HEALTH-KENYA: Women Prime Targets for HIV

By IPS Correspondents Reprint | | Print |

Joyce Mulama

NAIROBI, Nov 25 2004 (IPS) - Kenyan health officials have expressed concern about the fact that women in the East African country are more vulnerable to AIDS than men, and that the gap between men and women as regards new HIV infections appears to be widening.

“Women still shoulder the burden of the disease,” said Dr Patrick Orege, director of the National Aids Control Council (NACC), Tuesday.

He was speaking at the launch of the latest AIDS Epidemic Update, an annual publication produced by the Joint United Nations Programme on HIV/AIDS (UNAIDS). The NACC is the government body that coordinates efforts to reduce HIV in Kenya.

Orege noted that HIV prevalence amongst women aged 15 to 49 years was nine percent compared to under five percent for men in the same age bracket. This discrepancy was echoed in the statistics for Kenyans in the 15 to 24 years bracket. Six percent of women in this category were HIV-positive, while just over one percent of men were.

The trends noted by Orege are also reflected elsewhere on the continent.

According to the 87-page AIDS Epidemic Update, women and girls constitute about 57 percent of the estimated 25.4 million people who are living with AIDS in sub-Saharan Africa. And, “In most other regions, women and girls represent an increasing proportion of people living with HIV, compared with five years ago,” says the report.

Tradition, social norms and biology conspire against women in the transmission of HIV.

“Culture in Africa dictates that women do not have rights when it comes to sexual matters. There are women who get beaten even today for taking family planning pills, and others for asking their spouses to wear condoms when having sex – even if he had proven himself to be unfaithful or was HIV-positive,” Bella Matabanadzo of the UN Secretary-General’s Task Force on Women and AIDS told the press during Tuesday’s launch.

As noted in the report, a study in Zambia has shown that only 11 percent of women there believe they have the right to demand that their husbands use a condom.

“We will not get a reduction in AIDS unless there is a reduction in violence against women as well as in rape cases. Establishing and enforcing anti-rape laws can go a long way in reducing rape cases and the spread of HIV/AIDS,” Mark Stirling, director of a UNAIDS regional support team, observed.

Women parliamentarians in Kenya recently proposed a law that will allow for rapists to be castrated. Debate on the Sexual Offences Bill is expected to start soon, in the wake of a police report released earlier this month which revealed that 2,308 rape cases were recorded in 2003, up from 2013 in 2002. In 2000, the figure was 1,675.

In the first eight months of this year, 1,895 cases of rape were reported.

The high rate of HIV infection amongst women has also been blamed on the fact that the female condom is still not readily available in Kenya, seven years after its introduction.

“They (female condoms) are also significantly more expensive than the male condoms and, despite indications of increased uptake, they remain neither widely available nor socially accepted,” says the AIDS Epidemic Update. A female condom in Kenya costs about 2.5 dollars, while a male condom costs almost 13 cents.

The report also notes that “Female condoms offer protection to increasing number of women, but they still require some degree of negotiation and male cooperation.”

According to Orege, government is in the process of increasing efforts to reduce national HIV prevalence, which now stands at seven percent. These efforts include intensifying public awareness campaigns about preventive measures such as increased condom use by women.

“Although the awareness and knowledge about HIV/AIDS is relatively high, reported condom use among sexually active women is still low. Of the 18 percent of sexually active women in Kenya who engage in higher-risk sex, only a quarter of them report using condoms,” Orege said.

While government has increased the number of voluntary counselling and testing (VCT) centres in the country to 350 (and hopes to double this figure by the end of 2005), there is growing concern that women do not make use of the facilities.

The NACC says 54 percent of women have heard of VCT, but only 15 percent of them say they have tested for HIV. It appears that many women would rather remain ignorant of their HIV status – even if this means that they miss out on receiving assistance – than have their partners leave them if they test positive.

In light of this, the report recommends combining treatment for sexually-transmitted diseases in family planning services: “By integrating sexually transmitted infection treatment services with family planning activities, women’s fear of social censure could be reduced and their uptake of services increased. Wider efforts to reduce HIV-related stigma are vital too.”

As concerns treatment for AIDS sufferers, Orege says government is banking on the “Three by Five” initiative of the World Health Organisation, which aims to provide anti-retroviral drugs (ARVs) to three million people by 2005.

“We are working on this initiative and so far we have been able to put 24,000 people on ARVs up from 12,000 last year. We need to scale up so that we put 95,000 people on this treatment by end of next year,” Orege noted.

The AIDS Epidemic Update says five to six million people are in dire need of ARVs, but that only seven percent of the populations in low and middle-income countries have access to treatment.

Stirling noted further that it was imperative for governments of these states to demonstrate their own willingness to fight AIDS by increasing resources allocated to the pandemic. “Many governments are not,” he said.

Several people living with AIDS in Kenya hold the same view.

“The government needs to increase its budget on AIDS. It cannot boast of putting a few thousand people on ARVs, yet over 200,000 people in the country are in urgent need of this treatment,” James Kamau of the Kenya Treatment Access Movement told IPS in an interview earlier this month. Over two million people are living with AIDS in Kenya.

The UNAIDS report was released ahead of World AIDS Day on Dec. 1.