Mention sex in most places on the African continent and you are likely to be met with questioning glances. Most quietly wonder 'What is this person up to?' Venture into speaking about controversial sexual rights and you are likely to cause a furore. The most common reaction will ostensibly focus on their immoral or un-African nature. You will be lucky to leave the conversation unscathed, physically or otherwise.
Yet, our African reality suggests that if we are to deal effectively with the HIV/AIDS pandemic on the African continent, we must consider the tapestry of human sexuality and sexual rights issues, whether we consider them vile or not.
The 4th Africa Conference on Sexual Health and Rights, which took place in Addis Ababa in February 2010, provided an opportunity to debate diverse issues such as gender and masculinities and how they have contributed to undermining efforts to combat the HIV/AIDS in Africa.
As conference participant Julius Kaggwa noted, 'Sexuality is an integral part of the human experience. Whether we like it or not, sex occurs 125 million times a day! It is therefore at the core of who we are as human beings. This is where human rights come in. Every human being has a right to enjoy their sexual health.' The article below highlights some of the critical issues under discussion.
UN-AFRICAN AND IMMORAL! REALLY?
Homophobic individuals often argue that homosexuality is a 'foreign scourge' imported to Africa by white ne'er do wells intent on corrupting the continent's young minds and morals. They claim that there is no word for homosexual in African local languages. Evidence to the contrary, however, is widely published and it is well established that these arguments are unfounded. The conference provided a space to discuss controversial public health and rights matters, including those relevant to Africa's Lesbian Gay Bisexual Transgender Intersex (LGBTI) community.
While many people supported the discussion of LGBTI issues, an equal number of conservative voices opposed it. Encouragingly Africa's LGBTI community gave a number of presentations, articulating critical needs and priorities regarding their sexual health and rights. Despite great progress since the last conference, many repeated the default position that homosexuality is 'un-African', prompting Sylvia Tamale's sarcastic response that if we are to criminalise anything that we deem 'un-African', then we should criminalise perms, chemically treated hair, or the dying of hair in unnatural colours, such as the purple being worn proudly by one of the conference participants to express her homophobic sentiments.
CRIMINALISING SAME SEX UNIONS: RAMIFICATIONS FOR HIV/AIDS
The debate on the draconian Anti-Homosexuality Bill in Uganda represents an alarming trend to criminalise same-sex unions across the African continent; at least 39 African states have already done so. Burundi passed anti-homosexual legislation in 2009 and discussions on similar legislation in Rwanda are at an advanced stage. In Kenya, the issue has been highlighted severally in the ongoing constitution debate and most recently, in a swoop on homosexuals led by state security agents in the coastal town of Mombasa. Panelists on the criminalisation of same-sex unions presented compelling arguments on the implications for sexuality and HIV/AIDS.
Firstly, homosexuality is a part of our society and must be acknowledged. Compulsory heterosexuality is not a cure for homosexuality. The war on HIV/AIDS cannot be waged effectively without taking LGBT rights into consideration. LGBT individuals are already 'at risk' populations, as far as HIV/AIDS programming is concerned. Criminalisation pushes the LGBT movement underground, leading people to conceal their HIV status.
As Victor Mukasa of IGLHRC pointed out, 'this state of affairs threatens to roll back the gains made so far in the fight against HIV/AIDS.' Meanwhile, David Kuria highlighted that in Kenya 'at least 60 per cent of men who have sex with men (MSM) are also in heterosexual relationships in Kenya', with implications for the management and funding of HIV prevention and treatment programmes. But it is basic human rights that are at the heart of the debate, Kuria said, quoting Navi Pillay's 2009 World Human Rights Day speech: 'To criminalise people on the basis of colour or gender is now unthinkable in most countries. Discrimination feeds mistrust, resentment, violence, crime and insecurity and makes no economic sense, since it reduces productivity. It has no beneficial aspects for society whatsoever.'
TRANS AND INTERSEX ISSUES IN AFRICA:
Transgender and transsexual people in Africa face major challenges as a result of the denial of their existence, stigma, discrimination, and the general fear they face in accessing medical and other public health services.
