Tag Archives: HIV/AIDS

Homophobic Policies in Botswana

29 Oct

When I was living in Botswana, every citizen and expatriate knew the laws on homosexuality: it is illegal to have homosexual sex. This law was rarely enforced. 

Now, the government is calling for a campaign against gay men and sex workers in the country, in an attempt to curb the HIV infection rate. Suspected gay men and sex workers will now be arrested and detained, while foreigners of these groups can be detained and/or deported. Read the full story here

I am infuriated by this so-called “HIV prevention strategy.” I truly loved living in Botswana and was aware of many injustices and discriminatory policies, but this is the worst. Not only does this violate the Constitution of Botswana, but it is simply not a legitimate strategy for reducing the infection rates of HIV. While the prevalence of HIV/AIDS among sex workers is high, arresting them in certainly not the answer. Prostitution in Botswana is highest in the refugee camp and amongst the most vulnerable groups, and the government should be addressing the underlying issues that lead to prostitution – as well as the severe gender inequality that leads to women (especially sex workers) to be disempowered to insist on condom use. Furthermore, the prevalence rate among men who have sex with men is significantly lower than the national average (9% vs. 17.6%). 

I am absolutely disgusted by the government of Botswana right now. I urge everyone to oppose Member of Parliament John Toto who made an anti-gay speech last week, and to encourage human rights groups like Ditshwanelo and BONELA to stand against this campaign. 

Reducing HIV infection rates through non-surgical circumcision

29 Jul

The World Health Organization (WHO) estimates that over 34 million people are currently infected with HIV/AIDS. More than two-thirds of all people living with HIV are in Sub-Saharan Africa. There are many initiatives working to reduce infection rates in Sub-Saharan African countries, and one of the new exciting innovations is a device for non-surgical male circumcision.

Male circumcision reduces the likelihood of HIV transmission by approximately 60% when engaging in vaginal sex (WHO, 2013). However, the surgical procedure is painful and uncomfortable for men, and is said to reduce sexual pleasure. To increase the amount of voluntary medical male circumcision (VMMC), the WHO has prequalified PrePex, a device for non-surgical male circumcision in May of this year.

For the procedure, an inner ring and an elastic ring are placed on the penis by a PrePex operator. The inner ring keeps the foreskin from retracting, and the elastic ring gently compresses the foreskin to stop the flow of blood so that it loses sensation and dries out. This is a usually painless procedure, and the man returns seven days later to have the dead foreskin and the device removed.

PrePex does not require anesthesia or stitches, which means that medical workers other than doctors (i.e. nurses or traditional health workers) can be trained to do the procedure. Anyone who completes a three-day PrePex certification programme can be a PrePex operator. Although it is up to each country to develop their own policies on who can become a PrePex operator, technically it does not have to be a medical practitioner. This means that traditional circumcisers (who rarely have formal medical training) could potentially be taught to be PrePex operators. This has the potential to reduce the amount of deaths and complications due to infections from improper surgical circumcisions. PrePex is also safer and faster than the traditional surgical method and significantly reduces pain and discomfort, which means that men are more likely to voluntarily undergo the procedure.

There are also some downsides to PrePex. The device needs to be worn for a week and requires two visits to a Prepex operator (one for placement and a second for the removal). The healing time from the procedure is 8 weeks (2 weeks longer than surgical circumcision) during which the man cannot have sex. Additionally, the device has only been prequalified for men over 18 years or older (although trials for boys ages 10 to 17 are in progress).

The biggest downfall of circumcision is that it can sometimes give a false sense of security, reducing the usage of condoms. It is vital that any male circumcision be just part of a comprehensive HIV prevention package, which includes education about safer sex procedures, the distribution and education of condoms and HIV testing and counseling.

If devices such as PrePex become popular and easily accessible, there is great potential to increase the amount of VMMC and hopefully reducing HIV infection rates.

Gender and Health Workshop

3 Dec

This week Gantsi Craft hosted a gender and health workshop in collaboration with Letloa Health (another branch in the Kuru Family of Organizations). The aims of the workshop were to raise awareness and encourage open discussion on health and gender issues. What made this workshop unique compared to workshops in the past, was that it was held with both men and women.

The first day we had officers from the Ghanzi Clinic to come facilitate a session on family planning. The participants seemed really engaged and asked questions about different forms of contraception. It was particularly encouraging to see men be curious and ask questions about contraceptives that are used by women (the IUD had the most interest and questions).

The Ghanzi Clinic officer then demonstrated how to properly use a female condom, which got a ton of giggles and awkward faces from our participants – it reminded me of a grade six health class! But that was nothing compared to when she demonstrated how to properly use a male condom – by using a huge dildo.

As funny as it was to see all of the awkward reactions from participants, it highlighted how important workshops such as these are. Since sex and gender are not openly talked about, it is so important to have workshops where people can gain information, and most importantly, ask questions and generate discussions.

