“I’m sorry miss but the test proves you are HIV positive.”
These life changing words echo in the ears of many faithful monogamous women who go in for what they thought was a routine health check up.
Most leave the doctor’s office in shock and disbelief unable to make sense of the test results.
They are not the only ones trying to make the head or tail of Botswana’s HIV test results.
For most Batswana men and women some of whom have never taken an HIV test, Botswana’s HIV statistics do not seem to make sense.
While it is generally believed that Batswana men are more promiscuous than Batswana women, national HIV/AIDS figures show that more Batswana women are infected with the HIV virus than their male counterparts.
In Botswana, women make up 57% of people living with HIV, and three quarters of young people infected in the country are young women aged 15-24.
Tebogo Gaseitseiwe from BONELA (Botswana Network on Ethics, Law & HIV/AIDS) offers an explanation based on a number of researches. She told Sunday Standard Lifestyle that, “in May 2019, Botswana released the National Relationship Study which stated that 37% women in Botswana have experienced some form of violence in their lifetime most of which occurring within intimate relationships. This is indicative of power disparities between men and women and has an implication on the spread of HIV. The third National Strategic Framework indicates that persons aged 15-24 were estimated to have contributed 34% of the total new infections in 2017 with females contributing a higher proportion (43%) than males (23%). NSF continues to state that key vulnerabilities exposing adolescents and young people especially girls and young women to HIV include early sexual debut, a high rate of multiple sexual partners, low levels of consistent condom use, intergenerational transactional sex and exposure to coerced sex are the major contributing factors to these numbers. A plethora of studies indicate that HIV prevalence and incidence among females is higher than males which could be attributed to amongst other factors, gendered vulnerabilities. In light of this evidence, HIV infection as access to treatment, care and support is negatively affected by gender dynamics thereby making it a disproportionately female problem.”
A number of research findings support Gaseitseiwe’s explanation that despite attempts to achieve gender equality, there are inherent differences that make women more vulnerable to abuse and discrimination. While most women are aware of basic information about AIDS and HIV, social, cultural and religious norms often render a woman unable to use that information to protect themselves from unprotected sex. Women who are economically dependent on men often find it difficult to remove themselves from relationships that carry major risks of HIV infection. Social norms about female sexuality make it very difficult for women and girls to protect themselves from HIV infections. Women and girls are often encouraged to remain uninformed about sexual matters and/or remain sexually passive. The expectations for sexual passivity in women makes it difficult for women to be an equal partner in deciding the terms of sexual activity, including negotiating safer sex practices. The power imbalance between men and women also translates into economic dependency for women. In most societies, men have greater control and access to productive resources.
Although our HIV programmes have contributed to the steady decline in rates of infection over the years, there is still a lot of room for improvement. The annual numbers of new cases are still measured in thousands, and tons of money is invested in awareness campaigns that do not seem to effectively reach target groups, especially those from the lower income group. With the odds stacked against women, protecting them from HIV infections still proves difficult. Abstinence before marriage and monogamy in every relationship works in theory, but in reality it is difficult to achieve, if not impossible. Women may feel pressured to stay in risky or abusive relationships with men because of the economic consequences.