By Matṧeliso Phulane
Gender inequality still remains as one of the critical barriers to fighting the high HIV/AIDS prevalence among young women and adolescent girls, and reduces their ability to cope with the epidemic.
This is according to the Lesotho Population-based HIV Impact Assessment (LePHIA) 2020 report which was handed over by the United States Ambassador Maria Brew over to the minister of health Semano Sekatle on Friday last week.
The report states that 80 percent of new infections are among adolescent girls and young women (AGYW) of the age of 15 to 34 and the infections are substantially higher than among males of the same age.
LePHIA 2020 is a household-based national survey among adults, defined as individuals aged 15 years and older. It was conducted between December 2019 and March 2020 to measure the impact of the national HIV response.
LePHIA 2020 was the second survey to estimate national HIV incidence and the national and district-level prevalence of HIV and viral load suppression. It offered HIV counselling and testing with return of results to the participants and collect information about the uptake of HIV care and treatment.
In an interview with theReporter this week the National Aids Commission (NAC) chief executive officer, Moleboheng Mothae has affirmed that gender inequality is one of the main factors leading to the new infections among AGYW.
She stated that gender inequality is brought by different barriers which include social and economic barriers. As a result, that denies young women and girls the power to negotiate safe sex and make decisions on how it should happen in a way that they feel free and satisfied.
“Economic barriers result from unemployment rate which is the main issue faced by young women and girls in Lesotho that persuade them to end up engaging into transactional sex with older men than their age.
“Transactional sex means that sexual relationship is based on the important factors such as giving and receiving gifts, money and other services. Therefore, the chances of negotiating safe sex especially if the man does not want it are very low, and that means high chances of HIV infection,” she said.
Adding to that, Mothae said the same barrier applies in a form of cohesion; either in politically or in organizations. That happens mostly in different organizations whereby majority of the managers are men, so they normally want to provide job to young girls as well as women through sex as a means of payment, she observed.
Mothae said when a girl or a woman seeks for the job she will rather take an offer despite infection risks they will face consequently.
Speaking of the social barriers, she explained that it is a norm that in most of the families’ sex is not openly discussed because most of the people grew up in a society whereby sex is something which parents should not discuss with children.
“That being the case, young girls will take wrong decisions from their colleagues or at school even though it won’t be in a right manner because teachers are also too consecutive about sex related topics,” she stressed.
“Apart from that, early child marriages also contribute because parents turn to ignore the fact that their children are too young age to get married. All they want to benefit is, bride price or wealth from that other family.
“Parents sometimes, let their children get married at early age because of the fear of embarrassment they will encounter from the community, and that lead children to engage in sexual practises without having a clear understanding about them,” Mothae said.
“Another barrier is the legal one, it consists of legal and social whereby sex work in general is not considered legal in the country. That means their human rights in particular are not reserved.
“They are subjected to gender-based violence, and sometimes denied their payment after sex. One of the main reason is that even the people who violate them know they cannot do anything because they that they cannot go court to explain that they got violated through being the sex workers,” Mothae added.
She said socially, Basotho do not want to change their mentalities and accept the sex workers because nobody will ever end it. She urged that who are already there should be given an opportunity to access HIV services since that will reduce new infections.
Mothae emphasised there are no statistics based on gender inequality yet but there is a target set globally.
NAC has developed the indicators which are clinical at the community level which will assist it to identify what kind was the cause or the results of the inequality.
She further said that NAC have already began to take initiative and working hard to make people aware of HIV/AIDS as well as preventions more than any other thing.
“HIV prevention is not just about prevention packages such Prep and condom. But it is about the presence of social enablers to assist those who access them, because their intake is very low,” Mothae observed.
She also indicated that community engagement will play a vital role to inform gender inequality issues so that partners could understand risks which result from unsafe sex negotiations.
She said the commission works hand in hand with organisations’ forums such as HIV/AIDS forum which consists of all sectors to address gender issues and HIV.
There is also the ministry of police, which will also focus on GBV reporting. Media is also part of the stakeholder with the role to disseminate information about HIV/AIDS. The ministry of health role will address gender issues but their role is to provide Prep and condoms.
Commenting on the matter, ’Marapelang Ntene who is a nurse working under the department of maternal and child health (MHC) at Motebang Hospital, Hlotse in Leribe district; said gender inequality is still a major concern which needs to be addressed among men.
Ntene said during the meetings with women the health workers always hear reports about challenges that women encounter with their spouses, adding that women always say men do not want to go to the clinic and access health services such as testing for HIV/AIDS.
“Married women always say that whenever they try to explain to their husbands the importance of HIV testing, they say that they have already tested through their wife’s results.
“Again, when they tell them to use condoms men always come up with excuses such as they cannot use condoms. Again they do not want to attend campaign services held by health workers which sensitize them about HIV/AIDS.
“Men also do not like to attend family planning services. They normally enforce their women to stop using them convincing them that they now want have a baby,” she enthused.
Ntene observed that in some cases men assault women when they decline to admit to sex giving an example of woman who was badly violated upon refusing to bow to sex demands.
“HIV infection will increase because of the rate at which women are being treated. Adolescent girls are also at higher risks of HV infection because they negotiate unsafe sex with older men, for exchange of money or gifts.
”Sometimes if they come from the poor family they are promised benefits such as to pay them bills and school fees. This means that, they may have less to say over their sexual health choices like using protection and end because of their age difference and fear that they might be denied such benefits,” Ntene suggested.
That, she continued, results in unwanted pregnancy which might end up in abortion.
Ntene noted that there are many adolescent girls at MCH department who have unprotected sex with older men who they fail to identify due to being threatened by those men.
She suggested that the solution to fight the HIV prevalence is to hold public gatherings, distribution of pamphlets carrying HIV/Aids messages and media reporting about the epidemic. She also advised for use of social media platforms in order to address youth, women and men about safe sex and sexual health rights.
During a recent two-day workshop held in Teyateyaneng there was a commitment to fight HIV increase through a simultaneous broadcasting about HIV/Aids on different radio stations, writing stories and production of live videos. It was decided that there will also be edutainment such as drama, host events in schools and organising debates.
The 2025 10-10-10 global target aims to end gender inequality and violence with less than 10 percent, end stigma and discrimination to people living with HIV/AIDS with less than 10 percent and also reduce harsh laws and policies faced by people living with HIV/AIDS.
