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Africa: Women, Men, and AIDS
AFRICA ACTION
Africa Policy E-Journal
August 17, 2003 (030817)
Africa: Women, Men, and AIDS
(Reposted from sources cited below)
This posting contains two new reports, one a case study from Uganda
by Human Rights Watch on the impact of domestic violence in
increasing the threat to women from HIV/AIDS, the other a report
from a conference of NGOs and health experts in Southern Africa on
how to engage men in the response to the HIV/AIDS pandemic.
A wide variety of additional resources on gender and AIDS can be
found at the UNIFEM web portal Gender and HIV/AIDS:
http://www.genderandaids.org
Another posting today has a speech - "My Access to Life" by Mrs.
Morolake Nwagwu of the Treatment Action Movement, Nigeria,
given at an NGO symposium in Japan in preparation for TICAD III
(The Third Tokyo International Conference on African Development),
which will take place at the end of September,
+++++++++++++++++end summary/introduction+++++++++++++++++++++++
Note from E-Journal Editor:
Today's two postings are the last for this month. The E-Journal
will resume in early September, shortly before the World Trade
Organization Ministerial Summit in Cancun (September 10-14). The
summit, which takes place every two years, comes four years after
Seattle and two years after Doha. While demonstrations at the site
will be dominated by groups from Mexico and other countries in the
Americas, African and other developing countries have made strong
statements opposing the undemocratic procedures and positions
adopted on many issues by the U.S. and European countries. For
summaries of recent developments and the positions of African
countries, see in particular updates from the Third World Network
[http://www.twnside.org.sg and http://www.twnafrica.org]
- William Minter
Human Rights Watch (http://www.hrw.org)
August 13, 2003
Uganda: Domestic Violence Worsens AIDS
Battered Women Face Greater Vulnerability to HIV
[full report available at: The report is available at:
http://www.hrw.org/reports/2003/uganda0803/]
(Kampala, August 13, 2003) -- The Ugandan government's failure to
protect women from domestic violence and discrimination increases
women's risk of contracting HIV, Human Rights Watch said in a new
report released today.
The 77-page report, "Just Die Quietly: Domestic Violence and
Women's Vulnerability to HIV in Uganda," documents widespread rape
and brutal attacks on women by their husbands in Uganda, where a
specific domestic violence law has not been enacted and where
spousal rape is not criminalized.
"The Ugandan government's failure to address domestic violence is
costing women their lives," said LaShawn R. Jefferson, executive
director of the Women's Rights Division of Human Rights Watch. "Any
success Uganda has experienced in its fight against HIV/AIDS will
be short-lived if the government does not address this urgent
problem."
Many women told Human Rights Watch that a fear of violent
repercussions impeded their access to HIV/AIDS information, HIV
testing, and HIV/AIDS treatment and counseling.
Lydia Mpachibi (not her real name), a thirty-five-year old,
HIV-positive widow living in Tororo, in eastern Uganda told Human
Rights Watch that while her husband was alive she avoided HIV/AIDS
testing or information because she was afraid that he would evict
her. "I wouldn't dare because if I was HIV- positive, he would say
I brought the virus into the home," Mpachibi said. "I have seen
very many women being chased away by their husbands...I was scared
of being thrown out."
The Human Rights Watch report says that HIV/AIDS programs focusing
on fidelity, abstinence, and condom use do not account for the ways
in which domestic violence inhibits women's control over sexual
matters in marriage. The U.S. government has proposed a dramatic
increase in such programs as a way of combating AIDS in Africa.
Programs focusing on fidelity, abstinence, and condom use minimize
the complex causes of violence, and incorrectly assume that women
have equal decision-making power and status within the family.
"Being married should not be a death sentence for Ugandan women,"
said Jefferson. "Women should not have to give up their rights to
physical security and sexual autonomy just because they get
married."
Human Rights Watch urged the Ugandan government to enact domestic
violence legislation, and to make women's health, physical
integrity, and equal rights in marriage a central focus of AIDS
programming.
For more than a decade, Ugandan women's rights advocates have urged
Uganda to enact legislation addressing domestic relations and the
rape and battery of women by their intimate partners. Yet for
years, the bills have languished in parliament.
Donor assistance to Uganda for HIV/AIDS continues to be
considerable. Uganda is included among fourteen countries slated to
receive five years of AIDS program support from the United States.
The exact amount of U.S. aid that Uganda will ultimately receive
remains unclear.
In February, the Global Fund to Fight AIDS, Tuberculosis and
Malaria signed a grant worth over U.S.$36 million to support
Uganda's ongoing fight against HIV/AIDS. Human Rights Watch urged
the Global Fund, the U.S. government, the World Bank, and other
donors to ensure that AIDS-prevention programs specifically target
domestic violence, including sexual violence in marriage, as core
components of their strategies.
