Conveying Concerns: Media Coverage of Women and HIV/AIDS

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Title
Conveying Concerns:
Media Coverage of
Women and
HIV/AIDS
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Women and
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About Women's Edition

Women's Edition is a global activity of the Population Reference Bureau (PRB) that brings together senior
women editors and producers from influential media organizations around the world to examine and report
on issues affecting women's health and status. Women's Edition was launched in 1993 and is currently fund­
ed by the United States Agency for International Development (USAID) through the MEASURE Communication
project.

In 2000, Women's Edition members were selected from among a highly qualified group of applicants. The
group represented 10 countries, and their combined audiences number an estimated 25 million.
The mission of Women's Edition is to inform policy decisions through accurate and timely media coverage
that reflects women's needs and perspectives. By providing information to millions of women in develop­
ing countries on issues that affect them, Women's Edition also attempts to shape public discussion of the
problems and helps women make informed decisions on matters related to their livelihood.
The Women's Edition journalists meet twice each year for week-long seminars to examine reproductive
health and associated issues, to meet with experts, and to identify strategies for providing solid media
coverage of the topics. The Women's Edition seminar investigated the impact on women of HIV/AIDS.
Women's Edition members produced the programs and supplements in this collection following their par­
ticipation in the seminar. Coverage included pullout sections in newspapers, feature stories, news reports,
editorials, and talk shows.

Women's Edition also seeks to build institutional capability among media organizations. The journalists
share their experiences with colleagues through their local journalism associations. They also give presen­
tations at conferences and organize and lead training in topics they have dealt with at the seminars.

Women's Edition Members in 2000
Gabriela Adamesteanu, 22, Romania
Harikala Adhikary, "Milijuli," and Gorkhapatra, Nepal
Thais Aguilar, Servicio Especial para Noticias de la Mujer
(SEM), Costa Rica

Sarah Akrofi-Quarcoo, Ghana Radio News, Ghana
Broadcasting Corporation, and Daily Graphic, Ghana
Josefina (Pennie Azarcon) Dela Cruz, Sunday Inquirer
Magazine, Philippine Daily Inquirer, Philippines

Lemlem Bekele Woldemichael, Radio Ethiopia, Ethiopia
Judith Hadonou-Yovo, La Chaine 2, Benin
Eunice N. Mathu, Parents, Kenya

Sathya Saran, Femina, India

Nawal Sayed Mostafa, El Akhbar, Egypt
Sara Adkins-Blanch, Women's Edition, PRB, USA

About PRB
Founded in 1929, PRB is the leader in
providing timely and objective infor­
mation on U.S. and international
population trends and their implica­
tions. PRB informs policymakers, edu­
cators, the media, and concerned
citizens working in the public interest
around the world through a broad

range of activities. PRB is a nonprofit,
nonadvocacy organization. MEASURE
Communication is designed to pro­
duce accurate and timely information
on population, health, and nutrition
in less developed countries. The ulti­

mate objective of MEASURE is to
improve policies and programs.

Conveying Concerns:
Media Coverage of

Women and
HIV/AIDS
Table of Contents
Preface................................................................................................. 2
Global Overview: The Changing Face of HIV/AIDS................ 3

Women's Special Vulnerability to HIV/AIDS ............................. 6
Women and AIDS: Being Good Is Bad for Your Health .......... 7
Are You Positive? Women at Risk ...............................................9
The Agony of Being African and Woman ............................. 10
Calling the Shots......................................................................... 12
Mother-to-Child Transmission....................................................... 13

Report on AIDS ......................................................................... 14
HIV/AIDS—Silence and Deafness: The Hlabisa Hospital ... 15
..................................................... 16
Current Problems ....................................................................... 17
Are You Positive? ....................................................................... 18

Young People and HIV/AIDS

....................................................................... 19
Filipinos and AIDS: It Could Happen to You........................... 20
HIV/AIDS—Silence and Deafness: Rural Africa ....................22
Improve Our Behavior Ourselves ............................................ 23

Migration and HIV

People Living with HIV or AIDS .................................................. 24

Positive—and Carrying On ...................................................... 25
HIV/AIDS: Another Silence to Be Broken................................ 27
HIV-Positive Florence: The Face of Courage and Hope.......... 29
References.................................. ....................................................... 31
Acknowledgments .......................................................................... 32

