"AFRICA/KENYA - The practice of "three stones" widespread in district of Kilifi, where a population of half a million people finds 1 in 7 HIV-positive
Mombasa (Agenzia Fides) - Among the traditional practices that contribute to the spread of HIV in Kenya is the meko tatu, i.e. when a woman has three relationships simultaneously. Common among Miji Kenda tribes that populate much of the coastal area, the meko tatu contributes to increasing rates of infection in the Coast Province. Translated from Kiswahili, meko tatu means "three stones," which are those used to balance a pot in the traditional cuisine.
Our story has come from Zena Thuva, a resident of the village of Mnarani and health professional in the community. "The custom here is that a woman cannot have only one man. To survive, she needs two more. One to buy clothes, shoes, etc.., another to finance her other needs. All this in exchange for sex. "This is very common in the district of Kilifi, where there are about half a million people and one in seven are positive. Meko tatu affects both married and unmarried women and, as it forms part of the culture, it is no secret.
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This and other stories on HIV/AIDS have been disseminated through various journalism seminars sponsored by the Catholic diocese. Catholic media sources, in fact, continue to encourage journalists to seek out stories in the coastal region of Kenya that not only contribute to making known these retrograde practices and customs, but also to bring awareness and behavioral changes. (AP) (Agenzia Fides 1/12/2009)"
That HIV and AIDS have had a great negative effect on the world is known. It especially hits countries in the third world and in the second world, it of course also affects the more developed countries, but the epidemic is not that widely spread at it is in Kenya for instance.
AIDS is a medical condition, when a person's immune system is too weak to fight off infections. AIDS stands for Acquired Immunodeficiency Syndrome. HIV causes AIDS by knocking down a person's natural defense, his immune system. HIV means Human Immunodeficiency Virus.
The article above is the reason why I wanted to do research about women's rights in reference to HIV/AIDS. Of course I could have chosen culture and religion, but women's rights intrigued me, that is why I came across this article when I was looking for a good subject. We've got human rights already, so why would we need women's rights. I suppose we can consider women as humans, so is there really a need for these women's rights? How can it be that in the twenty-first century there still is a huge difference between the cultural and social placement of men and women? That is why I have chosen to investigate the gender inequality issue. To get a clear image of all the cases and further problems on which I might stumble upon I will compare Kenya and India. Both countries suffer from a great amount of gender inequality, men have got more rights than women although not everything men do to women is legal, but it is part of the culture and tradition, so hardly anyone objects against the unequal treatment of women.
In 1963 women in Kenya got the right to vote, in 1950 women in India got the right to vote. For comparison, women in the New-Zealand got the right to vote in 1893 and the women in the Netherlands in 1919. So there has been a change in the last sixty years in both countries, but there is still a lot of work to do, a lot of challenges to take, a lot of problem to tackle.
So the general problem I will look into is how does gender inequality affect women's vulnerability to HIV infection? There are a few things which immediately comes to mind on which I will investigate further in this research paper, but to give a short introduction I will mention a few below.
The first think that most people would think of is the lack of access to economic opportunities for women leads to an economical dependence on men according to National AIDS Control Council, 2002. The Kenyan women's unemployment rate is 19.3%, compared to men's unemployment rate of 9.8% according to Society for International Development, 2004. Women in Kenya lag in economic participation. More women are employed in the informal sector than in the formal sector, but men still dominate both sectors. Denial of property and abuse of inheritance rights also reduces women's access to factors of production such as land, housing, and credit according to UNAIDS, 2004a. An in-depth examination of the interplay of these factors and their contribution to women's vulnerability is therefore essential.
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Another possible explanation is that women are denied their right to autonomy and control of their own body. There are several ways in which women are denied their right to autonomy and control over their own body. The most common example are fathers that are marrying out their often young daughters to often older men. Women in some countries are also denied to refuse an offer of her husband to have sex with her. Since in Kenya it is not uncommon that men have several marriages and this means that they have several sexual partners. The men are not always faithful, so if the husband gets infected the women will get infected to.
