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Abuse
after disclosing status hinders HIV care
Gloria Ganyani
Extracted from Pambazuka News No. 330
November 29, 2007
http://www.pambazuka.org/en/category/comment/44710
24-year old
Ruth Sibanda* was pregnant and could not wait to have her first
baby. On one of her visits to the antenatal clinic, they gave her
an HIV test.
No one really
explained to Sibanda much about the test. She received no pre-test
counseling to mentally and psychologically prepare her for the action
she is about to take. All they said was that she must get the test
done, so that if she tests positive she can get assistance so that
she does not infect her unborn child.
As fate would
have it, Sibanda tested positive and her world was never the same.
When she arrived home and broke the news to her husband, she met
with blows and insults. The most terrible thing for her was that,
though she had only slept with one man, her husband, he accused
her of infidelity and of infecting him with HIV.
More than 25
years into the struggle with HIV and AIDS, and this is just one
among many stories of women who have experienced violent behaviour
and abuse by their partners after disclosing their HIV status.
"We receive
a number of complaints from women who are abused by their partners
after disclosing their status," says Sara Murera, the Programme
Assistant, Gender Violence and HIV and AIDS at Musasa
Project in Zimbabwe.
"It is
women who usually get to know their HIV status first and if they
discuss the results with their partners, they are blamed, shamed,
threatened and in some cases this can lead to divorce, stigma and
discrimination," she said.
Along with partners
and husbands, families also often shun women who disclose their
status, placing the blame squarely on the woman's shoulders.
According to the World Health Organization (WHO), among women who
disclose their HIV status in sub-Saharan Africa, between three and
15 percent report violent reactions to revealing their status.
"Even
in instances where there was no form of violence in the home before,
disclosure can ignite violent acts by the partner," says Murera.
"The husband can refuse to share a bed with the wife, even
if he does not know who infected who. The blame is always heaped
on the wife."
Murera's
organisation runs support groups for women. Because there are many
women who have been in such situations, it is easy to find some
willing to come and share their experiences with affected women.
"They try to show them that their problem is not unique. They
have survived it and have moved on with life."
Abusing women
who disclose their HIV status encourages people to keep their status
a secret and fear of testing and its consequences increases the
spread of HIV and AIDS.
The WHO estimates
that in Sub-Saharan Africa only 17 - 32 percent of women who
test positive for HIV reveal their status. Fear of violence and
reprisals prevents many women from accessing information on HIV
and AIDS, being tested, disclosing their status, accessing services
for the prevention of HIV transmission to infants, and receiving
treatment, care and support.
The main reason
health service providers test women for HIV during pregnancy is
to prevent mother-to-child transmission. According to UNICEF, if
a woman living with HIV becomes pregnant, there is a 35 percent
chance that she will transmit the virus to her child, if there is
no preventative action. Some 15 to 20 percent of children become
infected during pregnancy while 50 percent are infected during delivery
and 33 per cent through breastfeeding.
Yet in pursuing
this worthy cause, as in Sibanda's case, there are times when
there are no supportive measures in place to help the woman deal
with their newfound knowledge and to ensure that they return for
follow up, or even to make them aware of treatment options or positive
living messages. Ignoring women's needs for the sake of the
child's defeats the purpose.
Men who have
tested positive for HIV also have fears about disclosing their HIV
status. An Ethiopian man who discovered that he was HIV positive
started taking antiretroviral drugs, but kept it a secret from his
wife. The man told his wife that his anti-retroviral drugs were
vitamin tablets and that the doctor had prescribed him a "vitamin"
to boost his energy levels because he was always overloaded with
work.
He told his
wife that the tablets were not good for women's health. "My
husband confessed that he knew his status for three years and did
not tell me, fearing that our family and neighbours would discriminate
against us. The fact that the virus is sexually transmitted shamed
him," said the 35-year-old woman whose husband died shortly
after his confession.
Couples should
be encouraged to go for testing and counseling together and to be
supportive of each other whatever the results. They should also
try to avoid the blame game and instead focus on the way forward
and living positively. In the case of women especially, there needs
to be more work done to ensure that revealing one's status
is a healthy life choice, and not a catalyst for increased violence
and discrimination.
Recognising
that underlying gender norms are at the heart of some of the barriers
women face in sharing HIV test results with their partners, and
in the type of treatment they experience after revealing their status,
is key to making headway in preventing and caring for women when
it comes to HIV and AIDS.
* Not her real
name.
Gloria Ganyani
works with Southern
Africa HIV and AIDS Information Dissemination Service (SAfAIDS)
Media Unit in Zimbabwe. This
article is part of a series produced by the Gender Links Opinion
and Commentary Service for the Sixteen Days of Activism on Gender
Violence.
Please credit www.kubatana.net if you make use of material from this website.
This work is licensed under a Creative Commons License unless stated otherwise.
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