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For many young women, protecting themselves from HIV/AIDS is not a choice. As we mark both World AIDS day and 16 Days of Activism against Gender Violence, it’s important to look at just how closely the two are linked.
If governments are serious in their fight against HIV/AIDS, they must also deal with another worldwide "pandemic" - violence against women.
Across the world, women often confront circumstances that increase their risk of HIV infection in gender-specific ways. Many women face sexual violence and coerced sex inside and outside marriage, as well as harmful traditional practices such as genital mutilation, early marriage, and wife inheritance.
In Botswana, Lesotho, and Swaziland, prevalence rates still exceed 30% among pregnant women. In sub-Saharan Africa, three quarters of all 15-24 year olds living with HIV are female.
According to the government of Lesotho, 75 percent of all new infections in the country are among girls and 51 percent of young women aged between 15 and 24 are infected, compared to 23 percent of young men and boys in the same age group. Lesotho has an HIV/AIDS prevalence rate of 29 percent, the third highest in the world.
Violence is a key factor in increasing young women’s risk of contracting the virus. Various studies suggest that the first sexual experience of a girl is often forced.
Socially, women, especially young women, may be more vulnerable because they have difficulty negotiating protective sex due to power differentials.
Many women and girls in Southern Africa, find themselves using sex as a commodity in exchange for goods, services, money, or basic necessities - often with older men. Poverty and a desire for a better life often drive this “transactional sex.”
Oppression of women has played an important role in the rapid spread of the epidemic. Women's inability to refuse unwanted sex and demand condom use has contributed to HIV infections.
Joanne Csete, director of the HIV/AIDS and human rights program at Human Rights Watch, says, "Women and girls in Africa are dying by the millions, partly because their second-class status makes them vulnerable to violence and unsafe sex."
Yakin Ertürk, the Special Rapporteur on Violence against Women, has stated, "multiple factors associated with women’s subordinate position increase the risk of HIV infection. Among them are: illiteracy and poverty, conflict situations, lack of sexual autonomy, rape by intimate partners or strangers, multiple sexual partners, trafficking for sexual exploitation, genital mutilation and other harmful practices, prostitution and child marriage.”
Lesotho is still largely rural and heavily influenced by traditional customs. Yet it is has more educated women than men, a legacy of more than a century of migrant labour that took hundreds of thousands of the country's men away to South African mines.
For many women the highest risk factor they face is living with an HIV-positive husband or partner (whether he is aware of his status or not). Many women may lack decision-making power in even long-term relationships.
Many are scared to say no to sex or insist their partner use a condom. They are not able to talk to their partner about abstinence, faithfulness, using condoms and don’t know if their partner is doing things that put him and therefore her, at risk for HIV.
For many women, their highest risk factor is living with an HIV-positive husband or partner (whether he is aware of his status or not).
Women infected with HIV may have more difficulty accessing health care, possibly burdened by lack of financial resources, lack of transportation, or an added responsibility of caring for others, especially children.
Women may not earn much money, which makes it hard for them to pay doctors or even get a ride to their doctor appointments. With proper care and treatment, many women can continue to take care of themselves and others.
Women who have HIV may pass the virus to their babies during pregnancy, delivery and breast-feeding. When this happens, a woman is always blamed for infecting a baby just because she is the one who gives birth, regardless of the lack of decision-making power she had in planning children.
UNAIDS Executive Director, Dr Peter Piot (2005) said, "Strategies to address gender inequalities are urgently needed if we want a realistic chance at turning back the epidemic. Concrete action is necessary to prevent violence against women, and ensure access to property and inheritance rights, basic education and employment opportunities for women and girls."
With a prevalence rate of 29%, it is essential that HIV & AIDS be at the top of the development agenda, and that every Mosotho knows their status in order to be able to act accordingly.
Women are fighting both a virus and systemic discrimination in trying to overcome the threat of HIV/AIDS. It is time that Lesotho, and all countries in Southern Africa, realise that HIV/AIDS, poverty, and violence are all part of the same problem.
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