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CUBA
Empowering Women to Insist on Safe Sex
By
Dalia Acosta
HAVANA (IPS) - Only a revolution similar to the one women led 40
years ago in search of gender equality could curb the spread of
AIDS in Cuba and uproot the widespread resistance to the use of
condoms, say local AIDS prevention workers.
The process in which women began to achieve equal opportunities
in education and work after Fidel Castro came to power in 1959,
and to forge a space for themselves in this socialist Caribbean
island nation, was seen as ``a revolution within a revolution.'
'
Something similar is needed now, but with respect to sexuality,
María Julia Fernández, 48, who has lived with the
AIDS-causing human immunodeficiency virus (HIV) for 15 years, told
IPS.
``Women have to learn to say `no','' said Fernández, who
has dedicated most of her time for more than a decade to AIDS prevention
and helping people living with HIV.
Thanks to their strong social standing and broad access to education,
Cuban women have the power to make their own decisions, if they
would just decide to do so, she said. However, they remain slaves
to tradition, and do not demand the use of condoms, for fear of
offending their partners, she lamented.
In Cuba, women make up 43 percent of the workforce, hold nearly
67 percent of all technical jobs, and comprise 51 percent of the
total number of scientific researchers and more than 60 percent
of university students.
Cuban women are in an advantageous position with respect to their
counterparts in other developing countries, because not only is
female illiteracy a thing of the past, but the ``feminisation''
of the universities has been talked about here for years.
Although the severe economic crisis suffered by Cuba throughout
the 1990s tipped part of the population into poverty, access to
education and health care remains free of charge and working conditions
for men and women are still equal.
But despite these hard-preserved social gains, studies show that
only around five percent of people in Cuba use condoms for safe
sex. In a survey published by the National Office on Statistics
last year, a majority of female respondents who admitted to engaging
in casual sex in the previous 12 months said their partners did
not use condoms.
The study found that the women knew about AIDS and how to prevent
it, but nevertheless felt sure that they would not contract HIV.
The main reasons given for not using condoms were that the women
trusted their partners, or that they or their partners did not like
using condoms, or had never used one.
To the question of how they ``protected'' themselves, many women
mentioned other contraceptive methods like the pill or the IUD,
indicating that their concept of ``protection'' was limited to the
need to prevent an unwanted pregnancy.
Women are still a minority of HIV-carriers in this country of 11
million, but the public health system has registered a disturbing
rise in the number of infected women in recent years.
The increase in the number of women who have turned to prostitution
has also opened a door to AIDS and other sexually transmitted diseases.
Studies show that prostitutes also fear offending their clients
by demanding the use of condoms, while their customers, usually
foreign tourists, have an excessively rosy view of Cuba's health
statistics, and feel that they are in a place where it's safe not
to use condoms.
According to official statistics, 3,485 cases of HIV had been reported
in Cuba by late May, 1,254 of whom had developed full- blown AIDS
and 887 of whom had died, 54 of them due to unrelated causes.
The reports indicate that 2,701 of the patients were men and 784
women. Homosexuals remain the highest risk group, accounting for
82.7 percent of all male HIV-carriers and 64.2 percent of all people
infected with the disease.
Fernández told IPS that many women were infected by their
husbands, who had extramarital relationships with other men. She
said Cuban women were too used to simply waiting for their partners,
and accepting whatever they were told. ``The challenge is not to
refuse to have sex, but to learn to live with the virus, to say
'stop', and to use condoms,'' she underlined.
With that message, Fernández is participating in a project
carried out by the Ministry of Public Health's Centre for Prevention
of Sexually Transmitted Diseases and AIDS, in conjunction with the
Federation of Cuban Women (FMC).
The FMC, the only legally recognised women's organisation in Cuba,
opened up its nationwide chain of Centres for Orientation for Women
and the Family to the project, for the training of community educators
who carry out consciousness-raising and prevention work among women.
Joel Iglesias, an HIV-carrier and health promoter, said ``a man
carrying HIV is likely to infect more people throughout his life
than a female carrier.
``Sex between men jeopardises men as well as women. Studies carried
out in various parts of the world indicate that up to one- sixth
of the male population engages in same-sex relations, which are
generally kept secret,'' said Iglesias.
Women are also more vulnerable than men due to biological and physical
reasons. During heterosexual intercourse, a large surface area of
vaginal mucous membranes is exposed to semen, which contains a higher
concentration of the AIDS virus than do vaginal secretions. In addition,
semen stays in the vagina much longer than vaginal secretions remain
on the penis.
The risk is even higher among girls and teenagers, because the immaturity
of their genitals reduces the ability of the mucous membranes to
act as a barrier against pathogens.
Statistics from the joint United Nations Programme on HIV/AIDS reveal
that nearly 52 percent of the people who died of AIDS last year
were women. The UN agency also reported that more than nine million
people have died of AIDS throughout the world since data on the
disease first began to be collected.
Women make up 47 percent - or nearly 17 million people - of all
HIV-carriers worldwide, compared to 25 percent in Latin America
and 35 percent in the Caribbean.
``We are trying to get women to stop being passive. We want them
to be able to take care of their health, to empower themselves,
to demand that their partners use condoms,'' said Fernández.
The woman known as La Paloma (The Dove) among her fellow AIDS prevention
workers speaks from experience. She was a virgin at the time of
marriage, and remained faithful to her husband - even after he died
of AIDS.
She was the fifth woman diagnosed with HIV in Cuba, and the first
to join a prevention group. ``AIDS changed my life,'' she says,
contrasting the fearful woman full of prejudices that she once was
with the person who does not now hesitate to tell a full entire
auditorium that she is HIV-positive. (END/IPS)
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