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Women are the last to know By Nadire Mater Istambul - Often in Turkey, women are the last ones to find out that they have been infected with HIV or that they have AIDS. "There are no independent advisory institutions. Public services are limited, and most probably many women die from AIDS, yet they are unaware that they are HIV positive," says a government official who declined to be named. In an interview with IPS, the government official recalled the case of a 65-year-old woman, who was from a well-to-do family, who for three years went to doctors and clinics because she was constantly ill. During one of these visits, the official says, the woman said to the doctor, "maybe, I have caught AIDS," and she asked for further tests. "Come on," the doctor said, "you are too sceptical." But he did the tests and the results showed she had AIDS. She had been infected by her husband, who was undergoing medical treatment, but he never told his wife, says the government official who works on AIDS. Both are now dead. Dr Nazan Kuzgunkaya, a specialist with the Association to Combat AIDS, says her organisation attends to many women who only learn they are HIV positive after they lose a husband or a child. The Association to Combat AIDS has been working for years to increase public awareness , and conducts workshops for high-risk groups. The organisation has worked with the army and security units, and also with the muftis', local religious leaders. The group also organises public information programmes for high school and university students, with a particular focus on medical students. "We believe that it is much more sensible to focus on the doctors of future, than fighting to relieve the veteran doctors from their decades of old habits," Dr. Kuzgunkaya told IPS. Dr Kuzgunkaya says that violence against women is one of the major causes for the spread of HIV, although the country has yet to collect enough data and do more research on violence against women. "In none of the cases I have examined until now, have I observed a case where the female partners infected their male partners with HIV, the virus that causes AIDS," says Dr Kuzgunkaya. "It has been the other way around, yet these realities are not reflected in statistics. There are no reliable figures on rape or on domestic violence. These issues are not publicly shared and discussed, yet it might be easily deduced that one out of every three women in Turkey is battered by a husband, father or brother." "Almost 90 percent of the women who apply for help at the Family Advice Center, complain of general problems", says psychologist Julide Aral of Istanbul's Bakrkšy Mental Hospital. "But later when we probe deeper , we discover that the problem starts with domestic violence, proceeds to forced sexual intercourse and sometimes ends up in forced anal sex." Aral says that women in Turkey accept their "traditional obligations" in marriage and most would never insist on safe sex. "Most men refuse using a condom as they accept it as a sort of constriction imposed on their manhood," Aral adds. "The path to AIDS is opened in the unequal sexual relations, since women can not demand that men should use condoms." Men's refusal to use condoms is one of the major factors in increasing the spread of HIV/AIDS in Turkey. There are no reliable figures, but it is estimated that only one out of every 10 men use condoms. "Men rigidly refuse to use the condom. The mentality that flesh should stick to flesh' is widespread. They are obsessed that this makes them men, and funnily, those who resist most, have not even once experienced sex with a condom," Dr. Kuzgunkaya told IPS. "Even if the wife is 100 percent sure that the man has extra-marital relations, she is scared to raise the issue, and to ask the man to use a condom," she adds. Condom use is generally preferred in prostitution, Dr. Kuzgunkaya believes. "But even in this case, the motive is not to protect the prostitutes, but their clients." Even the mandatory tests sex workers are required to take by Turkish law are not in the women's interest, Dr Kuzgunkaya says, adding that, "obligatory tests are humiliating". Women in Turkey, like women worldwide "are under relatively greater risk (of being infected with HIV) due to their passivity and also their vulnerability to sexual harassment. Originally, women comprised 20 percent of the global total of those who suffered from HIV/AIDS. Now this ratio has swelled to 50 percent," Dr Kuzgunkaya says. According to Turkey's Ministry of Health records, the earliest HIV/AIDS cases in the country were diagnosed in 1985. Between October 1985 and July 2000, a total of 1067 HIV/AIDS cases were recorded, 763 of which were men and 304 women. The main route of transmission was sexual intercourse. "For years, speculations have been made that AIDS would boom in Turkey. However, the trend is not much different than other contagious diseases, but the data is scarce and not very reliable. I would guess that the actual number of total HIV positive persons might be around 10,000. But it might be greater or less than that," says Dr. Kuzgunkaya. "There are no high quality test services, no anonymous test centers and no test facilities free of charge," she adds. Women in Turkey face many forms of inequality and discrimination in the home, workplace and in their social life. And when it becomes known that they have HIV/AIDS, the injustices they face become worse. "I had a young woman patient who had caught AIDS from her husband. She learnt that her husband had AIDS only after they were married. She too was infected, and then she had to undergo medical treatment. Yet when her situation was discovered in her workplace, she was immediately fired," Aral told IPS. While women in this situation often feel anger at first, they soon give up hope and accept death, rather than to fight and live positively with HIV/AIDS in a country where they will face many hurdles, Aral says. "In the first instance when she discovers the reality, the woman bursts with rage. She bursts with rage for having been deceived and exploited. Then she sees that they (she and her partner) are on a road of no return, and bows to her fate to accompany the man to the grave." |
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