ABC strategy not working for women
Aug 24, 2006
The recent international conference on AIDS in Toronto brought to light the undeniable challenge of dealing with the increasing number of AIDs sufferers worldwide.
The recent international conference on AIDS in Toronto brought to light the undeniable challenge of dealing with the increasing number of AIDs sufferers worldwide. Statistics show that HIV/AIDS is becoming a female disease. There are over 40.3 million people living with AIDs worldwide of which nearly half of these are women. The scenario is not very different in Uganda. According to the Uganda AIDS Commission 2006 status report, the HIV prevalence varies between males (5.2%) and females (7.3%) and this has been rising over the last three years. Uganda has received international acclaim for a job well done in preventing the spread of HIV/AIDs using the ABC strategy through which the prevalence rates have successfully been brought down to the current 6.4%. The ABC strategy has however failed to protect women due to the actual sexual violence in marriage relations. So why are the rates of infections increasing among women? Are these common HIV prevention messages really working for women in Uganda?
Abstinence
Is it possible for married women to abstain? In Uganda today women and girls are portrayed as subservient and therefore incapable of making any decisions including those relating to sexual matters such as when to have sex with their partners. The socialisation of young women preparing for marriage in many societies of Uganda emphasises that they learn not to say no to their partners’ sexual demands. This in many ways fosters the power imbalance in sexual relations and makes it hard for women to abstain from sex even with full knowledge of their partners’ unfaithful sexual behaviours. As a result, women are left vulnerable to HIV/AIDs in sexual relations. Whereas with knowledge of her partner’s unfaithfulness, a woman may choose to abstain, she may be coerced and forced into sex by her partner. This leaves many women in a very difficult situations, as on one hand the choice to abstain may result into further violence from their partners whilst on the other hand, failure to abstain may result into getting infected by their partners. So can abstinence save women from contracting HIV/AIDs?
Being Faithful
Whereas a woman may choose to be faithful to her partner, the same may not be true for the husband. Marital infidelity and polygamy among men is a practice that is still considered normal in many societies of Uganda. Due to the power imbalance characterising many sexual relationships, men are considered free to decide on having more than one partner at a time whilst women cannot. Neither can the women abandon relationships that put them at risk of HIV/AIDs. How then can a faithful woman with an unfaithful partner be safe from HIV/AIDs?
Using Condoms
Whereas the use of condoms has continued to save many lives, several women cannot negotiate for safer sex due to the violence that characterises many relationships. Most women cannot freely choose safer sexual practices or refuse unsafe sexual activity but instead must negotiate within unequal intimate relationships. Many women do not have the social and economic power necessary to insist on condom use. Due to such glaring gaps activists have been advocating that government subsidises the female condom to save the lives of women but these demands have not been adequately responded to as the female condom continues to be inaccessible to women due to its unaffordable price. HIV/AIDs is a disease that can actually be avoided by most married couples but the reality now is that many of those dying of AIDs are married.
What does this mean to prevention campaigns? It means that other approaches that focus on addressing HIV/AIDs among the married people must be devised. In addition to ABC, power inequalities in sexual relationships must be addressed so that women are able to make choices regarding sexual matters.
The writer works for Centre for Domestic Violence Prevention, Kampala
Abstinence
Is it possible for married women to abstain? In Uganda today women and girls are portrayed as subservient and therefore incapable of making any decisions including those relating to sexual matters such as when to have sex with their partners. The socialisation of young women preparing for marriage in many societies of Uganda emphasises that they learn not to say no to their partners’ sexual demands. This in many ways fosters the power imbalance in sexual relations and makes it hard for women to abstain from sex even with full knowledge of their partners’ unfaithful sexual behaviours. As a result, women are left vulnerable to HIV/AIDs in sexual relations. Whereas with knowledge of her partner’s unfaithfulness, a woman may choose to abstain, she may be coerced and forced into sex by her partner. This leaves many women in a very difficult situations, as on one hand the choice to abstain may result into further violence from their partners whilst on the other hand, failure to abstain may result into getting infected by their partners. So can abstinence save women from contracting HIV/AIDs?
Being Faithful
Whereas a woman may choose to be faithful to her partner, the same may not be true for the husband. Marital infidelity and polygamy among men is a practice that is still considered normal in many societies of Uganda. Due to the power imbalance characterising many sexual relationships, men are considered free to decide on having more than one partner at a time whilst women cannot. Neither can the women abandon relationships that put them at risk of HIV/AIDs. How then can a faithful woman with an unfaithful partner be safe from HIV/AIDs?
Using Condoms
Whereas the use of condoms has continued to save many lives, several women cannot negotiate for safer sex due to the violence that characterises many relationships. Most women cannot freely choose safer sexual practices or refuse unsafe sexual activity but instead must negotiate within unequal intimate relationships. Many women do not have the social and economic power necessary to insist on condom use. Due to such glaring gaps activists have been advocating that government subsidises the female condom to save the lives of women but these demands have not been adequately responded to as the female condom continues to be inaccessible to women due to its unaffordable price. HIV/AIDs is a disease that can actually be avoided by most married couples but the reality now is that many of those dying of AIDs are married.
What does this mean to prevention campaigns? It means that other approaches that focus on addressing HIV/AIDs among the married people must be devised. In addition to ABC, power inequalities in sexual relationships must be addressed so that women are able to make choices regarding sexual matters.
The writer works for Centre for Domestic Violence Prevention, Kampala