Skipper Mogapi highlighted the lack of contraceptive methods specifically designed for and targeted at trans people. Gender Dynamix's Liesl Theron spoke about transphobia and gender based violence, highlighting several examples, such as the case of a trans F to M who feared his female heterosexual partner would be raped by a straight man while he was away at the Out Gay Games, because this man had threatened to show her what it was to be with a 'real' man.
Theron also spoke about the politics of naming and trans identity in Africa, where some argue that one can be transsexual without having changed one's body, because of the infrastructure and service limitations. South Americans, however, believe that one can only claim this identity after having undergone surgery. Africans must therefore continue to develop, reclaim, define and redefine our own language around trans and other sexual identity issues, to contextualise and concretise a strong and sustainable sexual health and rights agenda.
MEN OF QUALITY AREN'T SCARED OF EQUALITY
A panel on 'Masculinities, sexuality and HIV/AIDS' provided insights into what African men are saying about masculinity and the role that men play in supporting the sexual health and rights agenda. Aernout Zevenbegen made the case for engaging the patriarchs in the process of dismantling patriarchy. From long distance truck drivers who purchase sex across borders, to men engaged in informal labour, Zevenbegen stressed the need to expand our focus and reach where sexuality education is concerned. For example, at a training held with Jua Kali workers in Nairobi, in 2001, when asked why they did not use condoms, several men responded that it was their task as men to 'plant [their] seeds in as many pots as [they] can.' Most interesting, however, was the progressive suggestion that came from a group in Botswana to expand the ABC campaign to include a 'D': 'Abstain, Be faithful, Use a condom, and Do it yourself!' Were it not for conservative religious fundamentalists, the promotion of masturbation could go a long way in supporting the HIV/AIDS prevention agenda in Africa.
Holo Machonda spoke about the Young Men and Equal Partners (YMEP) programme, which works with men in Zambia, Uganda, Tanzania and Kenya to mobilise their communities to respond to sexual and reproductive health challenges in partnership with women. Because of misguided masculinity and male polarised power, men are at the centre of most sexual and reproductive health problems, Machonda argues. So YMEP is promoting the ideology that 'Men of quality are not afraid of equality.'
A presentation on 'Deconstructing and harnessing the 'trophy hunting mentality' amongst male university students in the fight against HIV/AIDS' highlighted the need to conduct similar research in academic institutions in other parts of the continent. Nelson Muparamoto showed how 'trophy hunting', 'one day internationals' or 'ODI's', 'test matches' and 'territorial marking' all play a role in constructing the kind of misguided masculinity that makes it difficult to promote a sustainable sexual health and rights agenda in academic institutions.
Sunday Akoh, coordinator of the Female Condom Project coordinator of Society for Family Health (SFH), looked at the role that men play, and should be encouraged to play, in promoting the use of the female condom in Africa. Akoh spoke about lessons learned promoting this project in Nigeria's oil-rich Delta State, where there is the common belief that 'All die na die', which in pidgin English means 'All men must die one way or another.' This makes HIV/AIDS prevention programming quite difficult. Promoting the use of the female condom is one way to ensure that women have more control over their sexual health. But by calling it the 'female' condom, says Akoh, it has been made a women's affair, making it more difficult to engage men in its promotion. Nevertheless, the project has enjoyed successes in Nigeria; as more men engage in the 'female condom' promotion campaign, more and more women are beginning to use it. Cost and accessibility have been a huge impediment in other countries, but a pack of two female condoms costs about US$0.25 in Nigeria, compared with US$2 for just one female condom in Kenya.
DISABILITIES & SEXUALITY
Efforts to mainstream previously neglected issues, such as sexuality as it relates to people with disabilities, are underway. Speakers Toyin Aderemi and Nancy Nteere shed light on the long journey to ensuring that people with disabilities in Africa can enjoy their sexuality and have access to adequate and relevant sexual and reproductive health information and services. The misconception that people with disabilities are asexual is one of the greatest barriers preventing us from addressing their SRH needs. About 10 per cent of Kenya's population of 36 million are people living with disabilities; the National AIDS Control Council (NACC) estimates that 10 per cent of them are also living with HIV/AIDS. This means that close to half a million people with disabilities have little or no access to the SRH information and services they need to live healthy and fulfilling lives. As Aderemi quoted, 'If you don't hear the cry of your brother or sister, aren't you the one with the disability?'