Population Reference Bureau

Preface
n many countries, HIV/AIDS repre­
sents the deadliest emergency and the
greatest social, economic, and health cri­
sis of modern times. The virus has many
allies. For one thing, silence and denial
have fueled its transmission. Just as cul­
tural and religious taboos inhibit open
discussion about sexual practices and
preferences, including the use of contra­
ceptives, shame and guilt have surround­
ed this virus that spreads mainly through
sexual contact. Many governments have
also been slow to acknowledge the crisis
and to formulate policies and programs
to halt the spread of the epidemic.
Poverty is another key ally. Those
who can afford the costly anti-AIDS
treatments prolong their lives, while the
world’s poor—the majority of whom are
women1—die in overwhelming numbers.
One of the most significant challenges is
the epidemic’s profound impact on the
lives of women, whose lack of economic
autonomy and low social status often
render them powerless to reject risky
behaviors or to negotiate the most basic
precautions against the disease. Women
and girls also provide the main sources
of support for the sick and dying, even
when they themselves need care.
This Conveying Concerns, the fifth in a
series compiled through the Women’s
Edition project of the Population
Reference Bureau (PRB), examines the
epidemic’s impact on women and girls
from the perspective of women journal­

I

2

ists (see description of Women’s Edition
on the inside front cover). In July 2000,
PRB assembled senior journalists from
10 countries for a seminar to discuss
women and HIV/AIDS prior to the 13th
International AIDS Conference in
Durban, South Africa. The journalists
subsequently produced special supple­
ments in their newspapers and maga­
zines as well as radio programs that
highlighted local and international
aspects of the epidemic. Excerpts from
these supplements and programs are
printed here.
The articles and scripts are abridged
and appear in five sections, each with an
introduction. These sections represent
the specific topics addressed by the jour­
nalists. The first section looks at
women’s special vulnerability to HIV
and is followed by sections on the trans­
mission of the virus from mother to
child, young people, migrants, and peo­
ple living with HIV and AIDS. The arti­
cles in this booklet were produced from
various cultural perspectives. However,
they all emphasize that women’s eco­
nomic dependence on men, as well
as society’s acceptance of different
standards of behavior for women and
men increases women’s vulnerability
and the burden of the epidemic on
women. The articles also demonstrate
that the media have a role in helping to
remove the shroud of silence and denial
surrounding the disease. ■

Conveying Concerns- Medio Coverage of Women and HIV/AIDS

Global Overview: The Changing Face of HIV/AIDS
s powerlessness and poverty place
certain groups and communities
around the world at heightened risk of
HIV infection, the AIDS epidemic is
increasingly female, young, and poor.2
Women are especially at risk because of
the interplay of biological, economic,
and social factors, a vulnerability that is
especially acute among girls. At the end
of 2000, women comprised roughly 47
percent of the more than 36 million
adults living with HIV or AIDS, and
more than 90 percent of infected adults
were from less developed nations.3
While HIV affects people of all ages,
half of all newly infected people are 15
to 24 years old.4 In African countries,
HIV-infected young women outnumber
infected young men by 2 to l.5
The risk for women is rising in both
more developed and less developed
countries, with the most dramatic chal­
lenges occurring in countries least able
to cope with the epidemic. In Spain,
women’s share of reported AIDS cases
climbed from 7 percent in 1985 to 19
percent in 1995.6 The increase has been
more dramatic in Brazil. In 1986, there
were 16 men with HIV/AIDS for every
woman with the disease; in 1997, there
were three men for every woman.7 In
Africa, the region hardest hit by the epi­
demic, 12 women have HIV for every 10
men with the virus.8
Most women with HIV or AIDS
become infected during unprotected sex
with their male partners. This is espe­
cially true in Africa as well as in South
and Southeast Asia.9 Women may also
become infected through intravenous
drug use or through blood transfusions.
In many cases, however, infection is
part of a long chain of transmission
that begins when husbands or

