'The rights of women have always been overlooked': How power dynamics fuel the spread of HIV

Unhealthy power dynamics in relationships — including polygamy — are destructive and fuel the spread of HIV.

Additionally, uneven power dynamics in intimate relationships diminish women’s ability to exercise their agency.

This is according to HIV/Aids activist Nonhlanhla Msimango, who was speaking at the Fourways-based nonprofit Witkoppen Clinic ahead of World Aids Day, which takes place on December 1.

“There are so many women who are knowingly sharing a man who does as he pleases. If he wants to have sex or [wants to have] children you can’t say no to him because you feel obliged.

“In such a relationship, if one is sick, we are all sick. You can’t tell him to use protection. It’s so sad. The rights of women have always been overlooked,” Msimango said.

She said the constant pressure on women by society to be submissive is one of the reasons why many die in silence.

“It spreads quickly, it becomes a cycle. Institutions like polygamy make women vulnerable; these are some of the cultural practices that should be collapsed,” she said.

She said the conversation around HIV should not be laid to rest. One of the reasons for the increase is that young women are being infected with the HIV virus by older men.

“Most people who live with the disease are in the closet. It’s not always easy for a person to make a decision about their health,” Msimango said.

Another panellist at the event was the clinic's executive director, Dr Jean Bassett. She emphasised that communities needed to be active in the fight against blessers.

“There are two areas in which communities can make a significant difference, firstly by addressing the impact of a blesser and blessee relationship. These complex relationships put young girls in dangerous situations. Another one is by addressing the issue of stigma,” she said.

An estimated one in five South Africans with HIV are unaware of their status, she added.

Ten times the number of adolescents aged 15-19 are being treated for HIV compared with 2010, but fewer than half of young South Africans who present for HIV care go on to initiate antiretroviral therapy, Bassett said.

She said people test for different reasons and we must find innovative solutions to accommodate them. “The self-screening kits are an effective way of addressing issues of access, stigma and confidentiality that are often barriers to testing.”

Self-screening is when a person collects their own blood or oral fluid and performs a rapid diagnostic test and interprets the result themselves. With a 99.7% accuracy rate, the test takes a maximum of 15 minutes to determine a result.

“We’ve had a positive response from members of the community, with many asking to take kits home to loved ones who are reluctant to go to a clinic for testing. While we are not offering this currently, we are looking at how we can reach more people who need this service,” Bassett said.  

Bassett said in the past two months, a 100% initiation of antiretroviral treatment for patients who have screened positive using the self-screening kits has been witnessed.

Part of the conversation was around how living with HIV has changed over the years, how it is now no longer a death sentence and life expectancy is the same as that of a healthy person if on the right medication.