Of course tradition and cultural inheritance plays an active role in the spread of HIV/AIDS. For instance a traditional practice that contributes to the spread of HIV in Kenya is meko tatu, when a woman has three relationships at once. Common among the Miji Kenda tribes that largely populate the coast, meko tatu contributes to the high infection rate in Coast Province. Meko tatu is a common practice in Kilifi district for both married and unmarried women. Many of these women do not use condoms with their various sexual partners. Interestingly, the practice is not shrouded in secrecy-it is openly talked about and is an accepted part of the culture.
Women are also more likely to get infected by HIV in contrary to men. According to UNICEF females are two to four times more likely to get infected by HIV. One of the reasons why is because women, as the recipients of semen, are exposed to semen for a longer time. The semen remains in the body of a woman for a few hours and the man is exposed to the bodily fluids for only a short time. Another reason is that the concentration of HIV in vaginal fluids is much lower than the concentration of HIV in semen. Furthermore one important reason is to avoid getting pregnant women practice anal sex, also to maintain their virginity or if the male partner prefers anal sex. Research has shown that the chances to become with HIV after one act of unprotected receptive anal sex is approximately twenty times greater than after one act of unprotected vaginal sex.
More than 36 million people throughout the world are affected by HIV/AIDS, it is one of the most important problems in the world. But let's start at the beginning, what is HIV/AIDS?
Human immunodeficiency virus (HIV) is a lentivirus, it is a member of the retrovirus family. The virus causes acquired immunodeficiency syndrome (AIDS). This syndrome causes the progressive failure of the human immune system. HIV is present as both free virus particles and with infected immune cells.
There are several ways how the infection spreads. Most people get it by having unprotected sexual intercourse with an infected person. Contact with an infected person's blood also gets persons infected. By sharing a needle of a heroin syringe, contaminated blood can flow in the person's blood and he or she will be infected now. The last and dangerous way to get infected is by passing the infection from mother to child and even through breastfeeding.
Transmission by blood transfusions or infected blood products have been eliminated by screening blood products whether they do or do not contain the HIV virus.
The HIV problem is considered as a pandemic by the World Health Organization. Since the virus has been discovered in 1981, AIDS has killed more than twenty-five million people. About 0.6 percent is infected by HIV nowadays. Most of these cases are found in the Sub-Saharan region, which exacerbates the economy of the countries and eventually leads to a chicken and egg situation.
There are a lot people that are unaware that they are infected with HIV. Less than 1 percent of the sexually active urban population in Africa has been tested and this rate is even lower in the more rural areas. A slight rate of 0.5 of the pregnant women have been tested, counseled or received their results in urban regions Africa, in rural regions this rate is even lower.
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The modern HIV testing method is very accurate. Modern HIV testing is extremely accurate. The chance of a false-positive result in the two-step testing protocol is estimated to be 0.0004% to 0.0007% in the general U.S. population.
HIV cannot be cured, however the development to AIDS can be stopped by administering antiretroviral medication. This medicine keeps the levels of HIV in the body at a low level, so that the immune system is able to recover and work effectively. This allows people who are suffering from HIV to lead a relatively normal and healthy life. Although antiretroviral medication is still not universally available, expansion of the treatment has helped to stop more and more AIDS related deaths and new infections. Awareness and preventive measures has also helped a lot to prevent HIV/AIDS to get a better grip on the world.
The exact origin of HIV is not known yet, the common thought is that it is originated in non-human primates in Sub-Saharan Africa and in the late 19th or early 20th century transferred to humans. The first paper which recognized the pattern of symptoms and characteristics of AIDS was published in 1981.
The first case of HIV in the world was diagnosed in Kenya in 1985. Kenya has got a population of an estimated 41 million people of those 41 million people 1.5 million people suffer from HIV/AIDS. India has got a population of approximately 1.2 billion people, 2.4 million people suffer from HIV/AIDS in India. The adult prevalence rate is 0.3 percent in India and 6.3 percent in Kenya. Prevalence is the proportion of people in a population who have a particular disease at a specified point in time, or over a specified period of time. Now I am going to look into multiple facets that affect women's vulnerability to HIV/AIDS.
