Gender: HIV/Aids – Married women face the biggest dilemma

HIV ribbon
Vaidah Mashangwa
Zimbabwe has experienced a decline in HIV infections by approximately 42 percent among adults that is; 15 years and older between 2001 and 2015.

Consequently the number of HIV/Aids related deaths has also decreased annually.

This has been attributed to population level changes in sexual behaviour and use of Antiretroviral Treatment (ART) over the past years.

According to ZimStat Multiple Indicator Survey 2014, the government of Zimbabwe also declared HIV and Aids an emergency in 1999 and introduced the Zimbabwe National Trust Fund (NATF) in 2000 commonly referred to as the AIDS Levy.

This also has helped considerably to militate against HIV/Aids.

While this is the case, it is unfortunate that Aids related deaths among adults had resulted in a total of 947,000 orphans by 2012 (ZimStat 2014).

This is an unfortunate scenario because the trend in almost 12 of the 15 Sadc countries is that women have a higher HIV and Aids prevalence than men yet they are the ones who provide care for sick members of the family and who are also responsible for the upbringing of children and the upkeep of households.

The survey conducted by ZimStat indicated that women aged 15-24 years had comprehensive knowledge on HIV/Aids prevention and transmission.

In Bulawayo, 69.9 percent of women had comprehensive knowledge compared to Matabeleland South Province which recorded 55.6 percent.

On the other hand, 60 percent of men aged 15-54 years had comprehensive knowledge of  HIV prevention and transmission.

In Zimbabwe, just like in other Sadc countries, more women than men have a higher HIV and Aids prevalence rate.

The main reason being that married women lack the choice and power to control their sexual and reproductive health as most of them fail to negotiate for safe sex.

A lesson learnt in Zimbabwe is that marriage can actually increase the vulnerability and risk of HIV among young women.

This is due to early marriage of young girls and women to older men.

The older the men the more sexual partners they are likely to have.

Due to that age difference many of these young women cannot negotiate for safe sex as they generally lack decision making skills.

Usually they are not given the platform to air their views. The same survey revealed that women aged 15-24 years lacked comprehensive knowledge of HIV prevention and transmission.

Only 56.4 percent of the women pointed out that they were aware of how HIV can be prevented and transmitted.

Married women are often afraid to ask their husbands to use a condom even where the HIV status is known.

Even in cases where the wife knows that her husband has other partners, women are still afraid to ask for use of the condom.

While married women are aware of the availability and proper use of the female condom, they are also afraid of using it since this may imply that they suspect their husbands of having other partners.

Sadly, married women do not often recognise that they are at risk despite the high rate of infection among them.

While there are some married women who are just afraid of using the female condom or negotiate for safe sex, there are some women who also think that marriage is a safe place from HIV infection.

Some married women are less suspecting of HIV risk and rarely discuss such issues with their partners.

It is also unfortunate that there are some married men who also refuse to get tested or get tested on their own and do not share the results with their spouses.

Women also face the problem of trying to convince their partners to go for HIV/Aids testing yet this is also an important health issue.

Getting tested early together and sharing information is important because early detection means early treatment.

Apart from that, one other fact that hinders married women from negotiating for safe sex are tradition values influenced by a patriarchal society.

In a patriarchal system the women cannot make decisions and the men have the overall say in issues pertaining to the family.

Though there is a shift in some households, there is need to maintain interpersonal relationships that allow a husband and wife to discuss issues of sexual reproductive health and reaching consensus on issues that affect them.

Mobility also increases the chance of HIV infection among married couples.

More recent research confirms that work-related mobility often significantly increases vulnerability to HIV infection.

The separation of couples as a result of labour migration is highly associated with high rate of multiple concurrent sexual partnerships.

When the husband comes back after say one to two years, the couples usually do not get tested first before sexual engagement to ascertain their HIV status.

The woman might be afraid to ask the husband to go for HIV tests or use protection till they get tested. It might be too late by the time they both get tested.

The other way to prevent HIV transmission among married couples is to introduce the female condom, not as an HIV prevention tool but as a family planning method.

The female condom is effective in that it does not present side effects like the other chemical contraceptives.

Soon most men who work in urban areas would be travelling to their rural homes for the Easter holidays and one wonders whether they abstained since their last visit during the Christmas and New Year holidays.

For those who tested positive during the absence of their spouses one wonders whether they will tell their partners or use protection.

Despite the long periods of separation, married women will rarely negotiate for safe sex.

About the writer: Vaidah Mashangwa is Bulawayo Metropolitan Provincial Development Officer for the Ministry of Women Affairs, Gender and Community Development. She can be contacted on +263 77 211 1592 email: [email protected] <mailto:[email protected]>

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  • kuda

    this is very true

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