Cases of Ugandan Women Featured in the report: (Pseudonyms are
used to protect privacy)
Hadija Namaganda's HIV-positive husband raped and beat her
viciously. During one brutal attack, he even bit off her ear. When
he lay dying of AIDS and was too weak to beat her anymore, he
ordered his younger brother to continue beating her. Namaganda, now
HIV-positive, told Human Rights Watch: "He used to force me to have
sex with him after he became ill. If he wanted to, he would force
me and accuse me of having other men. He said he would cut me up
and throw me out. I didn't know about condoms. We didn't use them."
Harriet Abwoli, thirty, found out that she was HIV-positive when
she became pregnant with her second husband's child. She told
Human Rights Watch, "When I gave birth and the child had passed
away they told me I was HIV-positive. I cried. The doctor told me,
`wipe your tears, the whole world is sick.' The very first time I
asked my second husband to use a condom because I didn't want to
give birth he said no. He used force and I got pregnant. That's the
child that died. That was when we first met. I'm with him because
I don't have a cent. He at least pays the rent."
MEN, HIV & AIDS regional conference 2003
Regional AIDS Initiative of Southern Africa/VSO
Posted August 7, 2003 on Aids-Africa
[http://www.yahoogroups.com/group/aids-africa]
Executive Summary by Mercedes Sayagues
Full conference report available at:
http://www.kubatana.net/docs/hivaid/vso_men_aids_2003.pdf
"Besides deep changes in society, what we need is a deeply
spiritual transformation in the identity of men."
This statement by a participant sums up the debates at a conference
on MEN, HIV & AIDS organised in Pretoria by the Regional AIDS
Initiative of Southern Africa (RAISA) of Voluntary Service Overseas
(VSO) between 11-13 February 2003. Seventy-one participants, mostly
from Southern African countries with a few from East and West
Africa, examined how to engage men in the response to the HIV/AIDS
pandemic.
In the region, national adult HIV prevalence has risen, says
UNAIDS, "higher than thought possible, exceeding 30% in Botswana
(38.8%), Lesotho (31%) and Zimbabwe (33.7%)." Namibia follows
(22.5%), Zambia (21.5%) and Malawi (15%). South Africa's estimated
13% prevalence translates into 4.5- 4.7 million people infected.
Twenty years into the pandemic, the bulk of studies and
interventions have centred on women and girls. There is greater
understanding of the gender dimensions of HIV/AIDS but little
funding and effort has gone into working with men, especially young
men. Many interventions fail because they do not take into account
the identity constructions of the men who interact with women and
girls as partners, husbands, fathers, teachers and so forth.
The VSO-RAISA conference provided an unusual and very needed space
for reflection and discussion among activists, researchers, and
people involved in service delivery and/or advocacy around
HIV/AIDS. The conference was structured around 10 parallel streams:
Enlisting men as people living with HIV/AIDS; Men in prevention and
advocacy; Marketing; Home based care; Man to man transmission; Male
reproductive health; Boy child and construction of masculinity; Boy
child and peer pressure; Men and cultural beliefs; Stigma and
Violence.
A description of the main threads of analysis follows, weaving
patterns of how men in Southern Africa relate to HIV/AIDS. A key
issue is that deeply held notions of masculinity lead to high-risk
behaviour for HIV infection among men and women. Research and
surveys across the region show that men are socialised into a
notion of masculinity as sexual prowess, risk-taking behaviour and
male dominance and superiority over women. At the same time, men
perceive their privileged space in society to be under threat from
socio-cultural changes taking place in the region. These include
rural/urban migration, Western culture seeping through mass media
and the entrenchment of women's rights. "Many men are feeling a bit
hopeless, like there's no place for them in the world." The sense
of loss undermines men's motivation for safe sex.
A study of how masculinity is constructed in schools in KwaZulu
Natal found that the conflict between traditional and contemporary
gender roles generates in boys and men a sense of displacement and
irrelevance that cuts across race and class. White students and
teachers feel threatened by the advancement of blacks and women.
Black pupils and teachers fear women's new status, poverty and
unemployment.
Similar findings emerged in a survey by the University of
Witwatersrand on risk-taking behaviour among youth in Soweto, South
Africa's largest township, where nearly half of young men are
unemployed. "If you have no job and no future, life becomes cheap,
and sex is a dangerous entertainment fuelled by boredom, alcohol
and poverty."
From the other end of the social spectrum, a survey among
traditional healers, chiefs and Zionist priests by the Promotion of
Traditional Medicine Association of South Africa (Pro-me-tra) found
that men feel socially disoriented through a loss of leadership
position in family and community. "Men have become spectators,
irresponsible and indifferent." Traditional practices, however,
make up male identity and to attack them is self-defeating, says
Prometra. Better to tap into the traditional notion of men being
responsible for their families. Male circumcision, wife
inheritance, scarification and polygamy can be managed responsibly
"in safe and best practice" if people are accurately informed about
HIV infection risks.
Many, if not most men, do not engage in risk behaviour - i.e.
promiscuity, irregular or no condom use, violence, alcohol and drug
abuse - but they have little visibility in the predominant
discourse of "men as drivers of the epidemic."
