Written By: Marie-Claire Klassen
Malilapa Mate says that if you had seen her five months ago, she wouldn’t be the vivacious, smiling young mother she is today. When the twenty-one year old became pregnant two years ago, there was a problem—she had no husband. Without the security of marriage she faced discrimination and harassment in her community.
“Before I came to Help Lesotho I was hiding. I was afraid to go into town because I worried I might see one of my former schoolmates and face their judgment.” – Malilapa Mate
Help Lesotho, an organization working in the tiny ‘Mountain Kingdom’ of Lesotho, started a Young Mothers Program to empower women like Malilapa with the life skills they need to keep their babies AIDS free and promote a culture in which HIV/AIDS is no longer stigmatized.
The impetus for this initiative stems from the brutal effects HIV/AIDS has had on the Basotho nation. Lesotho currently has the third highest HIV/AIDS prevalence rate in the world. While the overall percentage of HIV positive individuals has dropped since 2003, when estimates were as high as 30%, Lesotho’s current rate of 23% has remained static since 2005. In 2007, the chief executive of the National AIDS commission, Keketso Sefeane, stated that AIDS had the potential to wipe out the Basotho nation.
One of the difficulties Lesotho and other developing nations face in the attempt to address the AIDS pandemic is the lack of holistic, gender focused programming. All too often HIV is perceived through two narrow paradigms: HIV as a moral issue and HIV as a health issue. The former views HIV as a consequence of sexual promiscuity and seeks to change behavior. The danger of this framework is that it ultimately perpetuates the stigmas and guilt surrounding the disease. The second perspective removes morality from the equation and views HIV as a health issue. The solution is more testing, more clinics, and more free antiretroviral drugs [ARVs]. While a medical approach is necessary, the reality that certain population groups continue to be disproportionately affected begs the question—why are they not seeking testing and treatment?
At its core, HIV/AIDS is a gender issue.
The reason why both of these approaches ultimately fall short is because women are disproportionally affected by HIV; in Lesotho women make up 60% of HIV positive adults. This stems from a number of factors including the prevalence of rape and the difficulties women face negotiating condom use. However, the problem is not just that more women are HIV positive but the added difficulties women face due to their gender and place in society. Now that the second generation of HIV children have reached adulthood, we have a generation of new mothers who never had mothers; as a consequence, many lack the life skills and confidence they need to keep their babies AIDS free and raise their children.
The gender perspective on the HIV pandemic shows us what the moral and health based approaches ultimately fail to address—the power structures cemented by society and culture that marginalize women and perpetuate the cycle of HIV transmission. These issues are the reason why Help Lesotho believes a gendered approach to HIV is necessary and why the Young Mothers Program is proving effective.
The gendered approach to HIV embedded in the Young Mothers Program addresses women’s needs as a whole person. Programming begins with psychosocial support, which builds confidence in young mothers – many of whom have experienced devastating abuse and trauma in their lives. Participants then move to breaking-down the stigma and discrimination they face at both individual and community levels. Once the young mothers have begun to heal and develop coping strategies, they are not only ready to receive knowledge about HIV/AIDS but are also eager to implement it into their own lives.
When we look at the issue of HIV/AIDS through the lens of gender, we are forced to recognize that the AIDS pandemic cannot be addressed in isolation, but requires holistic programming that considers the whole person within the context of her community. Ultimately, this framework is radically different from those that focus solely on behavior modification or ARV distribution.
This article is a revised edition of a piece originally published in Generation C Magazine
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