TALKING ABOUT AIDS IN OUR SISTER KINGDOM

AIDS LIFELINE was privileged to be on hand in Maseru when the health stakeholders of Lesotho launched a new initiative that seeks to get to the heart of efforts to contain AIDS in a country whose AIDS statistics and situations are quite like Swaziland’s.
A new study confirmed what Lesotho’s health sector had long suspected – that the driving force behind the spread of HIV in the small landlocked country is multiple concurrent partners (MCP).  But how do we help sexually active men and women to actually change their behaviour to avoid risk of contagion?  A new awareness campaign commenced last week to encourage people to talk about what they already know and put knowledge into action.
“The levels of awareness about AIDS have been well established, with 70% of men and 78% of women identifying condom use as a means of preventing HIV infection and 76% of men and 82% of women indicating limiting sex to one partner as a means of protection.  However, the levels of adequate practical knowledge, skills and translating the knowledge into practice are still a challenge,” reports Multiple Concurrent Partners, Sex and HIV and AIDS in Lesotho, one of two studies on the subject whose findings are part of a “National Behaviour Change Communication Strategy Through 2013” began this past week.
“Yes, people know about HIV prevention but they are afraid to talk about it, so mothers do not discuss the practical application of their knowledge with their daughters, or husbands to wives.  The process of changing behaviour begins with communication,” said Ma-‘Neheng Ninie Mopeli, Director of Services for the National AIDS Commission Lesotho, which partnered on the behaviour change strategy with UNAIDS report with the Ministry of Health and Social Welfare.
“It is a question of educating people to be open about a disease that threatens them.  We need a national discussion made up of thousands of individual discussions,” said Bakoena Chele, founder of the Lesotho Network of People Living with HIV/AIDS (LENEPWHA).
Open and frank discussion cannot start soon enough.  24% of 15 to 49 year-olds are HIV positive.  Lesotho’s AIDS-driven death rate of 22.2 persons per annum per 1000 people ranks the country third in the world for mortalities.
Amongst the studies’ findings is that sexual relations between younger girls and men who are six or more years older is the major entry point for HIV into the younger generation.  Infected girls then pass the virus onto their male age-mate partners.
“Multiple concurrent sexual relationships are a key driver of the HIV epidemic in Lesotho.  There needs to be more focus on fidelity among married partners,” noted the study.
It is not promiscuity but poverty and other factors that drive the prevalence of MCPs.
“Financial neglect, along with domestic discord, physical and emotional abuse were mentioned as some of the reasons for seeking other partners,” said the report.
Marriage is no protection against HIV contagion if the husband has sexual partners outside the marriage.
infection
“Regular partnerships and marriage are a major source of infection to most women,” said the report, which indicated that the need to emphasise faithfulness for anti-AIDS efforts to succeed.
A widespread disuse of condoms, the study indicated, stems from men’s defensiveness toward accusations of infidelity.
“Condoms are perceived as being for people who do not trust each other.  It is critical to help people understand that condoms are used even in trusting relationships,” the report says.
“Some men who have sex with women other than their wives feel if they wear a condom at home they will be admitting to their wives about their affairs,” said Chele.
“Having the data is the starting point.  We suspected that MCP is a major driver and now we know.  Now we have the process of getting the word out,” said Mopeli.
Major media organisations will be guided on the dissemination of the study this week, followed by segments of society such as sports organisations, faith-based groups, urban-base and youth groups. 
“Men need to talk to men – telling each other not to be ashamed to carry a condom – and women should talk to women about such things as being frank about sexual matters with their sisters, daughters and neighbours. Then we will bring those groups together.  People have always had knowledge but talk of sex and HIV/AIDS has always been taboo,” said Mopeli.
The next step is to ensure that services are in place to allow persons to apply their knowledge about AIDS prevention.
“Condoms and prevention counselling must be available and a clear understanding where they can be found,”  Mopeli said.
Having people speak amongst themselves about AIDS prevention will surmount such hurdles experienced by health motivators who now need permission from parents to speak to children about sexual matters.
reasons
“Having different group discussions is also important for cultural reasons.  It is inappropriate to discuss condom use and such matters with the elderly, but there are things they too much know,”  Mopeli said.
Mohau Mokoatsi, a programme officer for UNAIDS’s Lesotho operations, said respect for the nation’s cultural set-up is key to getting the word out on the dangers of MCP.
“We have revised our national strategy to incorporate chiefs and traditional leaders to inform them of the message.  It is these authority figures who will take the message to their subjects,” Mokoatsi said.
Getting people to talk to each other about AIDS will end the taboo on such discussions by making such talk commonplace and less embarrassing. 
In time, the people of Lesotho will learn that talking about something removes the mystery from a subject and will hopefully lead to a willingness to examine the way lives are led, and how to adapt for survival in the age of AIDS.
  

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