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Silent rage of HIV among women in Southern Africa

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Throughout her school years, 35-year-old Thokozani Chithyoka from Ntchisi District nurtured the ambition to study for a degree in business administration and live an independent life.

Her dream has not materialised, although she holds a diploma in business administration from one of Malawi’s private universities. Now divorced and openly living with HIV, she recalls how the man she thought would be with her forever made her fall for the idea of abandoning school for marriage.

“My husband, Chikondi, proved to be loving and caring during our dating days and during the early days of our marriage, such that I did not hesitate to drop out of college. He asked me to do so and I could not resist the idea because he had a good job and could, therefore, take care of the family,” she says.

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While the 2004 UNFPA State of World Population Report states that married girls are less likely than others to finish their education, the report also gives a tedious picture that such girls are more likely to contract HIV and other sexually transmitted infections.

While one of the Millennium Development Goals (MDGs), which were agreed upon by heads of state in September 2000, is targeted at getting more girls into school to achieve the goal of gender equality, this is not the case.

This is because a 2004 International Labour Orgnisation (ILO) report on HIV and Aids indicates that many women in Africa are not considered to be part of the labour force, yet they grow food, run homes and care for children.

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Founder of the Graca Machel trust, Mama Graca Machel, observes that cultural barriers continue to deny women their socio-economic rights while, at the same time, exposing them to the risk of HIV infection.

Speaking at a Civil Society Nutrition Alliance meeting in Malawi’s capital Lilongwe, she explained: “It is very important that women’s working and economic rights have to be protected if we have to pull our girls and young women out of the HIV and Aids trap and achieve the goal to better nutrition for our infants in the first 1,000 days”.

While the ILO 2004 Economic Security Report indicates that, globally, women generally have less employment security than men, the little security that the women have is, according to the report, being eroded by HIV and Aids.

With UNAIDS statistics indicating that around 60 percent of adults living with HIV are women, the touching part is that 75 percent of the people living with HIV are young women and girls.

The simple explanation to this scenario, according to the ILO assessment, is that, universally, women are discriminated against. To make matters worse, levels of discrimination are higher in rural parts of Southern Africa, where women are treated as regal minors, than in other regions of Africa.

While an ILO survey conducted in Tanzania indicates that 19 percent of women employed in the informal sector reported to have, at one point or another, suffered harassment, a similar study conducted in Zimbabwe revealed that women that are involved in seasonal work are usually sexually abused by male supervisors who can threaten not to hire them or withhold payment for work unless they offer sexual favours.

Although it is said that the benefits of educating the girl child far outweigh those of educating a boy child, the rights of girls are often denied in many parts of Southern Africa as it is believed that, at one point, the welfare of a young woman will be taken care of by her husband.

George Kampango, Programme Officer responsible for research and advocacy at the Malawi Network of People Living with HIV , says that, while two of the MDGs were specifically geared at improving the welfare of women, it is clear that the goal of gender equality and women empowerment has not been met in many countries in Southern Africa if one considers the highly unacceptable HIV and Aids rate among women and girls.

“Many countries have indeed managed to put more girls into class and have promoted women into decision making positions, yet we cannot proudly say we have managed to promote the fair participation of women in the socio-economic realm when, in reality, we have unacceptably high HIV rates among women including those that are in the workplace,” Kampango says.

With statistics indicating that 70 percent of the world’s poor are women, a study by the New Nationalist over a 20-year period from 1970 to 1990 indicates that the number of rural women living in poverty had increased by 50 percent, reaching 565 million, while that of men had increased by 30 percent.

Interestingly, however, an analysis of the Human Poverty Index (HPI-1) used by the UNDP, specifically for 95 developing countries in the measurement of deprivations in three basic dimensions, captured in the Human Development Index (HDI), including a long and healthy life, knowledge and decent standard of living, shows that the situation has not changed over the past 25 years.

While unequal power dynamics in workplaces are usually symbolised by the notion that women’s main role is reproduction, which includes child bearing and taking care of children and family, the UNDP assesses that stigma, and discrimination towards women puts them at risk of HIV infection.

Lillian Saka Kiefer, Director at Panos Southern Africa, agrees with the notion that, while the HIV and Aids pandemic is destroying the livelihood of millions of people worldwide, the situation is worse in regions and countries where poverty is extensive and gender inequality is persistent.

“Poverty and gender inequality are critical factors for HIV spread in Africa and the situation is worse when women are denied their economic rights and are discriminated against,” Kiefer explained recently at the first Southern Africa Journalists Living with HIV meeting held in Pretoria, South Africa.

While it is a fact that, globally, the HIV and Aids pandemic is driven by men, considering that men have more chances of contracting and transmitting HIV, it is women that suffer the silent rage of HIV in communities.

With the UNDP indicating that 10 of the overall 16 Southern African countries were low income or on the lowest rung, economically, of countries worldwide, with Gross National Income per capita of $732 or less in 2002, the magnitude of the present pandemic and its potential multi-dimensional impact in the future is extremely difficult, if not impossible, to truly comprehend.

Meanwhile, while UNAIDS estimates that the proportion of people living in poverty has declined in sub-Saharan Africa in the past 20 years, from 50 percent to 33 percent, the report reveals that, despite HIV prevalence falling most steeply from 2010, the total number of adults that are projected to be living with HIV in 2025 will be 23.9 million— which is as high as 2004 figures, which stood at 24.1 million.

According to UNAIDS projections, women will still be adversely affected by the epidemic, with estimates indicating that 1.4 million women will be infected per year as opposed to 1.2 million men per year.

While the rights of women all over the world are violated every day, as portrayed by the fact that women in most circumstances cannot earn a living wage to afford the basic necessities of life, the International Partnership for Microbicides (IPM) believes that women can be given the power to protect themselves from HIV infection if they are empowered with products that would enable them to protect their sexual reproductive health on their own terms.

A statement signed by IPM’s Board Chair James McIntyre and Chief Executive Officer Zeda Rosenberg recognises that women face more complex challenges to their sexual and reproductive health than those men face.

According to IPM, issues such as HIV and unintended pregnancy have devastating effects on women, their families and communities.

But maybe the good news is that on-going studies may change the status of women, as far as HIV and Aids issues are concerned.

This is because the two phase III of the ring— the IPM-led Ring Study and Microbicide Network (MTN)- led Aspire trial —is in its final stages at over 20 sites in Malawi, South Africa, Uganda and Zimbabwe.

According to the IPM, pending results and regulatory approval, if results of the FACTS 001 trial, expected early next year, confirm the effectiveness of the tenofivor gel in HIV prevention, women in sub- Saharan Africa could be on the road to meeting their sexual reproductive needs by end 2017.

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