Grab and Bang – Man, Where’s the Condom?

Published on Botsotso, by Vonani Bila, article not dated.

In 1990, South Africa had an infection rate of less than one percent. By 1999, an average infection rate had peaked to 22.4 per cent. By the same year, a projected twenty-five per cent of all pregnant women in the country were already HIV-positive. In 2005, these figures had risen to nearly thirty per cent, and the death rate among women between the ages of 25 and 34 had more than quadrupled. In 2005, a government national household survey estimated that 10,8% of all South Africans – about five million people – were living with HIV. By 2006 the figure had risen to 5.5 million.

International health agencies estimated that, in 2005 alone, 320 000 South Africans, mainly blacks, died of HIV-related illness; about eight hundred a day. All age and sex groups were affected – including infants, pensioned-off grandfathers and grannies. This catastrophic figure is estimated to reach one million deaths per year by 2008. Recent UNAIDS surveys indicate that HIV in sub-Saharan Africa is estimated to constitute about 64% of the global total of 39.5 million people living with HIV. 

The Mpumalanga province which is number two nationally after KwaZulu Natal has the HIV/AIDS prevalence estimated at 32.5 per cent. KwaZulu Natal stands at about 40%. The highest hit district in Mpumalanga is eHlanzeni.

There are 23 antiretroviral (ARV) rollout sites in the whole province, but there is an apparent shortage of human resource. According to the 2003 national survey, the shortage stands at 63%. Before site accreditation, the enormity of the processes involved simply defeats the purpose of having many rollout sites. Some have to bypass two to three clinics to access ARVs, even though some can be made step-down facilities. Most AIDS patients from far-flung rural areas don’t have access to reliable public transport, thus limiting access to ARVs.

Poverty, migration, disempowerment of women, unemployment, illiteracy and poor education are some of the factors responsible for the rising HIV pandemic in Mpumalanga, and generally in South Africa. Of course there are other modes of infection such as mother-to-child HIV transmission, blood transfusion, exposure to blood and injecting drug use. There are shocking stories of people abandoning their prescription so that they can deteriorate to be recommended for the AIDS grant. Such is regarded as a survival mechanism to escape poverty … //

… A comprehensive and integrated plan to deal with the AIDS challenge is needed. “We can’t accept a situation where certain employers resist to hire HIV positive persons. We must fight against families who fire the maid because she is HIV-positive”, Phaphamani participants stressed at the workshop. They also stressed the importance of women claiming power by defending their rights as embedded in the country’s Constitution and various statutory documents. Captains of the commercial firms care so much about profit, and I don’t see them paying a new recruit they are not aware of his HIV status a large salary. I think they’ll always press for workers to disclose their status so that worker productivity levels can be managed better, where possible.

Material and social status play a huge role in increasing the infectivity. Fourteen years into our democracy, we need to build a solid AIDS consciousness among men and women, business people and workers; the youth; religious leaders and their followers; farmers and farm workers; the unemployed and the professionals; the rich and the poor – all of us, because AIDS doesn’t discriminate. That means husbands must begin to use condoms in their own homesteads, and wives must exercise power in the bedroom by negotiating safer sex practice because, clearly, women’s low social and economic status puts them to bear the brunt of the AIDS pandemic.

But then there’s the female condom story!

“But when you go to collect femidoms they will write your name down and give you numbers. Some girls were taking femidoms and making bracelets out of the ring!” The truth is that femidoms are not easily available. Others say they are not comfortable either! You must wear it hours before sex, sometimes even when you are cooking in the kitchen.

You also have to pin your hopes that your partner will have sexual appetite upon coming back from work. And if he’s tired and moody – roughed up by bosses, what do you do with the female condom? Flush it away? The truth is that even after taking a shower to refreshingly seduce your partner, you’ll have to wear another femidom – unless there’s no danger in washing and reusing the old rag! What I know about the male condom is that only morons wash and wear it after use!

The government says the femidom is expensive, thus it is hardly found in hospitals and clinics. Does that suggest it’s better to let the people die, than supply them with the available instrument which will at least protect them from being infected? Some participants felt the need for Phaphamani to negotiate with relevant government departments, especially Health and Social Services, to have female condoms distributed to the public without the nightmarish logistics of taking down people’s names.

Clearly, the fight against HIV/AIDS must involve all members of the community, but there will be an added value if HIV clinicians, retired nurses and the entire contingent of medical personnel could actively join hands with orgnisations like Phaphamani, since they have full knowledge of the HIV/AIDS.  The home-based approach and a host of other strategies adopted by Phaphamani such as voluntary counselling and testing, taking care of orphans and income generation are appropriate and require full execution by all layers of the organisation in partnership with its strategic partners. In this regard, Phaphamani restores the dignity of the infected and affected, and integrate them fully into society. (full long text).

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