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Anna Miti is a broadcast journalist and 2015 AVAC Advocacy Fellow. This post first appeared on her personal blog.
That's my new mantra after attending the recently held Zimbabwean feminists forum... my body my politics. Since time immemorial women's bodies have been subject to governance by patriarchy. In biblical times women who were on their periods were deemed unclean and could not enter the temple. They were supposed to cover the hair in the temple. If they had make-up on they were deemed to be “harlots”. Women were taught to be embarrassed about their bodies, to “cover-up” and to not enjoy sex. In some places in Africa female genital mutilation is widely practised and we still teach our girls to be ashamed of their sexuality. In fact, there is a common notion that women never say yes to sex, and even if they mean yes they still say no. So any man worth his salt will still have sex with a woman even if she does not say yes.
All these issues have contributed to the hindrance of young women's access to sexual and reproductive health and HIV services in general. Young women seeking sexual and reproductive health services are shamed at health centres, being asked or told to keep their legs closed rather than seek contraceptives. Or shamed for seeking treatment for sexually transmitted infections. Society fails to realise that if young women can barely admit to having sex, expecting them to be able to negotiate for safer sex is definately asking for too much. For those who do dare to say yes to sex, their male partners are reluctant to use condoms and often times flatly refuse to use them. The myths and misconceptions about the female condom, coupled with the same issues of male cooperation further complicates issues. In the mean time young women are twice as likely to become infected with HIV than their male counterparts. The implication of this is that the same young women will go on to have babies who will also end up with HIV. Even with the advances in treatment, HIV/AIDS still remains a huge public health concern. The National AIDS Council of Zimbabwe statistics puts ART coverage for paediatrics at less than 50 percent and at about 78 percent for adults. As our global goal of zero new infections by 2030 go, empowering young women is one of the best ways of getting to that zero.
Movement
We need a movement for young women to make them aware of themselves and to open up to the challenge of taking charge of their own health. We have seen these campaigns before and South Africa is already making strides with the ZAZI – know your strength campaign. We need to get to a situation where a young woman can say no to sex that puts her health at risk and we need to teach young men to be able to accept that. It would be a great world, ideal in fact, where a young woman can whip out a condom and demand that the male partner uses it, and the young men actually follow through and have safer sex. It might be a long shot though, rolling back centuries of patriarchy in one swift movement. We need something that can make them shout my- body my politics-and actually mean it and follow it through. In reality however, we need to tamper that strong push with practical ways of making an impact on young women's lives.
Control
Whilst we are building confidence in our young women and bringing our young men up to speed we need practical ways, like crutches to use on our way to the ideal world. We have new prevention technologies that are in the pipeline and those that have been proven to work. For example pre-exposure prophylaxis (PrEP) has been proven to be effective if used correctly and consistently. This is a pill that can be taken daily to reduce chances of getting infected with HIV. The advantage of PrEP is that it can be used discreetly without the need for the young woman to negotiate with her partner. Other countries like the US and closer to home in South Africa are moving forward, given the scientific research around PrEP, to ensure its availability. In Zimbabwe we need to create awareness around PrEP with a view for creating demand for it.
In addition researches have just concluded a microbicides trial in Zimbabwe and results are expected by the end of the year, while the HIV vaccine is undergoing research. All these are useful tools that young women can use, to empower themselves for their own health. It can be done, considering that male medical circumcision was incorporated into the public health response, offering a 60 percent reduction in the chances of HIV infection whilst PrEP has been shown to be more than 80 percent efficacy in some trials. Granted circumcision is cheaper, but the benefits of empowering young women are immense, preventing HIV infection in young women closes the tap on paediatric HIV and eventually on HIV related deaths.
As a world we have been failing the young women, leaving them vulnerable through our attitudes, and turning a blind eye on some home truths about young people and sexuality. I feel it is high time we turn back the time and stem the flow of new infections by actively pursuing options for young women. No I am not saying lets tell our young women to go forth and have sex... but sex is happening in young people whether we like it or not. All I am saying is at least let it be safer and let them have options for prevention for their health. The ball is in our court...