It is well known that women all over world suffer from mostly social and economical discrimination. This discrimination issue is integrally linked to women's experiences with HIV/AIDS. Because of discrimination women are often denied access to their human rights which include, education, equality, physical integrity, health care and economic security. This leads to the result that women are more vulnerable for HIV/AIDS. And once a woman is infected with HIV/AIDS, women are often abandoned and scrutinized by their relatives and acquaintances. Pregnant women are often forced to sterilization or even abortion. When a woman gets tested for HIV/AIDS the results won't be given to the woman but to her husband and he decides if the woman may continue her pregnancy. These issues inflicted by discrimination, discourages women to get tested or to get treatment, because they don't want to experience the social stigma attached to suffering from HIV/AIDS.
Sex related issues are a taboo which leaves it difficult to discuss about it, this leads to unawareness of HIV/AIDS. This also increases the risk of infection, if people don't know that HIV/AIDS is transmitted via sexual intercourse and contamination of blood, people won't know how to prevent an infection of HIV/AIDS. Furthermore this limits women's sexuality. Women are often valued for their fertility and are abused, repudiated and ostracized if they are unable to bear children. The perception and the cultural perspective towards condom use is not that positive either, because it is often associated with sex workers, thus prostitution. The fact that condoms are renounced highly increases the risk to get infected by HIV for women.
Female Genital Mutilation also increases women's risk of HIV infection. This ritual often involves groups of girls and young women to get circumcised by the same cutting device, so when everyone shares the same cutting device and if only one participant is infected with HIV, the whole groups is highly likely to get infected too by the contaminated blood.
Most cultural norms in developing countries promote male's sexuality and the unfortunate catch of this is that it also promotes the transmission of HIV. Men are encouraged to seek multiple sex partners. When a man becomes infected through an extramarital relation, they will transmit the HIV infection to their wife or wives, because women can hardly negotiate about the usage of a condom.
The notion of male aggressiveness and female passivity promotes the notion that women must submit to the sexual desires of their husbands, even in instances where sexual relations are unsafe.
Women working in Kenya are making a large and often invisible economic contribution. Mostly Kenyan women are working in the agricultural and informal business sector, men still dominate in the more formal sectors. Over 75 percent of the Kenyan women live in the rural areas where they dominate the agricultural sector by farming the land in order to grow vegetables, fruit and commodities. Because of the dual roles Kenyan women have to maintain by their roles in the household economy and the labor market. There is also a big difference between the working hours of men and women. On average women work for 12.9 hours a day and more than one third less which makes them work 8.2 hours a day. Another important aspect is the limited land ownership for women. Women's right to land is a critical factor in economic well-being, empowerment and social status. Owning a piece of land enables women to set up their own agricultural business and access to other productive sources and services. The Federation of Women Lawyers appreciates that women's rights to property are unequal to those of men in Kenya. Individuals including government officials who believe that women cannot be trusted with or do deserver property, customs and laws keep on attacking women's right to inherit, manage, own and dispose of property. This policy can lead to poverty, violence, homelessness and disease. Many such women find themselves forced into prostitution and as a result, may unwittingly contribute to the spread of HIV infection.
In India women face the same problems as Kenya where women are prohibited to own land, with the same evident results as the women in Kenya.
Women's denied autonomy
The information on perception and practices of sexual rights have been collected through two main indicators, equality in sexual relations and control over women's own body. In Aizawl, a major city in India with a population of 228 thousand people, ninety percent of young women would not accept their husband's/fiancée's extramarital relations, followed by 89 percent in Kishanganj and 70 percent in Kanpur. In contrary to Bellary where nearly 50 percent of the young women would accept their husband's extramarital relations. Although most women do not accept an extramarital relationship, they cannot deny sex to their husbands even if the women are not willing to have sexual intercourse. Male's attitude towards women's sexual rights is extremely encouraging across India. The enabling environment to ensure women's sexual rights seems to be restricted by the overall opinion of young men and their opinion about extramarital relations. There has been reported a high prevalence of forced penetrative sex in India. A high amount of these reports declare that husbands do not respect their unwillingness to have sex. These findings violate the concept of equality in sexual relations. This gender-imposed sexual violence should be minimized to decrease the spreading of HIV/AIDS. A very high amount of women experience their first penetrative sex before the age of 15 years. A cause of this could be that there is a low age at marriage in India, this leads to unsafe sex and unwanted pregnancies. Most young women know nothing about their (absence) of awareness and practices of their sexual rights. To prevent this to happen they should try to minimize the gender-imposed sexual violence in case of sexual relationships, by for instance increasing the awareness and an increasing age at marriage for girls.
