Women and HIV/AIDS

At the 8th Meeting of Women Presiding over National Parliaments, delegates from over twenty countries highlighted a wide range of legislative issues impacting the lives of women. The HIV/AIDS pandemic was seriously deliberated. Speaker of the National Assembly of Lesotho, the Hon Ntlhoi Motsamai gave some insight into the nature of the problem in her country and the Southern Sahara Region at large. The following is an excerpt from Motsamai’s presentation.

The nature of Basotho society provides an insight into, and the context within which most of the barriers encountered by HIV/AIDS prevention and control intervention can be understood. The society is a patriarchal one with corresponding ideologies and pro-naturalistic culture, which has legitimised and reinforced its hold further, by defining the Basotho female as “minors”. Basically therefore, unequal gender relations exist in all of the society.

Women could be classified as particularly vulnerable because of their biological, cultural and economic status. These factors place them at a higher risk of infection as this results in their social disempowerment, thereby robbing them of the ability to make decisions about issues related to their sexuality. Men have the power to decide when to procreate, initiate sexual intercourse, and for women to oblige. They also have the right to have multiple sex partners, while the same behaviour is frowned upon in women. These differences in gender relations provide blockages to the ability of women to make choices with regard to their reproductive health and also the possibility to negotiate safer sex.

To fully understand why women are labelled as the most exposed group, the following factors have to be examined:

* Poverty

Poverty has been termed “the world’s” most serious carrier of ill health. Lesotho’s experience is no different particularly with the female headed households accounting for about 40% of total poverty. The structural nature of poverty impacts on women in particular, and exposes them to poor health.

Their relatively low socioeconomic status perpetuates their low self esteem, limits their access to health care and exacerbates the process that makes high-risk behaviour more likely. The high percentage of female headed households coupled with poverty subject females to prostitution. Women, and girls inclusive, have to provide for themselves and their families, they therefore are forced to opt for and seek sexual partners for financial support. Faced with this situation they cannot afford to jeopardise such sexual relationships by demanding safe sex from their clientele. Thus prostitution does predispose sex workers to high risk of HIV infections.

* Culture

Cultural practices such as wife inheritance, polygamy and the cultural mistress expose women to HIV. A culture of silence about sex does also positively contribute to the advance of the disease. And also traditional medicine such as sacrifications, ritual sharing of blades at funerals and mass circumcision in traditional schools, if practised without necessary precautions, are occasions for transmission of the infection.

Polygamy however is in a masked form, and is characterised by the officially acknowledged wife living in the official matrimonial home, while the husband makes another living arrangement outside the home, thereby exposing the wife to infections.

* Social disorganisation

Alcoholism, domestic violence and rape are very common. According to statistics 22 per cent of Lesotho male population have alcohol related problems. Because of women’s low status they are deemed as frustration outlets by particularly drunk men who assault, rape and batter them.

Rape and domestic violence: These are serious problems in Lesotho which makes women more vulnerable to HIV/AIDS than their male counterparts. These controlling situations hardly provide opportunity for the negotiation of safer sex on the part of females. The spread of HIV/AIDS should therefore, be viewed within the power equation in unequal gender relations both in the home and community.

Abstinence: Abstinence from intercourse while still lactating, tends to facilitate domestic violence and rape by husbands, when wives continuously rebuff intimate advances. Husbands therefore find themselves mistresses or engage in casual intercourse outside the marriage. This principally presents risk factors for HIV/AIDS infection in the conjugal union.

* In Lesotho, there are two forms of marriage institutions, customary marriages and civil marriages, they are generally accorded their respective rights and obligations. In either type of marriage the wife or woman is accorded minority status, which puts her in a submissive role rendering her powerless when faced with sexual demands.

Given the factors expounded upon, it is quite apparent that empowerment of all the sexes especially women is basic to the control of the epidemic. Research has shown that 80 per cent of HIV positive women, are women in long term relationships, who have acquired the virus from their partners.

The question therefore remains as to what can be done to curb the scourge of HIV/AIDS: especially when the worst affected group are women, the mothers, the fibre our communities and families, the care-givers and nurturers. To answer this question the laws of the country have to be ensured and address the public health issues raised by HIV/AIDS.