SAFE ABORTION: KENYA & ETHIOPIA
Kenya has one of the most restrictive abortion laws in Africa and the world, says Dr Nehemiah Kimathi, IPPF's Safe Motherhood technical advisor, who moderated a session on 'Legal abortion and politics of choice: Impact on HIV/AIDS'. The language being proposed in the draft constitution is even more retrogressive. A clause stating that 'life begins at conception' criminalises any form of abortion, including in situations of rape, or where the pregnancy might put the mother's life in danger. Kimathi says this means the country is 'making safe abortion illegal, and unsafe abortion legal.'
Research by the Centre for Reproductive Rights suggests that over 300,000 abortions are performed each year, and more than 21,000 women are admitted to hospitals annually for complications from unsafe abortions. The actual numbers are thought to be much higher; these are difficult to document because of the clandestine nature of many of these procedures outside of medical facilities. There are only 5,000 doctors in Kenya properly trained to provide abortions; just 300 are trained in providing second trimester abortions. With 30-40 per cent of maternal deaths in Kenya caused by complications from unsafe abortions, it's time we face reality and provide the necessary services. It is in the government's interests to ensure that women have access to safe abortion - the cost of unsafe abortion is much higher. Furthermore, unsafe abortions remain a problem of the poor; safe abortions are available in Kenya for anyone that can afford them.
Ethiopia has made some progress on abortion law, but legal reform needs to be complemented with sensitisation and awareness raising efforts and the provision of proper training for mid and high-level health care providers. Jemilla Abdi's research suggests that despite cultural and religious beliefs, those who had received training understood the need for, and were more likely to provide safe abortions without stigmatising or discriminating against their patients.
Dr Kimathi encouraged partners to advocate for the provision of safe abortion across the continent, recognising that it took Nepal 30 years to go from strict abortion law, to abortion on demand. He noted that, 'there is nowhere in the world where restrictive laws have reduced the number of abortions.' As an Ethiopian gynaecologist who attended the session asked, 'Why should Africans adhere to the archaic laws we inherited from our colonisers when they are now providing legal and safe abortions to their own women?'
EVEN IN THE SPIRIT WORLD PATRIARCHY RULES
The spirit spouse phenomenon continues to intrigue various segments of society in Africa and beyond. Despite the significant role that spirituality often plays in the lives of many people, little has been done to unpack its intersectionality with other issues such as sexuality. The conference was pioneering in including Eno Blankson Ikpe's session on the 'Spirit spouse in the belief system of Nigerian peoples: Implications for sexual health and sexual rights'. The phenomenon 'constitutes a binding marriage between a spirit woman or man to a human woman or man...' Research indicates that more women than men claimed to have been party to the phenomenon. The jury is still out on whether the occurrence is a reality, or merely the product of sexual fantasy.
Nevertheless, it was clear that it presents critical ramifications for sexuality, sexual health and rights; the human spouse has no control or say as to when or how the sexual relations take place. This affects the psychological well-being of the non-consenting partner and has implications on how they relate to their human partners. The occurrence also leads to risky sexual behaviour ,as the spirit spouse can control the human partner and make them have multiple sexual partners. This heightens exposure to sexually transmitted infections including HIV/AIDS and is a matter that warrants further research. There is also an intersection between religion, spirituality and sexuality. Unfortunately, this belief system is being used by men, who claim that they are seduced by spirits who manifest as sexy women, raising the question whether patriarchy rules even in the spirit world!
The session raised several questions for further investigation: Do all spirits spouses have a gender identity? Are there any queer people who say they have spirit spouses? To what extent is this belief system being used as a coping mechanism in the age of HIV/AIDS?
REDEFINING FEMINISM: NO IFS, NO ANDS & BUTS
Discussions on redefining feminism brought to the fore questions that continue to beleaguer the feminist movement. Essentially, feminism is about politics and hence power - understanding power, which means questioning the structures that keep women subjugated, then redefining and claiming them. Naming yourself feminist is a political statement that is defined by various factors including but not limited to gender. There are different schools of thought on feminism but this doesn't take away from the essence of what feminism is or what a feminist should be.
