Women still more at risk

2009-12-05 12:46

THE dawn of democracy has paved the way to

­redressing gender inequality in South Africa, but the degree to which women are

able to take control of their sexual lives is still a critical concern for

health promotion and the prevention of HIV and Aids.

No fewer than 5.4 million people are living with HIV in the country

and 55% of those are women, according to the latest statistics from the national

health department.

South African National Aids Council women’s sector chair Nomfundo

Eland says this number could be higher because the figures are based only on

women attending ­antenatal clinics.

Women under the age of 30 are three to four times more likely to be

infected with HIV than men in the same age group; and women at the reproductive

age between 18 to 39 are the worst affected, says Eland.

This age group is in stable relationships based on trust – a reason

why Thabisile Dlamini got infected.

With a beaming smile and a bright gaze, she is the picture of a

happily married woman, but life has not always been a bed of roses for

32-year-old Dlamini, who lives in Sebokeng in the Vaal. She has been living with

HIV for 10 years. She contracted the virus from her former boyfriend.

“Mandla* was loving and he supported me emotionally and

financially. Within a year our relationship blossomed into something serious and

marriage was on the cards. But in June 1998 I started seeing blisters on his

penis and suggested that he go to the clinic.

“I also volunteered to have an HIV test. I found out my status when

I went for a pregnancy test at the same clinic,” recalls Dlamini.

“I was completely shocked, and ­after having my baby things changed

in our relationship. But I don’t blame my ex for infecting me.

Condoms were

never part of our conversations,” says Dlamini.

During his World Aids Day address in Tshwane this week President

Jacob Zuma said that while the country was still marking the 16 Days of Activism

Against Violence on Women and Children, it was ­“important that we also remember

to uphold the rights of women, including their right to protection from HIV”.

As in most developing countries, South African women are born into

inequality characterised by a low social status. Child rape, stemming from the

popular myth that “sex with a virgin” cures Aids, has also contributed to the

high number of rape cases in the country.

It is a norm for a man to have more than one sexual partner in many

African cultures. Dlamini says women in these relationships become comfortable

and often do not insist on protection if they know the other women in the

relationship.

No fewer than six million condoms are distributed yearly and 1.5

million of these are female condoms. “They are unequally distributed and this

does not give women any negotiating power. The same marketing and education

campaigns (used for male condoms) should be used to promote ­female condoms,”

says Eland.

Various income-generating projects aimed at improving the

conditions of women in rural areas are being implemented by civil society

groups. But most of them need government to take them further, adds Eland.

But women should be taking the initiative themselves through

community projects.

“You do not have to be infected or affected to seek support from an

HIV support group. Some projects go ­beyond HIV awareness. Women need to take

these opportunities,” adds Dlamini.

The new ministry headed by Minister Noluthando Mayende-Sibiya to

address issues concerning women, youth, children and people with disabilities is

yet to consult civil ­society on its plans and budget.

“The department should do an introspection on gender-based

violence. It also needs to invest as much resources as it does on male issues

(such as circumcision). The government cannot be biased when tackling problems,”

notes Eland.

Attempts to get comment from the ministry were futile this week.

  • Antiretrovirals (ARVs) have been

    effective in suppressing HIV replication in infected individuals.

They have been used to prevent mother-to-child infection during

pregnancy and are also prescribed to rape victims after they have been ­exposed

to HIV.

Current trials on pre-exposure prophylaxis (PrEP) HIV infection for

women at risk could be a major breakthrough towards real prevention and

intervention, says Jonathan Berger, a senior researcher at the Aids Law

Project.

The trials are testing the long-term use of ARVs prior (PrEP) to

HIV exposure so that the ARVs are already biologically active in the body when

exposure occurs, as opposed to post-exposure prophylaxis or PEP. The concept of

PrEP (pre­exposure prophylaxis) is not new and is based on the premise that

­effective therapeutic medications can be used by healthy people to ­prevent

certain infections.

For instance, a woman who in a high-risk relationship who cannot

negotiate safer sex could safely take ARVs when she is still HIV negative and

protect herself from chances of being infected with the virus.

Trial results could be available by early next year, says

Berger.

* Not his real name

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