13 July 2012

Zimbabwe: Change or Perish


BEHAVIOURAL change is still a topical issue and the question that many continue to ask is whether people have changed their sexual behaviour or not?

At national level, I want to believe there is some behaviour change worth noting which has seen the HIV prevalence rate of HIV going down to 15 percent from 26 percent a decade ago.

Mary is a woman who lives in Harare's red light district. She said if she was financially secure, she would not sell her body for money. Mary said the push factor is so great that she finds herself bending over.

"I have been a commercial sex worker for a decade or so. I am afraid that in this line of business as one gets older, demand for your services diminishes. I have to make hay while the sun is still shining," said Mary.

Mary said in her quest to make as much money as she can she ended up throwing protection out of the window.

"As you know, he who pays the piper calls the tune. There are times when a man offers more in return for unprotected sex. Under such circumstances I do not have the power to say no," she said.

"Although I know all the risks from STIs to HIV infection, I do not have a choice because those are the dangers of the trade," she said.

Mary went on to say at one time she got pregnant since she had missed her quarterly Depo-provera jab.

"I found out when I started vomiting and took a pregnancy test. I was two months pregnant.

"I already have two kids as a single mother. I lost my husband to TB several years ago so I could not afford to have a another one. To make it worse, I did not even know who was responsible," she said.

Mary said that she later went on to have a back-street abortion which nearly cost her life.

"I was hospitalised for two weeks and was discharged when I was still frail. Despite close shave with death, I still have unprotected sex. I have, however, taken further precautions; I now have the norplant insert and I know I am safe for the next five years," confided Mary.

Women seem to bear the brunt of economic hardships more compared to their male counterparts. Rural women are not spared either.

Take Amai Chido (not her real name), for example. She is a married mother of five and lives in Chihota communal lands. Amai Chido swears that she's not a commercial sex worker, but now and again she is forced to pay in kind for the odd jobs done by men at her homestead in the absence of her husband.

"At one time our kitchen roof caved in and we had no roof over our heads and the rains were fast approaching," said Mai Chido.

The thatcher demanded US$30, which she promised to pay this at the end of last month when her husband came home.

"When my husband came home, he brought just enough money for the children's school fees. He told me the rentals had gone up so he was not able to save enough for any extras.

"I told him about the debt I had incurred on getting the roof fixed and he suggested that I sell one of our goats," said Mai Chido.

But buyers were hard to come by.

"The man threatened to pull down the roof if I did not pay up. I offered him the goat, but he turned it down unless I added some extras. That is how I ended up sleeping with someone who is not my husband," said Mai Chido.

But as if breaking her marriage vows was not bad enough, the man flatly refused to use protection, claiming condoms irritated him.

"I cannot even tell my husband about this. I am a lawfully married woman, my parents got a herd of cattle so I cannot be found to have bedded another man," she said.

"That is my secret with my maker," she said.

Mai Chido might be a poor rural woman struggling to make ends meet. But she is not alone in this predicament. Even professional women are sometimes forced by circumstances beyond their control to do the unthinkable in exchange for the elusive greenback.

These women have a different push factor but also end up having extra-marital affairs or just a one-night stand.

A career woman in the city said she ended up giving in to her supervisor's demands since she needed the extra cash that comes with travelling away from home.

"I work as a civil servant and my salary is public knowledge. I manage to send my children to college because of the travel that my job entails," she said.

The woman said she gets fairly generous travel and subsistence allowances whenever she travels to regional or international destinations.

"I am able to send my children to college, thanks to these travel and subsistence allowances. My supervisor openly says there are other women scrambling for such an opportunity, so it's up to one to dance to his tune or get lost.

"I end up sleeping with him when we are on tour because I need the moneys," she said, although she was quick to add that they used protection.

It would seem women are at the mercy of men when it comes to sex. This is true even in marriage.

Mr Oscar Mundida, the National Aids Council Behaviour Change Manager, says married men and women were had become the most at risk from HIV infection.

Speaking during a workshop for journalists in Kadoma last week, Mr Mundida said men who had an extra-marital affair first used condoms but as they got to know each other due care was discarded.

"In extra-marital affairs condoms are used in the early days. A false sense of trust creeps in and they discard condom use. It's that sense where people 'trust' each other and stop using condoms. This same man has a spouse at home," said Mr Mundida.

Mr Mundida said when the husband got home he still went on to have unprotected sex putting the wife at risk.

"The husband goes back home and behaves as if everything is normal. He cannot tell the wife that we they should start using protection. The wife would want to know why, so in the end he puts the wife at risk," he said.

Mr Mundida said he was surprised to find that some men even fight over sex workers.

"It is surprising to find men fighting over a commercial sex worker. You hear one shouting, 'that commercial sex worker is mine'," he said.

He wondered how one would get to own something that is in the public domain. "How one gets to own a 'company bicycle' is something I do not understand," he said.

Mr Mundida said behaviour change was called for as the country was still saddled with the HIV pandemic.

"Eighty percent of hospital admissions are due to HIV-related illnesses and the earlier people mend their ways, the better," he said.

Behaviour change is the key to taming the spread of HIV. Other programmes like the prevention from mother to child transmission, condom use, universal access and condom use may be complementary in my view but behaviour change can set a tide of change.

The One Love Campaign in 2009 to 2010 focused on being faithful to one partner and with this one would surely be protected against HIV infection. That will certainly work when both men and women to one faithful partner.

The HIV awareness message has reached all corners of the country and it is now by design that one sticks to one partner. One love is the way to go.


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