A

boyfriends contract the virus through
intravenous drug use, relations with
sex workers or other female sex part­
ners, or by having sex with other men.
This can be seen in India, where high
infection rates among female sex
workers and their male clients have
been followed by a wave of HIV trans­
mission among wives.10 In many places,
migration is believed to contribute sig­
nificantly to the spread of infection.11
As men and women leave their spouses
and partners to work in the city or in a
new country, they form new sexual net­
works that increase the risks of HIV
transmission.
For biological reasons, the risks of
contracting HIV through unprotected
sex are higher for women than for men.
The lining of a woman’s vagina and
cervix contains mucous membranes
that provide a large, hospitable environ­
ment for infection.12 The mucous mem­
branes are thin tissues through which
HIV and other viruses can pass to tiny
blood vessels.13 Also, infected semen
typically contains a higher concentra­
tion of the virus than a woman’s sexual
secretions. Women are also more sus­
ceptible than men to other sexually
transmitted infections (STIs), which,
if not treated, multiply the risks of
contracting HIV Tearing and bleeding
during intercourse, whether from
coerced sex or prior genital cutting,
also heighten the risk of infection.
The risks of contracting HIV are even
higher for younger women whose immature cervixes put up less of a barrier to
infection.
At the same time, however, the high
rates of HIV infection among women
and girls often have less to do with biol­
ogy and more to do with fundamental

Conveying Concerns: Medio Coverage of Women and HIV/AIDS

The AIDS
epidemic is
increasingly
female, young,
and poor.

3

Women’s
vulnerability
to HIV
is increased
by economic
or social
dependence
on men.

4

issues of power and control between
women and men. Women’s vulnerability
to HIV infection is increased by eco­
nomic or social dependence on men. As
AIDS and Men editor Martin Foreman
notes, it is usually men “who determine
whether sex takes place and whether a
condom is used."1,1 In situations of eco­
nomic dependence, women’s ability to
insist on condom use becomes even
more difficult. If women refuse sex or
request condom use, they may risk
abuse or suspicion of infidelity. They
may even be abandoned or forced to
leave the home. Sexual violence,
including rape and sexual molestation,
is a particular danger to the reproduc­
tive health of women and girls and
heightens the risk of HIV infection.
The face of AIDS is also increasingly
young. The Joint United Nations
Programme on HIV/ALDS (UNAIDS) cal­
culates that half of all new HIV infec­
tions around the world occur among
youth between the ages of 15 and 24.15
Girls are particularly vulnerable to the
sexual transmission of HIV since they
lack the information, confidence, or
resources to decide on or negotiate con­
dom use or other sexual matters. Girls
are also more likely than boys to be
raped or enticed into sex by someone
who is older, stronger, or has more eco­
nomic power. As Antigone Hodgins of
the International Community of Women
Living with HIV/AJDS explains, “young
women face most of the issues that
women do; you just have to add 10
times more difficulty....”16
Increased incidence of HIV/AIDS in
young women has led to an increase in
transmission of the virus from mother
to child, since a baby may contract HIV
during pregnancy, delivery, or breast­
feeding.17 Mother-to-child transmission

is by far the most common mode of HIV
infection for children below the age of
15.18 Since the start of the epidemic,
an estimated 4.3 million children have
died of AIDS before the age of 15, well
over half a million of them in 2000
alone.19 Another 1.4 million children
are currently living with HIV20; most
may die before they reach their teens.
Though HIV infection is not confined
to the poor, poverty has contributed to
its spread by creating yet another situa­
tion of vulnerability. The overwhelming
majority—about 94 percent—of all peo­
ple living with HIV/AIDS at the end of
2000 were in less developed regions,21
where a large proportion of the poor are
women.22 Sub-Saharan Africa bears a
disproportionate burden of the epidemic.
The region is home to 70 percent of the
world’s adults living with HIV or AIDS.23
In what has emerged as a vicious cycle,
AIDS deepens the poverty of households
and nations, and poverty favors the
spread of the virus. With few financial
assets, the poor are often politically and
socially marginalized and often have lim­
ited access to health care information
and services. Women living in poverty
may adopt behaviors that expose them
to HIV infection, including the exchange
of sexual favors for food, shelter, or
money to support themselves and their
families.
“Breaking this cycle will require not
only greatly increased investments in
more effective HIV prevention and care,
but also more effective measures to
combat poverty,” said Robert Hecht,
UNAIDS Associate Director for Policy,
Strategy, and Research, at the July 9-14,
2000 International AIDS Conference,
held in Durban, South Africa.24
In order to address some of the root
causes of HIV’s rapid spread, prevention