The Charter of Feminist Principles for African Feminists provides insights on what it means when we say 'no ifs, no ands and buts': That 'challenging patriarchy effectively as women or in the name of women means one has to understand the totality of oppressive and exploitative relations that not only affect African women but also that relate to other forms of oppression and exploitation. This is because they mutually support each other.'
A powerful way of making/exploring these connections comes from the sharing of various experiences. Participants were stunned by the sentiments expressed by a woman member of the Pan African parliament who said 'we are not here to hear your stories.' Yet her views echoed those severally expressed by women members of parliament in the course of the conference, especially on the rights of sexual minorities: 'If we support some of these issues you are talking about we will lose our jobs.'
This brings to the fore a critical point that the women's and feminist movement must confront regarding women's representation in key decision-making spaces on the continent. Numbers are important but substance counts more if any inroads are to be made in realising gender equality, equity and women's empowerment.
ROOM FOR IMPROVEMENT
For a conference that sought to interrogate diverse issues - such as vulnerabilities, gender, masculinity, positive sexuality and sexual pleasure - as fundamental to resolving the disease burden of HIV/AIDS on Africans, much work still needs to be done to ensure that it is inclusive and representative of a diverse range of constituencies.
For example, participation by non-Anglophone Africans needs to be better accommodated and integrated, since the HIV/AIDS struggle is one that knows no borders. To rephrase a quote by Eugene McCarthy, the 'linguistic and/or cultural differences in Africa should not separate us from each other, but rather linguistic and/or cultural diversity should be a platform to bring about collective strength as Africa charts a new path on sexuality, sexual health and rights matters on the continent.
While there was greater diversity among participants in terms of constituencies represented, the same considerations need to be made when selecting panelists, as the majority of presenters were men. To address the patriarchy at this conference, more women's rights activists and African feminists need to claim this space and be encouraged to respond when the next call for papers is launched.
The conference significantly profiled MSM sexual health and rights issues but the same was not true for women who have sex with women (WSWs). Given that many WSW in Africa are also, or have been, in heterosexual relationships, whether by choice or circumstance, the misconception that queer women are not as vulnerable to STIs, HIV/AIDS, and unwanted pregnancies, needs to be dispelled if we are to address the SRH needs of all people. The provision of safe sex information and services for queer women in Africa needs to be prioritised as we move forward. The same is true for intersex issues, which continued to be left at the margins of many of the discussions held at this conference.
Although we acknowledge the importance of grounding activism and policy development in evidence-based research, much of the work presented at this conference further emphasised the fact that the majority of scientific research being done on people and communities is still too quantitative, inaccessible, and often does not go beyond high-level conferences where the majority of research participants would never even have the opportunity to attend.
Ethical research practices must therefore be promoted to ensure that scientists and other researchers are held accountable to the people they claim to be performing research for. Otherwise, these and other conferences will continue to be nothing but high level 'talk shops' where individuals and institutions get to show off their research findings, show off fancy power point presentations, and deliberate on the next piece of research that needs to be done to fill the knowledge gap.
The next conference will be held in Egypt in 2012 with its overarching theme being on 'Culture and Sexuality'. Given that this contentious subject has far reaching implications for sexuality, sexual health and rights, it is critical for the conference and organisers to reflect on of the outcomes of this conference and what we need to build on to affirm that sexuality is an integral part of all persons, with freedom to express that in any form without coercion, fear, harm or violations, with people able to make informed decisions about their sexuality, including their sexual relations that is responsible, and whether to connect sexual activity with reproduction or not.'
Zawadi Nyong'o is the author of 'When I Dare to Be Powerful', published by Akina Mama wa Afrika. Kavinya Makau is acting progam officer, HIV/AIDS with Urgent Action Fund-Africa.
 Having sex with as many women as possible in order to 'display' them as hunting trophies.
 Similar to friendly cricket matches, this term is used by Zimbabwean university students to describe casual sexual relationships.
 Like cricket tournaments this term is used to describe relationships that require a little more emotional involvement than ODI's.
 This is when a man intentionally impregnates a woman in order to mark his territory.