Mozambique: Wives Hide HIV as Stigma Undermines Progress on AIDS

In a busy Mozambique clinic, a 25-year-old mother says she won’t tell her estranged husband she has HIV for fear she will be blamed and beaten.

“Very often here women won’t tell their partners or ex-partners that they’re HIV-infected,” said Sifronia Filipe, an educator at the clinic where the mom is being treated for AIDS. “She is scared he will leave her or will tell the neighborhood and the neighbors will discriminate against her.”

It’s a scene oft repeated across sub-Saharan Africa, where young women account for a quarter of new HIV infections and where AIDS remains a devastating scourge. The problem is especially acute in southern nations like Mozambique, where 7 percent of all teenage girls are HIV positive. That number doubles to 15 percent by age 25, according to a report by the Joint United Nations Program on HIV/AIDS released last week.

“Some people, if they find out they’re HIV-positive, they will change hospitals or scratch out their test result on their medical records,” said Aleny Couto, head of the HIV program with the Mozambique government’s Ministry of Health. “We still have stigma in this country, which is still a very big obstacle.”

‘Youth Bulge’

It’s been three decades since AIDS began ravaging populations around the globe. While new infections have fallen to the lowest level this century and AIDS-related deaths are at a seven-year low, a “youth bulge” experienced by many countries with the highest HIV prevalence means that the number of young people living with HIV or at risk of becoming infected will increase in the next five years, the New York-based Population Council said last week.

A so-called Melbourne Declaration prepared for this week’s meeting affirms that stigma and discrimination “have no place in any effective response to HIV,” said Francoise Barre-Sinoussi, the conference’s co-chair, who was awarded a Nobel prize in 2008 for discovering HIV.

Stigma Sting

As the meeting opened yesterday, Barre-Sinoussi invited dozens of representatives of HIV research and advocacy groups to the stage as she paid her respects to the passengers and crew who died on board flight MH17 from Amsterdam to Kuala Lumpur. Former International AIDS Society President Joep Lange and his partner, Jacqueline van Tongeren, were among the dead.

“In sub-Saharan Africa, adolescent girls and young women are up to five times more likely to get HIV as young men, and HIV is the biggest killer among women of reproductive age in low- and middle-income countries,” said Michael Kirby, an HIV campaigner and Australia’s longest-serving judge, who also spoke at the opening ceremony.

Root Causes

“Gender-based violence, lack of legal protection and inequality fuel the spread among this highly vulnerable group, and stigma and discrimination are root causes of the inequality,” Kirby said in an e-mail.

An “unacceptably high” prevalence of HIV women from age 15 to 24 is seen in almost every country in eastern and southern Africa, UNAIDS said in the document, calling the data “stark and worrisome.”

Migrant laborers working in South African mines and their partners are among those at greatest risk of HIV. A job in the mines means living away for months in an area with an active sex industry, a 2012 study by the World Bank of mines, migration and HIV/AIDS in Southern Africa found.

A survey of more than 700 Mozambican miners working in neighboring South Africa found 75 percent who tested positive for HIV didn’t know their status. In the absence of routine sexual health screening, infections are often noted first in pregnant women attending antenatal clinics.

Whether it’s the male or the female who introduces HIV into a relationship, broaching the topic and treating the infection is often difficult, says José Enrique Zelaya Bonilla, director of UNAIDS in Mozambique.

“We have seen that if the man knows that he is HIV-positive only after the woman is known to be infected, she is deemed responsible,” Bonilla said. “That has other effects. For example, when the man dies, his family will take all the belongings from her.”

Bloomberg L.P.
HIV, AIDS, stigma and discrimination, HIV positive women, UNAIDS, teenage mothers, adolescent girls, gender based violence, migrant workers