Conveying Concerns: Medio Coverage of Women and HIV/AIDS

programs are adopting gender-sensitive
approaches that consider the economic,
social, and legal factors that fuel the
epidemic. These programs seek to
increase women’s access to information
and services. More importantly, however,
they attempt to bring about structural
changes that redress power imbalances
between women and men. In the few
countries that have programs on women
and AIDS, the emphasis continues to be
on education, counseling, partner reduc­
tion, male condom promotion, and
monogamy. Unfortunately, the messages
aimed at women often disregard the
power imbalances that inhibit women’s
active use of most of these options.
Successful programs also aim to
empower women economically. AIDS
prevention activities are increasingly
linked to programs that support
women's economic independence
through training activities, credit pro­
grams, saving schemes, and women’s
cooperatives. Other programs aim to
develop communication strategies to
make it easier for young people to dis­
cuss STIs, HIV/AIDS, the use of con­
doms, and sexual behavior. In Uganda,
the government and religious leaders,
as well as community development and
other organizations have developed a
campaign to reduce HIV infection. The
Kampala-based nonprofit Straight Talk
Foundation produces a weekly radio
program that reaches more than 1.5
million young people, providing commu­
nication techniques for getting out of
difficult sexual situations.
Other interventions engage commu­
nity participation. Women from Nepal,
who are sold for work in brothels in the
Indian cities of Bombay, Delhi, and
Calcutta, are at especially high risk of

contracting HIV The Maiti Project in
Nepal provides education, vocational
training, and support and counseling for
girls who either escaped their traffickers
or are in danger of being sold.
On the medical front, there is much
to be done. New drugs that inhibit the
development of full-blown AIDS allow
some people with HIV to prolong their
fives and reduce transmission of HIV
from mother to child. These antiretrovi­
ral drugs are costly, however, and
remain unavailable to the overwhelming
majority of those infected. Similarly,
some progress has been made on con­
traceptive barrier methods—such as
the female condom—that protect
against HIV and other STIs and that a
woman can control. However, many
women in less developed countries lack
access to the technology. In the mean­
time, the search continues for virus­
killing creams, foams, or gels that
would allow women to protect them­
selves without having to secure the
cooperation of their partners.
The impact of HIV/AIDS goes
beyond the lives of infected people. The
disease changes community dynamics,
undermines the structure of the family,
and threatens the future of children.
Experience shows that good informa­
tion and the involvement of all levels of
society are key to containing the virus.
Effective strategies also require full
government commitment, strong public­
health outreach, and the participation
of the pharmaceutical industry.
Successful country-level efforts have
stressed wide access to medical care
and drugs, political commitment, and
responsible sexual behavior by women
and men. These are key components to
ending the spread of the epidemic. ■

Conveying Concerns: Medio Coverage of Women ond HIV/AIDS

Good
information
and the
involvement
of all levels of
society are key
to containing
the virus.

5

WOMEN'S SPECIAL
VULNERABILITY TO HIV/AIDS
he profound impact of HIV/AIDS on the lives
of women is one of the most critical repro­
ductive health concerns of our times. The inter­
play of certain social, economic, and biological
factors, including policies that undermine the
rights of women, heightens women’s vulner­
ability to a disease whose most common mode
of transmission worldwide is sexual contact.
Women are especially vulnerable to HIV on
two counts. Anatomical differences make trans­
mission of the virus through sexual contact far
more effective from men to women than vice
versa. Even more significant, though, is the fact
that powerlessness, dependency, and poverty
serve to diminish a woman’s ability to fend off
the risks.
The Platform for Action adopted by govern­
ments at the 1995 Fourth World Conference on
Women in Beijing recognizes that low social sta­
tus is at the root of women's vulnerability to
HIV.25 While individual behavior is largely
responsible for the spread of the infection, pre­
ventive measures are often beyond a woman’s
control. Her choices are often restricted by an
inability to insist on safe sex, society’s accept­
ance of different standards of behavior for
women and men, and economic dependence on
men. For these reasons, married women—
whether or not they are monogamous—are the
largest group of women at high risk of HIV
infection.26 Since most infected women are of
childbearing age, they face the likelihood of
infecting their children. As mothers, daughters,
wives, grandmothers, sisters, and aunts, women
also care for dying family members and for chil­
dren orphaned by the disease.
Health experts and institutions are advocat­
ing ways to combat the virus that take into
account the distinct social roles and circum­
stances of women and men. Governments and
donor agencies are placing increased support
behind women’s rights groups that promote the
human rights of women, including the right to
have control over and decide freely and respon­
sibly on matters related to their sexuality.

