The Face of the HIV Epidemic Is the Face of a Woman

Zambia 2013

By Catherine de Lange

July 16, 2013

Also published at Catherine de Lange's blog, Global Health in Zambia

Faces of the future?

As I was preparing for this trip, I read a lot about the specific challenges for women in dealing with the risk of HIV, especially in countries like Zambia, where the status of women is low and they are generally dependent on their husbands (or lovers) for their income and a roof over their head. It is no big secret that women have little say in whether or not their partner uses a condom, for instance.

But despite what I thought I knew, whilst listening to a background talk on HIV in Zambia given by Dr Manasseh Phiri – a straight talking physician, journalist, and HIV/AIDS activist here who was not shy to discuss issues that, in his own words “don’t smell good and don’t taste good” – I found the truths and the extent of the situation that bore out to be pretty shocking.

The way we Zambians have sex

On discussing some of the key drivers of the epidemic in this country, Dr Phiri spoke candidly about the “the way we Zambians have sex.” Firstly, it is perfectly normal and acceptable for men here to have more than one concurrent partner. Even though in, say, the US, people have more sexual partners over their lifetime, the key difference is they don’t have them at the same time, which means the spread of infection is lower. In countries where polygamy is accepted by religion, again the spread is contained. If a woman in Zambia leaves her man on the grounds that he is having an affair, she will be sent straight back to him, and simply told:  ”it happens to everyone,” Phiri says.

Sexually Transmitted Diplomas

More shocking was what Phiri refers to as STDs and STGs- sexually transmitted diplomas and degrees. This is the accepted transaction between a male teacher and his female students, and one which came up later in the day when our group visited the Safe Love Campaign. It’s not a secret, it’s not illegal (unlike homosexuality, but that’s another topic) – it’s just what you have to do to get a degree.

Dr Phiri believes that helping women to take charge will be the turning point in tackling the HIV problem in Zambia. He spoke of women he knows who have been taking antiretroviral drugs (ARVs) for over a decade in secret from their husbands to protect their babies from infection, because they know they would not be allowed to take them. He said jokingly that they hide the pills in the store cupboard with the food, because they know it’s one place the man never goes.

One place to start in giving women the strength to take control might be with the Chezela– the ceremony that takes place the night before a young bride’s wedding (Chezela literally translates as staying up all night). The evening is spent teaching the young woman how to please her future husband sexually. It is then that she learns that if she finds out her man is sleeping with someone else, “just to stick it.” Women as young as 12 or 13 may be “taught how to dance in bed,” says Phiri. He suspects that the women – known as Alangizi – who lead these traditional gatherings could help change some of these attitudes.

All that to say, really, that after just one day here I’ve started to realise just how much we become de-sensitised to many of these issues. In Zambia, as in much of sub-Saharan Africa, women carry the brunt of the HIV burden. 14.3 per cent of the population in Zambia is living with HIV, but for women that rises to 16.1. As Phiri puts it, the face of the epidemic is the face of a woman. Hopefully that can change.

For more information on our talk with Dr Phiri, the IRP have put together a great Storify:

[View the story "Health and HIV/AIDS in Zambia" on Storify]

Catherine de Lange is reporting on HIV/AIDS, malaria, and TB in Zambia on a trip with the International Reporting Project (IRP).