Another aspect that decreases women's vulnerability to HIV/AIDS are condoms. Condoms are highly effective in preventing heterosexual sexual transmission of HIV, the virus that causes AIDS. Research on the effectiveness of latex condoms in preventing heterosexual transmission is both comprehensive and conclusive. The ability of latex condoms to prevent transmission has been scientifically established in laboratory studies as well as in epidemiologic studies of uninfected persons at very high risk of infection because they were involved in sexual relationships with HIV-infected partners. However the condom use in India is very low, this could either be because the man in the sexual relationship forbids the use of condoms or because both man and women are unaware of the functions of a condom.
As stated before in the introduction part, women are two to four times more likely to get infected with HIV through unprotected vaginal sex than men.
One of the factors that highly increase the risk for women to get infected with HIV/AIDS is that women are exposed to semen for a longer time, because they are the receivers of semen and it remains the women's body for a longer period. Men are exposed to the body fluids of women for a far more shorter time. Furthermore semen contains a much higher concentration of HIV in contrary to the body fluids of a woman located around her vagina. The third thing that contributes to an increased risk is the fact that women possess a larger surface area of mucosa, the thin lining of the vagina and cervix, which is exposed to their partner's secretions during sexual intercourse. Many women have got cervical or vaginal conditions for instance, erosions, open sores, infections and sexually transmitted infections. Many women often practice "dry" sex and they cause infection or damage to the vaginal walls. Dry sex is a cultural practice where women us herbs or other substances such as Jik or wishing powder to dry out their vaginas, women practice these rituals because some men believe that a dry vagina is a sign of faithfulness or to heighten their sexual pleasure. This practice is painful and very dangerous because the wounds and or infections highly increase the risk of a HIV infection. The menstruation cycle is a great hazard for women, when menstruation occurs the large, raw area of the inner uterine lining is exposed. If women have sex just before during or immediately after menstruation the risk to get infected with HIV/AIDS is very high. Younger women are especially vulnerable to HIV infection because their genital tracts are not yet fully mature, their vaginal secretions are not so copious, and because they are more prone to lacerations or tears of the vaginal lining. (There is also evidence to suggest that women once again become more vulnerable to HIV infection after menopause). Furthermore one important reason is to avoid getting pregnant women practice anal sex, also to maintain their virginity or if the male partner prefers anal sex. Research has shown that the chances to become with HIV after one act of unprotected receptive anal sex is approximately twenty times greater than after one act of unprotected vaginal sex.
Myth of virginity
The myth of virginity is that sexual relations with a virgin will cure a person of AIDS has lead to increased sexual violence to young women in all parts of the world. This belief has been adapted broadly in countries in Africa like Kenya. To make sure a woman is still a virgin, the victims are being raped in a very early state so the rapist is sure the cure will work. Unfortunately this cure does not work and only increases the spread of this horrible disease and it does an enormous psychological damage to the young women.
Women's right to health
Because of the discrimination, it is very common amongst women that they do not have access to medical treatment including medical treatment for HIV/AIDS. Another issue where women are denied their right to sufficient healthcare is in the prison, where women are often denied the medical care they need to survive. Women that were raped are often afraid for the social stigma and social ostracism, thus they will not look for medical help or even medical treatment. Prostitutes are discriminated in almost every region in the world and therefore afraid to seek for medical help if needed to avoid harassment. The probability of an infection can be reduced by using an antiretroviral prophylaxis within 72 hours after a rape or unprotected sexual intercourse. Because of the stigmatization of women in society and in hospitals women do not seek for assistance and because of this they do not learn about the different treatments and hazards. This is sometimes even supported by the government, since they do not want to give these expensive treatments to women that are discriminated because of the high costs involved. These policies exacerbates the global problem of HIV/AIDS.
After having read about all the factors that influence women's vulnerability for HIV/AIDS, women's vulnerability is highly influenced by gender inequality. Not only because women are socially and economically discriminated. Discrimination of women leads primarily to denied access to their human rights such as physical integrity, health care, economic security, equality and education. Once a woman is infected she undergoes the social stigma and is very often deserted by her family and acquaintances.