T

As laid out in the Beijing Platform for Action,
this right includes the ability to choose safe,
effective, and affordable methods of family plan­
ning, and to have access to appropriate informa­
tion and health care services. Reproductive
health experts widely agree on the critical need
to enhance access to barrier contraceptive
methods that place control in women’s hands.
Options include making female condoms more
accessible and affordable and developing vaginal
microbicides—virus-killing creams, foams, or
gels. Educating boys and men to engage in
responsible sexual behavior is another objective.

Philippine Daily
Inquirer, Philippines
September 17, 2000

Women and AIDS: Being Good Is Bad for Your Health
by Pennie Azarcon Dela Cruz
iving up to society’s definition of a
good woman may be hazardous to
one’s health, at least when it comes to
AIDS. Being passive, submissive and
naive in sex matters, as well as too
unquestioning of a partner’s peccadil­
loes have made women more vulnerable
to HIV, the virus that causes AIDS,
experts have noted.
In this country, HIV/AIDS registrar
Dr. Consorcia Lim-Quizon reveals that
of the 1,390 reported cases of HIV-posi­
tive Filipinos from January 1984 to June
2000, 547 are female and 836 are male.
Heterosexual contact remains the main
mode of transmission, with 818 cases
out of 1,390. Homosexual encounters
account for 241 cases, followed by
bisexual contact (71), perinatal trans­
mission (19), blood or blood products
(13), injecting drug use (6) and needle­
prick injuries (3).
According to Dr. Quarraisha Abdool
Karim of the South African Medical
Research Council, a woman’s biological
makeup places her at higher risk of con­
tracting the virus than a man for several
reasons. The female genitalia has a
greater exposed and mucosal surface
which can suffer lacerations during sex,
allowing entry points for the virus. In
girls, the risk of microlesions in the
genitals is greater because of the added
factors of lower defenses and immaturity
of vaginal tissues and cervical mucus.
Because they are economically
dependent on their spouses, few women
can negotiate safe sex for fear of risk­
ing violence, mistrust and recrimina­
tions, abandonment, or withdrawal of
financial support. Hence, women con­

L

tinue to be passive and nonassertive in
sexual relations.
Economic dependence also forces
women to endure forced sex, early mar­
riage, and incest, all of which might
cause vaginal tearing and expose young
women to HIV. For the same reason,
most women accept their partners’
extramarital affairs though these put
them at risk. Most HIV cases are root­
ed in heterosexual contact involving
monogamous women and their philan­
dering husbands.
Cultural factors accelerate the risks
of HIV transmission, adds Nonhlanhla
Makhanya, research manager of South
Africa's Health Systems Trust. “In
many cultures, women are not expected
to know more than their husbands,
especially when it comes to sex mat­
ters," Makhanya says. She recalls inter­
viewing long-distance truck drivers
about condom use and found that the
drivers would use condoms for casual
sex if health educators tell them to do
so. “But no, they wouldn’t use one if it’s
their wives telling them, because they
don’t want their wives to think they are
smarter than their husbands,” says
Makhanya, shaking her head.
Adds Geeta Rao Gupta of the
Washington-D.C.-based International
Center for Research on Women: “Many
societies dictate that ‘good’ women are
expected to be ignorant about sex and
passive in sexual interaction. This
makes it difficult for women to be
informed about risk reduction or, even
when informed, makes it difficult for
them to be pro-active in negotiating
safer sex."

Conveying Concerns: Medio Coverage of Women and HIV/AIDS

Low social
status is at the
root of woman's
vulnerability.

7

“We will not
achieve progress
against HIV
until women
gain control of
their sexuality. ”
—Dr. Gro Harlem
Brundtland,
Director-General,
World Health
Organization

8

Across many cultures, women are
not expected to discuss or make deci­
sions about sexuality, so suggesting
condom use is out of the question. They
are also expected to trust their hus­
bands unconditionally. Feelings of love
and trust often paralyze women and
prevent them from perceiving the real
risk, taking preventive measures, and
seeking safer sexual relations.
In some societies, women cannot
object to their husbands having multi­
ple partners, because this is culturally
accepted. In some cultures, men believe
that sex with young virgins can cleanse
them of sexually transmitted diseases
(STDs) and HIV
At the International AIDS Conference
in Durban, South Africa, in July 2000,
several suggestions were advanced to
make women less susceptible to the
deadly virus, among them:
• improving girls’ access to education
and information to give them more
economic options and prevent them
from going into the sex trade;
• developing female-controlled preven­
tion methods, like female condoms

