SA’s women bear the brunt of HIV stigma

SA’s women bear the brunt of HIV stigma

SA’s women bear the brunt of HIV stigma 787 525 Right to Care

HIV strides heavily undermined by female disempowerment and GBV 

Women are facing a myriad of challenges which negatively impact SA’s progress towards an HIV free generation. Many are being humiliated and are experiencing abuse in their communities and homes simply because they are HIV-positive and taking antiretroviral treatment. Even adolescent girls and young women who are HIV-negative and taking pre-exposure prophylaxis (PrEP) to protect themselves from HIV are having to deal with similar challenges and being ostracised.  

Nearly twenty years into South Africa’s antiretroviral treatment (ART) programme, HIV-positive people still face stigma and women are bearing the brunt of this discrimination. This is thwarting SA’s efforts to end Aids as a public health threat by 2030. 

Dr Seithati Molefi, deputy chief of party at Right to Care, a leading health NGO, says, “ART adherence is key to keeping patients well and preventing HIV transmission, but the stigma women face is dissuading them from taking their treatment. Women are unable to make better choices about their own health for fear of discrimination and violence at the hands of their male partners and society at large. 

“HIV prevention is key to achieving a decrease in HIV infections, mortality and deaths. Young women aged between 15 and 24 are most vulnerable to new HIV infections, unplanned pregnancies and sexual violence. In sub-Saharan Africa, one thousand young women are infected with HIV every day. Right to Care has a dedicated programme to introduce vulnerable young women to PrEP, but they fear backlash from their family and friends if they take it. Women also struggle with abstinence because they are often coerced and forced into sexual relations and often believe that they have no agency. 

“Our Right to Care teams are active in the fight against stigma and violence,” she says. “We have reports of women being sworn at because they are HIV positive. Upon receiving their medication, they decant it to a different container to conceal it. Many do not return to facilities to get their ART, particularly when they worry that their confidentiality is threatened,” she says. 

“HIV-positive women are often labelled as socially unacceptable and adulterous. They are referred to as ‘geu’, ‘mongwanti or ‘letekatsi’. Mongwanti is a term that means whore. Letekatsi refers to a woman who ‘sleeps around’. ‘Geu’ is a new derogatory term on social media. It is derived from a photo of a man who is so frail he can only eat mageu, a traditional drink made from maize meal.The assumption is that he is dying from AIDS, and those who are HIV-positive are being referred to as geu.

“Many women don’t want to disclose their HIV status to their partners for fear of rejection. A patient reported that she was mocked by her partner for being on ART, who swears at her every time she takes her treatment,” says Molefi. 

“A young girl was laughed at by her friends who labelled her as promiscuous for being HIV-positive, when in fact she was born with HIV. Young girls also fear becoming victims of cyberbullying if their status is exposed on social media. 

“Gender-based violence (GBV) has been shown to increase women’s risk of HIV acquisition and is also a barrier to accessing HIV services, treatment and care. A 35-year-old woman who tested positive would not bring her partner to get tested and would not take ART. She returned to the facility after two days having been beaten blue by her partner. She would not open a case against him.” 

Molefi adds that the introduction of an intimate partner violence (IPV) screening tool in facilities is allowing healthcare workers to identify and better support vulnerable women. This tool involves questions that healthcare workers ask women who test for HIV or start ART. They note the woman’s answers but also her physical responses to the questions, which often tell the real story. 

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