Another important issue is the fact that talking about HIV/AIDS and how the infection spreads is a taboo in many countries, especially among women, because they are often denied to go to school. Because of the high value assigned to women's fertility they get abused, repudiated an ostracized if they are unable to give birth to children.
Furthermore the low rate of condom use increases the risk for both men and women to get infected by HIV/AIDS. Women are often prohibited to use condoms by their husband, because the husband wants to increase his sexual pleasure by not using a condom. This is a huge flaw in the prevention of HIV. Condoms are highly effective in preventing heterosexual transmission of HIV. Condoms are the only preventive measures that could be taken in case of sexual transmission besides abstinence. Unfortunately the condom use rate in India and Kenya are both very low. Another reason why these rates are so low might be unawareness about condoms and how they can prevent a person from getting infected.
A common ritual in Kenya where girls and young women get circumcised to prepare them for marriage and adulthood, is a huge factor in spreading the infection. It often shows that the same cutting device is used by the rite and if one woman is infected, she spreads to the other women that are being circumcised.
Male's sexuality is often promoted in the world, this means that men are encouraged to seek multiple sex partners. If a man gets infected through an extramarital relationship, they will transmit the HIV infection to their wives and women can hardly say no to their husbands if the husband wants to have sexual intercourse.
In Kenya and India women are denied the right to own land, this is a critical factor in the economic well-being, empowerment and social status. When a woman owns a piece of land they are able to set up their own agricultural business and gain other benefits such as access to productive sources and services. This right is denied by the government because the affiliates do not think that women are capable to maintain their land. So the customs and laws in both Kenya and India keep on attacking women's rights to inherit, manage, own and dispose of property. These laws and customs might lead to poverty, violence, homelessness and disease. As a result of this, women can be forced into prostitution and this increases their risk on getting infected by HIV/AIDS.
Furthermore the sexual rights, equality in sexual relations and control over their own body are highly neglected by men in both Kenya and India. Men are encouraged to seek for extramarital relationships, although women do not consent with these practices they have to comply with these wishes, they cannot deny their husband to have extramarital relations, because of the overall opinion of young men on extramarital relations. A high prevalence of forced penetrative sex has been reported in India, a high amount of these reports say that husbands did not respect their unwillingness to have sex. These results violate women's rights on the aspect of equality between men and women.
Women in India and Kenya experience their first penetrative sex before the age of 15 years, one reason of this is that there is a low average age at marriage in India and Kenya. This may have HIV infection and unwanted pregnancies as a result.
There are a lot of biological factors which increases women's vulnerability to HIV/AIDS. I will list a few here. Women are exposed to semen for a longer period, while men are exposed to the body fluids of women for a shorter time. Semen also contains a higher concentration of HIV in contrast with the vaginal fluids of a woman. The menstruation cycle increases the risk of a women to get infected too, if women have sex just before, during or right after the menstruation cycle the large, raw area of the inner uterine lining is exposed. Because of this large contact area the risk increases.
Furthermore one important reason is to avoid getting pregnant women practice anal sex, also to maintain their virginity or if the male partner prefers anal sex. Research has shown that the chances to become with HIV after one act of unprotected receptive anal sex is approximately twenty times greater than after one act of unprotected vaginal sex.
The belief that sexual relations with a virgin will cure a person of HIV and AIDS has also lead to increased sexual violence to young women all over the world including Kenya and India. The victims are being raped when the girls are very young, so the rapist is sure that the victim is still a victim and can actually "cure" his disease". Obviously this so called cure does not work and as a result of the rape the victim can be infected with HIV/AIDS.
The last major issue that I found during my research is the fact that women are often denied access to medical treatment. Unfortunately without proper medical treatment HIV cannot be disputed properly.
This research paper supports my hypothesis and brings a lot of questions to mind. How can it be that in the twenty first century where globalization has taken over the world and universal human rights should be applied there still is a large group of women that are discriminated and scrutinized? Why is there a need for women's rights, because we already have these universal human rights? Who should be held accountable for the discrimination of women? Who should supervise this? Is it even possible to keep track of discrimination towards women, because there is a lot of "invisible" discrimination? These questions might be a good subject to look into next time.