and microbicides (substances that
act as barriers to prevent the AIDS
virus from getting into the body
vaginally);
• addressing the issue of desire for
children by developing microbicides
that are not spermicides;
• reinforcing women’s economic inde­
pendence by multiplying and
strengthening existing training
opportunities, credit programs, sav­
ing schemes and women’s co-ops,
and linking them to AIDS preven­
tion activities;
• integrating STD treatment services
with family planning services so
women can access them without
fear of social censure; and
• building safer social norms by sup­
porting women’s groups and commu­
nity organizations that question
dangerous behavior like child abuse,
rape, sexual coercion, etc.
As Dr. Gro Harlem Brundtland,
Director-General of the WHO [World
Health Organization], puts it, “We will
not achieve progress against HIV until
women gain control of their sexuality.” ■

Conveying Concerns: Medio Coverage of Women and HIV/AIDS

Femina, India
November 1, 2000

Are You Positive? Women at Risk
by Sathya Saran
t is a fact that now HIV has moved
beyond gays and drug pushers and
entered the bedrooms of married and
faithful women who would die rather
than look carnally at men other than
their husbands. The Indian married
woman, regardless of whether she is a
blushing bride or a young mother, is at
risk. And that means all of us too—you,
me, and that high-profile banker across
the counter.

I

Fact: Women are increasingly contract­
ing HIV. In some African countries,
there are more infected women than
there are infected men. These women
are wives, daughters, grandmothers,
sisters, aunts, and nieces.
Fact: Women are becoming infected at
ages significantly lower (often five to 10
years earlier) than men.

Fact: Along with teenagers and post­
menopausal women, married women in
their early twenties form a high statistic
in the “new infection” group.
Fact: Ten years after the first woman
was diagnosed as being infected with
HIV in 1982, an estimated three-and-ahalf million were infected, a vast major­
ity through sexual transmission. For
most women, the major risk is the fact
that they are married.

Add to this other risk factors, such
as their nutritional level, incidence of
sexually transmitted and reproductive
tract infections, lesions, inflammation
and scarification in the female genital
tract, and careless medical practices

that could infect a woman even on the
doctor's table.
Trust no one.

A young accountant once contracted
HIV from her husband. Of course, the
husband did not know he was HIV posi­
tive, or perhaps did not tell her about
it—probably hoping, as some of us do,
that he could wish the problem away. It
was at the antenatal clinic that she dis­
covered her condition. And the dread
that took hold of her as she heard the
doctor say the words, like a death sen­
tence, lived with her through labour and
the first few years of the baby’s life.
Luckily, the child did not prove to be
HIV positive. But the sword still hangs
over the couple’s heads.

The fear of
ostracism and
rejection makes
many women
hide or neglect
their condition.

Fact: Most women, regardless of age or
socioeconomic status, get infected by
errant husbands who are engaged in sex
with other partners, who could include
sex workers. The fact that many Indian
women silently suffer from sexually
transmitted infections (that increase
vulnerability to HIV infection from a
partner) compounds the problem and
accounts for the high incidence of HIV
infection among women. Also, the fear
of ostracism and rejection makes many
women hide or neglect their condition,
even when they know that the only
source of infection is the husband.

“I trusted my husband!" is the cry
that is most often heard from countless
HIV-positive women who are today
ostracised and blamed for bringing
AIDS into the home. ■

Conveying Concerns: Media Coverage of Women and HIV/AIDS

9

Parents, Kenya
December, 2000

The Agony of Being African and Woman
by Eunice N. Mathu

s the AIDS epidemic sweeps across
developing nations with a venge­
ance, women are the most hard hit.
African women are hit even harder.
Research findings indicate that 55 per­
cent of adults infected with HIV/AIDS
in Africa are women. Statistics show
that women and girls 15 to 24 years
show the highest rates of increase.
Women in Africa are bearing the
brunt of the epidemic, not only as people
living with AIDS, but also as the ones
caring for infected relatives, orphaned
children, and others. The many male­
female inequalities also make women
increasingly vulnerable to HIV infection.
It is a fact that, physiologically,
women are more vulnerable than are
men to HIV transmission. For African
women especially, this vulnerability is
heightened by social, cultural, and eco­
nomic factors that place them at a disad­
vantage within relationships, the family,
the economy, and the society at large.
In total, the African woman’s glaring
lack of power over her body and sexual
life, coupled with social and economic
inequalities, make her an easy prey for
contracting and living with HIV/AIDS.
World Health Organisation (WHO)
statistics show that the rate of HIV
infection is higher for women than for
men in most African countries and that
in several big cities, one out of three
pregnant women has HIV The vast
majority of these women are monoga­
mous and have been infected by their
husbands. A study in Uganda found that
60 percent of HIV-positive women are
married and monogamous. Thus, more
often than not, HIV is brought home to
the woman by her partner. Furthermore,

