By Raliat Oluyemisi Sunmonu
The AIDS epidemic ravaging Africa and other parts of the developing world is no longer news. The horrific effects are being felt in every African country, so much so that the continent's leaders, who are not usually known for speedy action in the cause of human/social development, have had no choice but to sit up and take notice.
Although no one is immune to AIDS, as is the case with other sexually transmitted diseases, women are especially vulnerable. In Africa, HIV infection occurs almost entirely through heterosexual contact. In its December 2001 AIDS epidemic update, UNAIDS estimates that out of the 28.1 million people (adults and children) living with AIDS in sub-Saharan Africa, 55% of them are women. In some parts of Southern Africa, prevalence rate among pregnant women is more than 30%! Several factors explain why women are more at risk from this particular disease:
Biologically, women are more susceptible to sexually transmitted diseases than men. In the case of rough sex or rape, this is even more so because of the increased risk of micro lesions in the vagina through which the virus can enter the body.
Cultural and/or societal norms may relegate women to a passive role when it comes to sex. This means they often have little or no say in their choice of partner(s), cannot insist on protection or make other choices in sexual matters.
Many women depend on men for financial and/or material support, often trading sexual favors for gifts and money. Whether the arrangement is strictly financial (ie prostitution) or otherwise, this dependence again prevents women from having the authority to insist on protection.
Many young African women are woefully ignorant of the disease. According to the UNAIDS/WHO 2001 update, "a UNICEF study found that more than 70% of the adolescent girls in Somalia and more than 40% in Guinea-Bissau and Sierra Leone, for instance have never heard of AIDS. In countries such as Kenya and the Republic of Tanzania, more than 40% of adolescent girls harbor serious misconceptions about how the virus is transmitted."
In spite of the arguments above, women are not always hapless victims of society or fate. Even women who do have the knowledge and the independence, sexual and otherwise, to make their own decisions ignore the risks of STIs and fail to take the proper precautions. This may be partly due to the authorities' failure to, until recently, treat the HIV/IDS epidemic like what it was: a major human and economic disaster.
In addition to the several initiatives introduced by various countries, women's particular vulnerability to AIDS requires a gender-based response that should focus on helping women prevent and combat the disease. Some areas on which to focus include:
Education: A study conducted by the University of Ibadan College of Medicine (Nigeria) on high school students showed that a school-based education program significantly increased the participants' knowledge and understanding of HIV/AIDS. Many young girls become sexually active at a very young age; the sooner they learn about AIDS, the better the probability that they will take the necessary precautions to prevent infection. All sections of society must work together to spread information about the disease. Religious organizations must be co-opted as necessary partners in the fight against AIDS. The Nigeria-based Journalists Against AIDS organization (http://www.nigeria-aids.org) is a prime example of how indispensable the media is in combating AIDS. The group, founded by journalists, provides white papers, training sessions, information workshops, etc. and has an online forum that serves as a medium where activists, policymakers, journalists, AIDS patients and the general public can interact and discuss AIDS-related issues. African governments must define AND implement clear policies to disseminate information about AIDS. Cultural and/or religious norms that usually regard public discussion of sexual matters as taboo (especially when the intended audience is female) have no place in the glaring reality of AIDS and must be overcome. Our societies need to be more open about discussing sex, AIDS and other STIs. The archaic view that sex education leads to promiscuity is not only impractical, it's dangerous.
Health care: Considering that women are more likely to contract AIDS than men (through sexual intercourse, blood transfusions during ante- and post-natal care), it is clear that more women-focused research needs to be done. An alternative to the female condom or at the very least, a less expensive and less complicated model is needed to give women more control over preventing STIs.
Accessible, quality healthcare is always a problem in developing countries and for women, it is even more so. The WHO estimates that majority of Africans living with HIV are even unaware that they have the virus. A study found that most of women who were tested did not return to collect their results. In Kenya, over half of a group of women surveyed who did find out they had the virus preferred not to share that knowledge with their families for fear of discrimination and being cast out of their homes. Again, adequate policies and social services need to be put in place provide quality healthcare to everyone and women in particular.
Economic Development: Removing a woman's material dependence on a man empowers her and puts her firmly in control of her life. Of course this does not necessarily mean that she will still make the right choices in her sexual dealings but at least she will have a choice.
Perhaps the biggest challenge in the fight against AIDS is that it requires each of us to change. A change in our societies' attitudes towards sex, women, AIDS and people living with the disease; a change in men's behaviors when it comes to sex; a change in the way women are taught to think about themselves and their bodies; a change in the way our governments work because AIDS is a major impediment to our development and irregular, half-hearted policies and measures will only exacerbate the problem. Most of all, it requires that each of us accept that it is our collective problem because at the end of the day, we are all affected. AIDS is not just misogynistic-it's misanthropic.
HIV In Site: http://hivinsite.ucsf.edu
Journalists Against AIDS (JAAIDS): http://www.nigeria-aids.org