When sexual inequality fuels HIV infections

Since Esinati got married to Geoffrey seven years ago in Mzuzu, it is always the husband deciding when to have sexual intercourse not her.

And this is normal in Malawi and sub-Saharan Africa region where raping wives even does not exist because cultures call women to submit themselves to their husbands for sex without questioning.

However, men in the region (where 67 percent of over 33 million global HIV and Aids cases are), should start regarding women as partners in sex, fully participate in sexual reproductive health if the region is to reduce infections, deaths linked to the pandemic to achieve social-economic development, eradicate poverty.

In a study with her team, Mina Mauerstein Bail, manager for United Nations Development Programme (UNDP) in New York, United States (US) discovered that sub-Saharan African men’s more power over women on sex and reluctance to practice safe sex is fuelling more HIV and Aids infections.

“Women in the region also reported that the perception was that condoms were seen as appropriate for casual and not within the context of a longer relationship,” said Bail.

“It was also revealed in the same study that because women had less control over sexual communication in the region a substantial number of programmes concentrated on work to empower girls and women,” she said.

However, Bail added that failures to help women to change sexual behaviour and bringing about more equal gender roles demonstrated that boys and men must be involved.

“A recommendation was even made that it was essential that interventions to strengthen women’s sexual negotiation skills be conducted concurrently with educational programmes designed for boys and men,” said Bail.

She disclosed that only a small number of programmes were designed to involve men yet their sexual practices were putting their health and that of their partners at risk of sexually transmitted diseases (STDs) including HIV and Aids.

“Estimates in the same study suggested that between 60 to 80 percent of women in sub-Saharan Africa infected with HIV had only one sexual partner,” said Bail.

The study also reveals that in many documents of the world it was suggested that men have a greater lifetime number of sexual partners and that there were clear double standards regarding the behaviour of men and women.

She added that it was also revealed that for a man, even having many sexual relationships in sub-Saharan Africa made him popular and important in the eyes of his peers.

“Male sexuality was also often according to the study thought of by both men and women as unrestrained,” said Bail.

She added that in many cultures in sub-Saharan Africa girls and women obeyed their boyfriends’ wishes because they believed they are meant to be compliant and subservient.

Institute of Tropical Medicine [Charite University Hospital, Berlin, Germany] Research Associate Stefanie Theuring says if HIV and Aids programmes such as Prevention from Mother To Child Transmission (PMTCT) have to succeed in Malawi and sub-Saharan Africa, men and women should equally share sexual decisions and work together.

Principal Secretary (PS) for Nutrition and Aids in the Office of President and Cabinet, Edith Mkawa, disclosed that a Unicef-funded PMTCT project in Malawi has helped saving thousands of babies from contracting HIV from their HIV positive mothers because both men and women are involved.

“Involving males in PMTCT support groups is an excellent approach for breaking down fears that prevent a number of pregnant women from accessing PMTCT services,” said Mkawa.

College of Medicine’s researcher and lecturer in Blantyre, Professor John Chisi in early 2000’s in his column in The Daily Times warned that HIV and Aids prevention in Malawi would be history only if men stopped practicing risky sexual behaviour and their partners questioned them on such decisions. n