On AIDS and Women’s Empowerment

The first reason why I think AIDS is so much more pervasive in South Africa is the long-standing poor treatment of women. At almost every HIV clinic in the country, you see long queues of women with very few men. But why does HIV disproportionately affect women? This is a very complex question to answer, but some reasons are because women are more likely to seek medical attention, the men are working in the cities, one man tends to infect many women, or the men have already died. Ultimately I think it has to do with women’s rights and the ability of women to exert control in sexual relationships.

In most rural communities, the role of women has not changed in 300 years. They are the predominant child-bearers, keepers of the home, and water-fetchers. What I found interesting is they are also predominantly the ones who tend to the crops and watch the livestock. The issue of childbearing is also interesting. I just finished reading Jeff Sachs’ book which shows that educational level correlates very strongly with the number of children per woman. In rural South Africa, average family size is between 5 and 6 children with most mothers not making it past the 10^th grade. This gets to the idea of power dynamics in (even monogamous) relationships. Men exerting control, especially with regards to condom use, over disenfranchised women leads to increased family sizes and ultimately increased HIV prevalence.

Domestic violence is also rampant in South Africa and plays a strong role in persistent HIV transmission. If you fear physical abuse to you or your children, are you about to force your boyfriend to use a condom? With few police in rural communities to act as guardians of women’s rights, the cycle of violence and increased disease communication endures. Men also tend to engage with multiple (3-4) sexual partners whereas women tend to have 1-2 sexual partners. In South Africa, the labels of promiscuous male as “stud” and promiscuous female as “slut” are taken to an extreme, with women regularly chased out of communities. Naturally, with men taking many sexual partners, HIV distributes towards women.

So what can be done about this? “Women’s empowerment” has become a buzz-word in South African AIDS awareness campaigns, but all I’ve found are thin education measures aimed at teenage girls. If you’ve seen the Love Life campaign, you’ll agree with me that the “Get Attitude” slogan makes no sense and does little to improve the power dynamic within relationships. In my mind the biggest revolution will be economic and educational. As women enter the workforce and are less dependent on men for subsistence, the will tend to have fewer children and be able to advocate for stable monogamous relationships. I’m also appalled by the lack of female condoms in this country. If women had the choice of when to use condoms, wouldn’t some of the decision-making influence shift towards women? At the moment, clinics around the country are piloting availability of female condoms but for most women these remain out of reach. There certainly isn’t a silver bullet for solving women’s rights issues, but it will take much more than lukewarm empowerment campaigns to improve the AIDS crisis.