Focus on female vulnerability to HIV/AIDS infection

When Marita Barassa's husband died in 1990, she knew he had died of an AIDS-related illness. She also knew she was HIV-positive herself. So when his family announced that a cousin would inherit her as his wife, she realised she had to make a choice. "I knew I would infect him if he inherited me, and reinfect myself," Marita, a counsellor working with a Kenyan NGO, Women Fighting AIDS in Kenya (WOFAK), told PlusNews. So she accepted the consequences of saying no to inheritance. "You are not allowed to inherit your husband's property or land, you become an outsider, you and your children are no longer part of the family, you lose everything," she said. For many Kenyan widows, who are economically dependent on their husbands, saying no is simply not an option. So the age-old custom - originally conceived by communities as a means of protecting widowed women and their children - can easily become counter-productive. In some cases, the inherited wife lives with her husband's family or other wives and is thus provided for, while in others a husband simply "inherits" sexual rights. Either way, the new wife is expected to produce several children, thus increasing the risk of HIV-infection to herself, her husband, and her babies. Some women end up being inherited several times. Each time a husband dies of AIDS, or any other illness, his relatives arrive after the funeral to claim their new "property". "Women have no value without a man, you don't have any respect," said Marita. "A woman on her own is deemed to be odd, or promiscuous." Kenyan girls/women and HIV At the end of 2,000, the Kenyan Ministry of Health estimated that there were 2.2 million people living with HIV infection or AIDS. While overall numbers of HIV-positive males and females are about equal, women between 15 and 24 are more than twice as likely to be infected as males in the same age-group. A study conducted in Kisumu, western Kenya, found that girls from 15 to 19 years old were about six times more likely to be infected than boys. Studies have also shown that women are three times more likely than men to be infected through sexual intercourse, because the vaginal wall is prone to sores and abrasion, and the viral load in semen is higher than that in vaginal fluid. High rates of infection can therefore be attributed to a combination of biological and social factors. Girls start sexual activity earlier than boys, have large numbers of sexual partners, a high prevalence of sexually transmitted diseases, and are victim to a high incidence of violent sexual contact. On top of this - and much more difficult to combat - are the age-old practices such as wife-inheritance, coupled with beliefs about female roles in society, which make women and girls particularly vulnerable. Early sexual contact Christine Akinyi, a social worker working with Slums Information Development & Resource Centres in the capital, Nairobi, told PlusNews that most girls she worked with started sexual activity at around 10, while pregnancy at 13 to 14 was "very common". Now and again, she said, she came across girls who were pregnant at nine or 10, most of whom had back-street abortions. Marita, who in WOFAK works with a wider section of society, said many girls who did not go to school were sexually active from 10 or 11, while those who were better educated tended to wait until their mid-teens. Daughters of poor parents were often given in marriage at 13 and 14 to much older men, who could provide a dowry, she said. Parents who did not marry off their daughters were often aware that they were having sex with older men, but poverty made them turn a blind eye. "Maybe at home girls never get proper meals so they are lured into having sex to get food and clothing," Marita said. Many older men - known as "sugar daddies" - choose young girls for sex in the belief that they couldn't possibly be infected with HIV. Another reason is to avoid having to pay for it. The younger girls might be satisfied with sweets, while a regular sex worker could charge anything from 100 Kenyan shillings, or US $0.80, said Akinyi. Oral sex could cost half that sum, she added. Poverty and lack of education are among the greatest contributing factors to girls' early sexual activity. "The environment promotes a lot of sexual behaviour. Children grow up knowing it's something you can do for money," said Marita. Many children from poor households grow up in cramped, run-down housing, seeing their mothers selling their bodies, so it becomes a natural progression. "And once they [the girls] start, they don't stop," she said. "Mostly teenagers have many different boyfriends. For those who don't go to school, they may have a different sexual partner every day," said Akinyi. The health ministry cites a study in its 2001 "AIDS in Kenya" report showing that 18 percent of women and girls were HIV-positive within two years of becoming sexually active. Rape is another contributing factor. A nationwide study of Kenyan women aged between 12 and 24 found that one quarter had lost their virginity because they had been "forced", the ministry reported. Many Kenyan women say this figure is grossly underestimated; the incidence of rape, normally perpetrated by relatives, neighbours or family friends, is much more widespread, they say. And where force is used, abrasions and cuts are more likely, thus making it easier for the virus to enter the bloodstream. The politics of marriage Many Kenyans admit that unfaithfulness within marriage, among both sexes, is extremely common. If a husband is providing for his wife materially, he is commonly perceived to be a good husband, irrespective of how he treats her, said Marita. "It is expected that men have girlfriends. A man that has only one woman is no man among the others," she added. The practice of polygamy, coupled with many sexual partners outside marriage, renders the spread of HIV within families extremely easy. Furthermore, rape within marriage is neither recognised by Kenyan law, nor by the vast majority of men, Kenyan feminists point out. Neither is a wife's right to say "no" to sex. "You're his wife, you're supposed to give in to him," Marita told PlusNews. "You are his property, his belonging. You have no rights over yourself - your body is his. It doesn't matter whether you are participating or not." In cases where wives suspect that their husbands are unfaithful, or that they may be HIV-positive, there is little they can do to stop being infected themselves. While condom-use has increased in recent years thanks to billboards and advertisements promoting safe sex, most people agree that condoms are unpopular except with a minority living in urban centres. "They say sex with a condom is not sweet, they can't feel each other. They won't even talk about it," commented Marita. People's reluctance to admit to their spouses that they are engaging in risky behaviour outside marriage also prevents them from taking the necessary precautions within it. HIV/AIDS denial and stigma Despite the numbers of infected people in Kenya, the stigma attached to HIV/AIDS remains intense. Some continue to deny its very existence, especially in rural areas where superstitions are common. "People see others dying of AIDS but they still don't believe in it. Some say they were bewitched, they don't believe it's AIDS," Marita told PlusNews. Some considered it to be a punishment for past sins, such as promiscuity or unfaithfulness, or a result of the evil eye, she said. In turn, many others continued to believe that "decent", churchgoing people, or "good" spouses, could not possibly be HIV-positive, and that there was therefore no risk to themselves. The culture of secrecy in this staunchly Christian society remains strong. Despite the huge risks to young Kenyans - especially young girls - from risky sexual behaviour, sex education in both schools and homes remains practically nonexistent. "It's just something you don't talk about," said Akinyi. Kenyan women are supposed to be virgins when they marry, and that's how people like to think of them.