Break the silence, get past the noise ...

In Sub-Saharan Africa women comprise 60% of the adults who are HIV-positive. What puts women so much at risk of HIV infection? Poverty, unemployment and limited access to resources all play an important role, but according to a 2006 study on Culture, Women's Rights, and HIV/AIDS in Namibia, women are especially at risk due to the cultural beliefs and practices that support male dominance.

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The study, commissioned by the Southern Africa HIV/AIDS Information Dissemination Service (SafAIDS), was conducted by Diane Ashton, Cynthy Haihambo, Laura Jenner and John Mushaandja of the University of Namibia, and recently launched in Windhoek. The researchers examined women's status in two areas of Namibia: Omusati Region in the north and Karas Region in the south. They gathered data through focus group discussions and interviews with traditional leaders, community members, people living with HIV and Aids as well as with activists. Discussions with both cultural groups (Owambo in the north and Nama in the south) revealed that in order to combat the spread of HIV and Aids, Namibia must address the cultural practices that violate women's rights.

THE CULTURE OF MALE DOMINANCE

According to the study, even though the constitution says women are equal to men, most Namibians do not believe it. Many cultural practices and beliefs reinforce patriarchy (male dominance) and limit women's ability to control their lives and their health, for example, notions surrounding marriage and divorce. Women who are not married, or have pre-marital children, are given derogatory names such as oshikumbu. Their homes are belittled and they are seen as somehow inadequate. Women are thus taught that a life without a husband is shameful. Divorced women, too, are viewed as failures or prostitutes. Therefore, women often remain in bad or abusive marriages to avoid the stigma associated with being a divorcee.

Marriage and motherhood are viewed as the pinnacle of womanhood, while polygamy and male promiscuity are often condoned or ignored. In this patriarchal culture, women, who have little control over their sexuality, are hesitant to demand other ways of behaving from their husbands or partners and simply accept the fact that their men have multiple sexual partners. Members of both cultural groups also revealed that decisions about condom use, birth control, and reproduction are often left up to the male partner. Thus, a woman who knows that her husband or partner engages in high risk behaviour feels she has no right to protect herself from HIV infection by insisting that he wear a condom or by refusing sex.

Women are also burdened with poverty, unemployment, limited access to resources and lack of control over property and assets. Customary law, when it comes to marriage, divorce and inheritance, affords few rights to women and often threatens to take whatever little property a woman does have. In the face of poverty and loss of inheritance, many women 'choose' to stay with partners who put them at risk.

THE CULTURE OF NOISE

There has been a great deal of talk about educating women about their rights in our country, but little attention to things that will actually empower women such as education, access to resources, control over assets and property, social and political advancement, and access to HIV prevention methods that women themselves are able to control. This is referred to as the culture of noise. "Noise is an empty and impotent concept unless it includes activism and commitment to long term change," concludes the report. "Government policies that are not aggressively implemented only serve to perpetuate this noise, which gives the impression of forward movement, but actually obscures the basic problem."

According to the recommendations, Namibians need to start "walking the talk" of women's equality. If women do not know their rights, if they are afraid to exercise them for fear of being ostracised by family and friends, or if the legal system makes it extremely difficult to press charges, women remain at risk.

CHANGING CULTURE

Breaking the silence and getting past the noise means challenging and transforming cultural practices. Fortunately culture is not stagnant; it changes over time and will continue to evolve. The study asserts that traditional leaders are in a strong position to change the practices and beliefs that discriminate against women and put them at risk of HIV infection. The report recommends that we reach out to traditional, political and religious leaders at the local level and workshop with them to identify those practices that put women at risk, so that they can help to change these practices and promote positive cultural practices in their place.

The report also recommends that any meaningful prevention programme will have, at its core, the concept of female empowerment. If women do not have control over their economic, social and sexual lives, if they continue to be subject to patriarchy, they will not be able to protect themselves from HIV. Therefore, meaningful prevention programmes will give women the economic opportunity that lessens their dependence on men, the political advancement that gives them self-determination, and the control of their own sexuality that enables them to protect themselves. Women must have greater access to contraception that protects against HIV and other sexually transmitted diseases, as well as the power to decide where when and with whom to have sex.

MOVING FORWARD

The findings suggest that this culture-based approach to preventing HIV and Aids can be implemented by conducting further research in Namibia and using that research, in conjunction with current findings, to guide policy and decision making. Researchers hope to replicate the study in other regions of the country, specifically Caprivi where the highest incidence of HIV occurs.

Believing that male sexual behavior needs to be changed in order to prevent the spread of HIV among women, they also suggest a study closely examining male attitudes on masculinity and sexuality. The study also recommends talking to HIV positive women to discover what they think about prevention strategies that work. Based on their findings, the authors of the report also suggest the implementation of three programmes: parent education (teaching them to talk and teach about sex), education programmes designed for men, and a 'know your status' campaign to mitigate the effects of stigmatisation on the increased spread of HIV.

At the conclusion of the study's launch, Lois Chingandu, director of SafAIDS, pointed out that cultural laws and practices are deeply ingrained in people. She emphasised that unless the messages of HIV and Aids prevention are designed around cultural context, they will continue to be ignored. According to Chingandu there is a need to move beyond a simply 'Africa'-centred approach, towards culturally specific approaches. "If not," she says, "gender equity and control of the HIV/AIDS pandemic will be lost in a culturally silent quagmire of ancient laws that bind all who are born under their influence."

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