence HIV-resistance clusters in families.

"We think there's something fundamentally different about their immune systems that is mediated by genetics, and we're trying hard to track it down," Plummer said.

It isn't just safe sex that has kept the prostitutes HIV-free, he insisted.

They, too, sometimes contract other sexually transmitted diseases, such as gonorrhea or syphilis, a sign that they don't always use condoms. Women in the study for a decade, including the cousins, would have experienced about 500 unprotected exposures to the AIDS virus, Plummer said.

To feed their families, the cousins entertain about five men a day each for the going rate of 20 Kenyan shillings, about 30 cents. That is the price of a loaf bread, not enough to buy a cold Coke.

The cheap price is what makes the prostitutes of Majengo so popular. Men come by for a few minutes on the way to work or at lunchtime. Women like Chelangat and Chemutai are just another commodity in the rundown, square-mile market town within sight of the towers of downtown Nairobi.

People come to Majengo from all over the country to buy secondhand clothes and shoes donated from abroad, mosquito nets, sheets, food -- "everything, even a human head," a clinic nurse said, exaggerating the array.

The slum is so poor that shriveled bulbs of garlic are sold by the clove. Seventeen families crowd into 17 rooms at the warren Chemutai calls home. Women carefully wash tattered rags that are Sunday best and hang them on clotheslines crisscrossing muddy yards.

Amid the poverty, Chelangat and Chemutai are working mothers struggling to provide for their families. They are self-employed -- there are no brothels, no pimps in Majengo. They work during the day while their children are at school.

Chelangat didn't have many customers in October. Schools were closed by a teachers strike, and rain kept the two youngest of her five children indoors on bunk beds pressed against the double bed where she usually works.

"When the children have gone to school, I just work here in my house. But if a client comes, and the children are here, then I ask him to go out and look for lodging for the sake of privacy," Chelangat said.

Chemutai, too, tries to keep her work from the children, shooing them away when she has customer for the lower deck of her bunk bed.

"We try to keep our business as private as we can. We are looked down upon," she said, hoop earrings bobbing rhythmically to her soft-spoken words.

Both women turned to prostitution -- Chelangat in 1983 and Chemutai in 1987 -- because divorces left them with no incomes and children to support. Chemutai said she was cast out of Kericho in central Kenya because "it is taboo for a divorced woman to stay in the village."

Chelangat's easy smile and lineless face framed by a scarf cheerfully festooned with blue peacocks belie her hard-scrabble life.

"I was left alone to care for these children, having to work like this to provide for them. It has not been easy."

One of bright spots in the cousins' lives is their friendship. "I am so grateful to be next to my cousin. We can visit each other, share ideas, help each other as family," Chemutai said.

Although her unusual status as HIV-resistant might be good for business, Chelangat said she doesn't tell customers. They probably wouldn't believe her anyway. Besides, she doesn't want to give them an excuse not to use condoms.

"They don't know that my blood is clean. They just come," she said.

Chemutai said she is afraid her luck will run out.

"It has been so difficult for me because we see people around us who go down with HIV and AIDS and die. It's a natural fear that maybe one day my blood will turn positive and I will die," she said.

Once a month for more than 10 years, the cousins have gone for blood tests to the Majengo clinic, dedicated to the care of prostitutes. Chelangat said she is proud to be involved in research that "might bring hope to the future."

The blue petals of jacaranda trees carpet a dirt yard surrounding the clinic's low, concrete building. Raspy voices of hawkers roll inside where women wait for their turn on wooden benches. One mother tries to silence her crying infant with a breast.

In 1985, Canadian, Kenyan and American researchers started a study of sexually transmitted diseases at the clinic. But they found two-thirds of the prostitutes were infected with the AIDS virus, so the scientists refocused their attention.

They made a perplexing finding: The longer a woman had been a prostitute, the less likely she was to be infected with the AIDS virus.

Plummer, who first came to Kenya in 1981 to study infectious diseases, and his colleagues decided the women without infections might somehow be HIV-resistant.

"It took us a long time to develop the evidence for that. You can't do the direct test -- you can't inject people with HIV and show that some are resistant -- and so you have to wait for the natural experiment to happen. People expose themselves through sex work," Plummer said.

The investigators developed convincing evidence of HIV resistance in 1993 and announced their results at an AIDS conference in Berlin.

What keeps these women healthy?

Plummer thinks one answer may be in proteins called human leukocyte antigens, which coat the surface of cells. HLA proteins help identify foreign invaders such as viruses.

Plummer suspects that if certain HLA proteins are present on the coating of cells, they may trigger a more powerful immune response against the virus.

HIV-free women have HLA proteins very different from the more typical ones found in Majengo's other prostitutes. How these rare HLA proteins might repel HIV remains a mystery.

"This is probably not the only mechanism, however. We are working on others," Plummer said.

Nathan Landau, a staff investigator at the Aaron Diamond AIDS Research Center in New York, said the Majengo study is "very important work," particularly because the women seem to be protected by an immune response.

"It will be very important for us to understand why these people do not become infected, and it may bring crucial clues to how ... we can make other people resistant, too," Landau said.

A small number of people in other high-risk groups like homosexuals and spouses of infected hemophiliacs also are resistant to infection. But the Majengo prostitutes, regularly exposed to the virus for many years, provide some of the strongest evidence yet that people can have a natural immunity to AIDS, Plummer said.

There is no guarantee the women will never become infected. Another infection might depress the response to HIV, or a sufficient dose of HIV could overwhelm the women's defenses, Plummer said.

Most successful human vaccines have been developed on the basis of understanding natural immunity, he said. "If you understand how natural immunity happens, you can duplicate it through making a vaccine that imitates natural immunity."

The world's first vaccine resulted because Edward Jenner noticed in 1796 that English milkmaids who had cowpox were naturally immune to the much deadlier smallpox.

Plummer said he hopes Kenya's HIV-free prostitutes can play the same role today that Jenner's milkmaids did two centuries ago.

Copyright 1997/The Associated Press. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Permissions Desk, The Associated Press, 50 Rockefeller Plaza, New York, NY 10020.
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