The most useful dialogue came on the second day. We did an exercise where the facilitator would read a statement, then participants would stand by one of the following signs: Strong Agree, Agree, Disagree, or Strongly Disagree. There was often a very clear gender divide on some of the statements, such as “It is harder to be a woman in this world.” We discussed every statement, and it was really valuable to have both men and women explain what they feel.

Overall, I was really happy with the workshop – it felt like I had finally done something that was actually in my mandate! Now I have my fingers crossed that we will get funding to do these workshops in all of the settlements we work with.

New HIV law in Canada: Too Strict or Too Lenient?

7 Nov

This article was originally published by the International Women’s Initiative Survivors’ Blog.

A court ruling in 1998 stated that it was a crime for HIV carriers in Canada to not reveal their status to a sexual partner if there was a significant risk of transmission. Last month, the Supreme Court of Canada updated this law. The Supreme Court ruled that people with low levels of HIV do not need to disclose their condition to sexual partners if they use condoms. This was decided because “the realistic possibility of transmission of HIV is negated” when the carrier has a low viral load and a condom is used. In all other situations, HIV carriers must disclose their status to their partner. HIV carriers who do not meet these conditions and do not tell their partners can be charged with aggravated and sexual assault. 

To read the rest of my post, please go here

 

The High Incidence Rate of HIV in Botswana

31 Oct

Botswana is an upper-middle income country with a strong push for education from the government. All students can attend a public, or government sponsored, school until Form 3 (equivalent of Grade 10) and then they write examinations. Students with passing grades are then sponsored by the government to go to Senior Secondary School for Form 4 and Form 5. Students may then apply to attend the University of Botswana, and successful applicants are sponsored by the government. The Government of Botswana spends 8.9% of its GDP on education (compared to 4.9% in Canada).

So why does this educated country with a strong economy have the second highest HIV prevalence rate in the world? Even after both private and public sector attempts to educate the population and mitigate the spread of the disease, why is the incidence rate of new infections a staggering 2.9%? I asked “In your opinion, why does Botswana still have such a high HIV infection rate?” to coworkers, friends, and acquaintances. I tried to ask a mixture of both men and women, but I only felt comfortable asking a select few men, so only 3 of the 11 responses are from men. These are the answers I received:

  • “Our culture promotes cheating.”
  • “People, men especially, don’t feel guilty about cheating.”
  • “It’s almost like people have gotten so used to it that they’re proud of it.”
  • “Men rely on women to get tested – if their partner is negative, they assume that they are also negative. If their partner is positive, they just assume that they are positive as well.”
  • “The free condoms that the government gives out are crappy condoms.”
  • “Men don’t like wearing condoms.”
  • “Men take off the condom in the middle of sex.”
  • “Men are smooth-talkers and try to convince you to have sex with them because they don’t have HIV. If you ask them to go to the clinic, then they will just stop talking to you.”
  • “People will use a condom when they are having affairs, but they think that they don’t have to use one when they have sex with their main partner.”
  • “If a woman asks her boyfriend or husband to use a condom, then he will assume that it is because she is cheating on him. So she doesn’t ask because she is afraid she will be beaten.”
  • “Even if you go to the clinic with your partner, the test is 3 months old, so one of you might be positive and you wouldn’t know. Then you have sex with your partner and get infected,” (in Botswana, the HIV test given at clinics tests for the antibodies not the actual virus, which generally take about 3 months to become present in the blood stream).

The two trends I noticed in the answers were: people have multiple sexual partners, and women do not feel safe to negotiate safe sex. I have been told that both of these are “cultural”. Are they cultural, or is that just an excuse to continue the behaviour? How can this mindset (or culture, if you buy that) be changed?

I don’t have any of the answers, but I look forward to discussing this issue, among others, next week. I have the opportunity to represent Gantsi Craft at the forum for Reinvigorating the Gender Movement in Botswana. This national forum is a chance for organizations across the country to discuss and collaborate gender issues within the country. I am hoping to come away with a greater understanding of the issues facing Botswana and ideas on how to facilitate gender and HIV workshops within the producer settlements.

*Statistics on Education Expenditures from the CIA World Factbook

Breastfeeding and the Vertical Transmission of HIV in Botswana

27 Sep

I originally wrote this blog for the International Women’s Initiative

HIV/AIDS is one of the most significant development challenges facing Botswana, a sparsely populated country in southern Africa. The prevalence of HIV/AIDS in Botswana is nearly 25% among adults, which puts Botswana as the second highest HIV/AIDS prevalent country in the world. The virus is spread mainly through heterosexual transmission among adolescents and adults and vertical transmission from mother-to-child.

The government of Botswana has put several measures in place to mitigate the spread of HIV. Particular focus has been put on reducing the new infections of infants through vertical transmission. Antiretrovirals (ARVs) are provided to women from when they are seven months pregnant, through childbirth and until they stop breastfeeding. However, there is still a lot of controversy surrounding HIV-positive mothers and breastfeeding, especially in Botswana.

Please go here to read the rest of this article.