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Why African Women Are at Risk for HIVResearch Paper

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Heterosexual Women and HIV

It is estimated today that roughly 15 million heterosexual women have HIV (Avert, 2014). By far and away, the majority of these women are found in sub-Saharan Africa, where it is believed that "close to 60% of adults living with HIV are women -- or 13.3 million" (UNAIDS/WHO, 2004). In the U.S., it is a different story: while 20% of new HIV infections are contracted by women, the numbers pale in comparison to those in Africa, with just 8,000 reported incidents of contraction by heterosexual women (CDC, 2011). Compared to the millions of reports in Africa, it may be said that HIV epidemic is far worse in the sub-Saharan continent than in America. This paper will discuss the problems faced by heterosexual women with HIV in Africa and what is being done to help them.

Challenges

One of the main challenges of addressing the problem of heterosexual women in danger of contracting HIV is that the "masculine" identity in Africa is very pervasive and it is described as a "dominant ideal of black African manhood" which "emphasizes toughness, strength and expression of prodigious sexual success" (Jewkes, Morrell, 2010, p. 1). Heterosexual women "desire" this expression of masculinity, according to the researchers -- however, it puts them at risk of contracting HIV when so many men in Africa are receiving treatment for this (Jewkes, Morell, 2010). Thus, the challenge of preventing the spread of HIV to heterosexual women in Africa is not simply a medical one but also a cultural one. The sexual culture of Africa is one in which men "are expected to be in control of women" and the "dominant ideal of femininity embraces compliance" with this masculine violence (Jewkes, Morell, 2010, p. 1). Changing that culture is a major challenge.

What researchers believe is that heterosexual women are mainly at risk because they do not "control" their surroundings or their sexual situation. Instead they are accustomed to handing over control to their masculine counterpart. For the women, there is a kind of reciprocity that is at work. The women offer the men their docility and the men in return give the women "social or material rewards" (Jewkes, Morell, 2010, p. 2). Thus, if women can be made to feel more secure without having to engage in such risky behavior it may be possible to overcome this challenge. Meeting it requires education and persuasion.

However, simple education is not enough because it does not necessarily fix the problem of income disparity. Part of the reason that women look for social protection from men is because they do not have the means to secure for themselves the goods that they would like. As Mans (2011) reports, "it is women who are the backbone of food production and who provide the basic necessities for families and social capital of communities." And yet even with women playing such an enormously important role in African society, they are still treated inhumanely: "The harsh reality is that women bear a disproportionate burden of Africa's poverty -- a staggering 70%." This example of income disparity is one reason that women are compelled to seek security from the male whose "ideal" dominance also carries with it the risk of HIV.

There is also the challenge of overcoming the stigma that heterosexual women face in receiving HIV treatment from "health care settings" in Africa (Okoror, BeLue, Zungu, Adam, Airhihenbuwa, 2012, p. 27). This stigma is associated with the cultural landscape of the African communities, and it appears to be yet another cultural problem for researchers and medical doctors seeking ways to prevent the spread of HIV among men and women on the continent.

Concerns

Unmet healthcare needs are placing heterosexual women in Africa in especially risky positions of contracting HIV mainly because of cultural cues that are deeply embedded within the society. It is not so much that there are not programs and facilities available for testing; there are. It is, on the contrary, that the vast number of women in Africa accept the paradigm in which they are situated and are more willing to continue to live and die within its structure than to embrace new cultural attitudes that are foreign to their native way of life.

The importance, therefore, of addressing this need is extremely vital. It must begin at a grassroots level so that it can grow organically. In this sense, change must come from within -- but the instigator for this change, paradoxically, cannot come but from without. Therefore, the crisis is at a crossroads and the problem may be put in these terms: how to grow a new culture within an existing one without being detected or chased out.

On the other hand, Uchem (2003) suggests that the problem is not growing a new culture but rediscovering the old culture that was suppressed as a result of colonialism in Africa. Prior to the introduction of Western cultures in Africa, African women, according to Uchem (2003) had a more dominant role in society and were, therefore, less likely to be placed in subservient situations like the ones in which they find themselves today. Uchem (2003) cites differences in the Igbo and western cultures found in Africa and argues that the pre-Western culture is capable of giving women what they need to rise out of their current state of oppression.

Example of a Program

One program that looks to help in this situation is Africare, a non-governmental organization dedicated to assisting African communities in their development. It works with African natives and is said to be by Africans, for Africans. It combines teaching programs with economic aid, agricultural assistance, sanitation, and women's empowerment projects such as the Economic Empowerment of Women Enterpreneurs Project (sponsored by ExxonMobil). The goal is to help women become more financially independent and academically and economically diversified. So far, the program has helped more than a thousand women graduate from its business education training program and in turn grow their income by more than 70% (Africare, 2015). With programs like those of Africare in place, there is some possibility that the cultural landscape could change, but the progress appears to be slow, with only a thousand women, for example, earning degrees. Meanwhile, millions of heterosexual women are at risk of contracting HIV.

Conclusions

I have not had any personal contact with women in Africa and so cannot discuss this issue from a personal perspective. However, I can offer an alternative viewpoint based on educative material that is not mainstream and offers counter-information to the prevalent issues analyzed herein.

This counter-information comes from a documentary entitled House of Numbers, which has questioned the legitimacy of the HIV epidemic in Africa after thorough investigation of the claims of doctors and patients around the world. What the documentary reveals is the possibility that HIV may not be what it is popularly believed to be -- in other words, the causes for sickness may be due to a combination of factors that can be solved from more basic approaches to health issues rather than from pharmaceuticals designed explicitly for HIV patients. From my perspective, this information is at least worth pursuing because it may in the end help treat African men and women without fear of creating stigma. If it turns out that the culture in Africa is too deeply embedded to be changed, then the possibility of treating patients by using alternative means as suggested in this documentary could be an avenue towards saving lives.

This documentary should be considered by all involved in dealing with Africa because it actually includes the plight of Africa in several scenes, with the maker of the film visiting the country and the HIV facilities and talking to several people who live and work there. I think the information presented could be helpful in eliminating confusion and bias when it comes to talking about HIV and heterosexual women, not just in Africa, but around the world.

In conclusion, what I learned from this research is that the majority of heterosexual women with HIV can be found in sub-Saharan Africa and that the culture of Africa (regarding the relationship between men and women) is the main reason that this risk is so high. Coupled with the stigma associated with receiving HIV treatment and the risk level becomes even higher. Some programs are available, for example, through Africare, that are designed to help women become educated and financially independent (which in effect changes the nature of the cultural relationship between men and women); however, these programs appear to be small in comparison with the overall numbers of at-risk women. On the other hand, the documentary House of Numbers suggests that the numbers may not be at all what they appear to be -- and that the problem may lie elsewhere.

References

Africare. (2015). Women's Empowerment. Africare. Retrieved from https://www.africare.org/africares-approach/womens-empowerment/

Avert. (2014). Women and HIV / AIDS. Avert.org. Retrieved from http://www.avert.org/women-and-hiv-aids.htm

CDC. (2011). HIV Among Women. CDC.gov. Retrieved from http://www.cdc.gov/hiv/group/gender/women/index.html

Jewkes, R., Morell, R. (2010). Gender… [END OF PREVIEW]

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