According to the Centre for the Study of Aids at the University of
Pretoria, which works with marginalised young men - unemployed,
junkies, bodybuilders, drag queens and male sex workers, negative
male images channelled by the media and by society are internalised
by young men and turn into a self-fulfilling prophecy. "There is
more rejection than inclusion. As a result, young men feel blamed
for all social evils and withdraw."
There was consensus that blaming and scapegoating are not
productive or helpful and undermine male selfesteem. "The
men-drive-the-epidemic slogan has outlived its usefulness." "We
shouldn't blame men, women or culture but take responsibility."
Another common thread is the pervasive silence surrounding male
sexuality. Parents don't talk about sex with their children.
Husbands don't talk with their wives. Men generally feel
uncomfortable discussing intimacy. Their reproductive health needs
remain invisible.
At the National Association for People Living with HIV/AIDS in
Malawi (NAPHAM), nine out of ten male members would not disclose
their HIV status to their spouses. Secrecy brought stress, risk of
infection for the wife through unprotected sex, and inability to
change lifestyle and live positively. But when NAPHAM started
support groups for couples, 65% of men brought their wives. Male
membership increased. "The groups enabled men to talk."
"Men need opportunities to explore and talk about their sexuality
in non-threatening environments," concluded a regional survey by
Southern African AIDS Information and Dissemination Service
(SAfAIDs).
Zimbabwe's Men Forum Padare/Enkudleni reaches boys and men in
schools, pubs, sports clubs and churches, where they can debate, in
a non-threatening space, issues of sexuality, masculinity and
power. So does South African Men's Forum (SAMF). "We need to
challenge this destructive concept of manhood that men make all
decisions, men need many sex partners."
The wall of silence is finally crumbling around the last taboo
topics in Africa - male rape and male-to-male sex. Some political
and religious leaders have denounced gay men and women as
un-African although 19th century ethnographic research documents
sex between men in Africa. Politically constructed homophobia has
a negative impact on public health because it excludes homosexuals
from prevention and awareness campaigns, making them vulnerable to
HIV infection. A combination of research and activism is breaking
the silence about men who have sex with men across race and class.
Researchers at UNISA in South Africa and the Population Council in
Kenya reported on the sexual and reproductive health needs of men
who have sex with men. A study of black, gay and bisexual men in
Katutura township, Namibia, found they experience verbal, physical
and sexual forms of assault and discrimination from hospital staff,
police, army and church officials. Facing barriers in employment,
they turn to (unsafe) commercial sex work.
That sex happens among male prisoners is now acknowledged even by
correctional services. The Prison Fellowship of Zambia described
its project to bring AIDS awareness, peer counselling and condoms
into prisons. With HIV prevalence of 27-30% in its crowded prisons,
Namibia offers counselling to prisoners but not condoms because it
could be seen as encouraging sodomy, which is a criminal offence.
Male rape, possibly the last frontier in public debate, was brought
into the conference by Men United, a South African group dedicated
to breaking the silence about male rape, providing support and care
for survivors and their families, and educating youth to speak out
against all sexual abuse.
Some success was noted in men's involvement in home based care,
reversing the tradition that nursing the sick is a female domain.
Tovwirane in northern Malawi and Kara Counselling in southern
Zambia have growing numbers of male care givers. Chiefs and church
leaders help identify volunteers who are provided with training,
bicycles and team support.
The conference showcased a number of male-centred AIDS awareness
initiatives in the region, with migrant miners in Zimbabwe, through
soccer games in Zambia, and with adolescents in Malawi. The
Southern African Men's Network, formed in October 2002, seeks to
amplify small local initiatives into visible and structured
actions, and to mobilise national men's movements.
A vigorous debate centred on the role of African culture(s) in
shaping masculinity. A consensus emerged that traditional culture
is dynamic, it changes and adapts, and can accommodate and shape a
different construction of masculinity.
After 20 years of rampant spread, AIDS is driving changes in male
behaviour in Southern Africa. "Men's perceptions of identities are
changing." These changes need to be followed-up and supported.
Participants agreed that the concept and practice of masculinity
needs to be reconstructed in ways that fit new socio-economic
realities, from rural-urban migration to women's advancement, AIDS
and unemployment. A new way of perceiving manhood would empower men
to live their sexuality differently and to take active community
responsibility. Such efforts should be grounded in a culture of
human rights that can bridge cultural differences and span the
variety of situations men experience, i.e., rural and urban, old
and young, heterosexual and gay, single and married, etc. The
notions set out in the UN Declaration of Human Rights provide a
common ground for the complex and conflictive task of renegotiating
gender power relations.
Summing up the conference, one participant said: "Men should think
not about what we stand to lose but what we stand to gain."
+++++++++++++++++++++Document Profile+++++++++++++++++++++
Date distributed (ymd): 030817
Region: Continent-Wide
Issue Areas: +gender/women+ +health+
The Africa Policy E-Journal is a free information service
provided by Africa Action, including both original
commentary and reposted documents. Africa Action provides this
information and analysis in order to promote U.S. and
international policies toward Africa that advance economic,
political and social justice and the full spectrum of
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