AIDS Care Watch

Thursday, November 02, 2006

SOUTH AFRICA: Young women falling into AIDS trap

By, Bristol-Myers Squibb, IRIN PlusNews, October 27, 2006

JOHANNESBURG - High-risk sexual behaviour has become common practice among young women and girls struggling to make end meet in the semi-rural Embo area of South Africa's KwaZulu-Natal Province.

Zandile Shange, an AIDS educator with the Hillcrest AIDS Centre Trust, a nongovernmental organisation (NGO) operating about 15km north of Embo, expressed concern that young people, lured by the "fancy lifestyles" portrayed on television and in magazines, were placing themselves at risk of HIV infection.

She told IRIN PlusNews that her awareness talks at schools had made her realise the extent to which some girls would go to feed siblings after their parents had succumbed to AIDS-related illnesses, or simply to get desired items that indicated affluence and social status.

"Although poverty in the area is an issue, due to breadwinners dying of AIDS, they [young people] also feel pressure from friends who have both parents and can afford luxuries like mobile phones and labelled fashion items," she said.

Girls as young as 15 were deliberately falling pregnant to secure a monthly social grant of US$24, while others exchanged sexual favours for the financial comfort offered by employed or wealthier older men, commonly known as 'sugar daddies', Shange added.

Sugar daddies usually had multiple sex partners, putting their wives at risk of infection, as was the case with Phumzile Mkhize, 43 and a mother of four, who uses her experience of living with AIDS to educate young girls in the community.

"My husband was very popular with the young ladies because he was earning well. I left my job to raise a family and relied on my husband to put food on the table. When I tested positive in June last year, after becoming ill with hepatitis, I was shocked because I did not expect it from a marriage," she said.

According to Mkhize, the prospect of 'lobola' - the traditional bride price - made marriage an attractive financial proposition to families with one or more daughters in an area where most people struggled to find work.

Officials at the Hillcrest AIDS Centre Trust cited other cultural practices as factors contributing to the vulnerability of women to HIV infection.

"A virgin bride will generally afford her family a heftier price during lobola negotiations. But I have heard, during my discussion groups at schools, that young men use this knowledge to coax virgins into having anal intercourse as a means of maintaining their virginity," said Shange.

She feared that because anal intercourse posed little risk of pregnancy, some girls might also be engaging in it without using a condom.

The South African Medical Research Council (MRC), during its recent clinical trials into the effectiveness of vaginal microbicides at eight sites around KwaZulu-Natal, found a prevalence of more than 43 percent among women receiving voluntary counselling and testing at Embo in preparation for the trials.

"Of the 1,800 respondents tested for HIV, 783 were positive. Although this figure is indicative of a worrying upward trend among women in this and other areas where we conducted our research, it was not necessarily representative of the situation of all women in these communities," said Prof Gita Ramjee, director of the MRC's HIV Prevention Research Unit.

She warned against women in the trials becoming the target of stigma and discrimination as a result of the media sensationalising the purpose of the research.

Her team was presently conducting very intense Phase III human trials on microbicides, which hoped to establish the efficacy or strength of the product as an HIV prevention tool for women, Ramjee said. Since 2004, up to 12,000 women have participated in the trials and the first results were expected to be published in 2007.

Applied before sex, vaginal microbicides are substances that could potentially kill, neutralise or block HIV and other sexually transmitted infections.

"Even an efficacy rate of between 35 [percent] and 50 percent would be viewed as successful for the time being. However, at this level of efficacy, women would be advised to always use the product together with condoms," she said.

Ramjee was confident that an effective microbicide would be the best defence for women against the spread of HIV.

hh/he/kn

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