Traditional practices in Malawi that had disappeared such as 'fish for sex' are gradually resurfacing, much to the alarm of those working on the national HIV response.
'Fish for sex' is transactional sex in which girls and women offer sex services to fishermen in exchange for fish. Another such traditional practice 'kupimbira' allows a poor family to receive a loan or livestock in exchange for daughters of any age (the 2012 Malawi Human Rights Commission report).
These harmful cultural practices are regaining ground despite the childcare, protection and justice act passed by parliament in 2010. This prohibits a child from any social or customary practice that is harmful to the health or general development of a child.
Cultural practices impact HIV response
Faith Kalonga is the national coordinator for the association of young people living with HIV, and has expressed concern over recent reports about these practices. Faith says: "It's quite unfortunate because the cultural practices are largely affecting girls and young women ... hence posing a great threat to the national response to HIV and AIDS."
Reports about the practices surfaced during the joint annual review of the national response to HIV and AIDS for 2014-15 held in October 2015 in Lilongwe. The evidence came from field visits conducted in 12 of the country's 28 districts in September 2015 by a team of representatives from the Malawi Partnership Forum, National AIDS Commission and HIV and AIDS Donor Group.
The visits took place to appreciate progress, challenges and prospects for scaling up the national response to the epidemic. However, it became clear that harmful cultural practices - having previously died down following initiatives by non-governmental organisations (NGOs), government and traditional leaders - are resurfacing.
Annie Banda, executive director for a coalition of women living with HIV and AIDS, presented the report on behalf of the field team. She reported the finding that kupimbira has resurfaced in Karonga district and fish for sex has resurfaced in the country's fishing districts. This was possibly due to the lack of exit strategies by NGOs working in those communities.
Implications for the national HIV response
The harmful cultural practices largely affect young people, on which the country's future depends and - if not urgently stopped - pose a great threat to the national HIV response. Two-thirds of the county's population is below 25 years old and vulnerable to sexually transmitted infections, including HIV (2014 Malawi Youth Data Sheet).
According to the 2003-2010 publications by the National Statistical Office, over 60 percent of Malawians are estimated to be earning less than a dollar per day, and poverty is an inevitable factor in the spread of these harmful cultural practices and in HIV. They will likely overshadow the gains so far made between 2004 and 2014 in which new HIV infections dropped from 85,000 to 42,000 (National AIDS Commission).
That is unless Malawi's 2015-2020 national strategic plan for HIV and AIDS (NSP), which has prioritised addressing gender inequalities and gender-based violence as key drivers of HIV, can make a difference. To do so it will need to tackle the fact that 13 percent of women aged 15-49 are living with HIV, compared to 8 percent of men (Malawi Population Data Sheet 2012).
Human rights and HIV
The Malawi Human Rights Commission 2012 Report observes that one of the major challenges for Malawi is the need to comprehensively and effectively address human rights within the national response to HIV and AIDS, recognising human rights abuses as a cause for the spread of the epidemic.
The 2010 Malawi Demographic Health Survey says 17.8 percent of women aged 15-19 have experienced sexual violence. It further reveals that 26.8 percent of girls were 14 years old or younger when they were first victimised and that 15 percent of women reported that their first sexual intercourse was forced, in other words they were raped. The survey also says that 41 percent of women reported being victims of physical or sexual violence.
The resurfacing of harmful practices such as kupimbira and fish for sex indicates that the human rights discourse is of great relevance to girls and women who are vulnerable to HIV. The big question for Malawi is whether the integration of human rights within the national response to HIV and AIDS can bring to an end to these abuses that help fuel the spread of the epidemic.