A
Women in
Africa not only
live with AIDS,
but also care
for infected
relatives and
orphaned
children.

10

and to the detriment of African women,
they have little say on the use of con­
doms. It is the men who decide whether
to use condoms or not and even when
sex takes place.
Once a woman is HIV positive, she
faces stigmatisation. She is rejected by
even her own family, regardless of
whether or not it was the husband who
brought the infection home. She is espe­
cially subjected to the violation of her
sexual and reproductive rights. She is
forced to suspend or change her sex life
and will not be allowed to have children.
In many instances, HIV-positive married
women are abandoned by their husbands
with no legal or economic recourse.
Recently, a Kenyan man ejected his
HIV-positive wife from their main house
to live in modestly furnished servants’
quarters. The wife, a 34-year-old bank
cashier, had contributed through mort­
gage payments to the buying of their
home. However, when she tested HIV
positive, the husband kicked her out.
He went to court and sought estrange­
ment from his wife, saying that her HIV
status had put his life in danger. He
also claimed cruelty, assault, abuse,
and other matrimonial offences.
In a landmark ruling on July 31 this
year [2000] that was hailed as a good
precedent and practical policy state­
ment on AIDS, three Court of Appeals
judges hearing the suit ordered the hus­
band to take back his wife. They noted
that although they sympathised with
the husband’s fears, it would have been
morally wrong for him to desert his
spouse until a court decreed otherwise.
This case was, however, more the
exception than the rule. Many women

Conveying Concerns: Media Coverage of Women and HIV/AIDS

cannot pursue their legal rights. Often,
after being widowed by AIDS, a woman
loses her property to greedy relatives
and finds herself abandoned by the
whole family. She has to take care of her
children in addition to buying drugs to
manage her HIV status (if she is infect­
ed) . Many such widows turn to pros­
titution to generate income, or they
encourage their female children to take
up prostitution. As is common, sex
workers often cannot ensure their
clients’ practice of safe sex or their own.
In other cases, infected women,
including single mothers, are not only
faced with the task of expensive man­
agement of their status but also of car­
ing for their children. During a recent
World AIDS Day celebration, a single
mother living with AIDS confessed that
she had to breastfeed her baby, although
doctors had warned her that in doing so,
she risked infecting the child. She had
no money to buy him milk. She said it

was a struggle in her slum life to raise
the 600 shillings (US$8) required for
her monthly dose of AIDS drugs. She
asked the crowd whether they could
blame her for breastfeeding when
nobody was willing to give her money to
buy milk for the baby.
Various traditional practices expose
African women to HIV infection. For
example, early forced marriages for
girls and wife inheritance create high
risks of HIV infection. Widow inher­
itance, commonly baptised as home
guardianship, is common in East and
Southern Africa. In Kenya, it is common
within the Luo community. When a hus­
band dies, one of his brothers or cousins
marries the widow to ensure that the
children remain within the late hus­
band’s clan and that the widow and her
children are provided for. If the husband
died of AIDS and the woman is infected,
she could pass on the virus to her
guardian and children. ■

Conveying Concerns: Medio Coveroge of Women and H1V/AIDS

Early forced
marriages for
girls create high
risks for HIV
infection.

11

Femina, India
August 15, 2000

Calling the Shots: Treating Oneself With Respect Can
Give Anyone Great Respectability
by Sathya Seiran

he wore a stylishly cut robe that fell
to her feet, a heavy gold chain, and
her hair was orange. She Eves in Cape
Town, South Africa, and has been a sex
worker for all of 20 years.
No, she was not like the call girls we
see in Hindi movies—not slinky, svelte,
and rich. Rachel has always and still
continues to solicit business from the
street. She has a stretch of road where
she operates from; and when she finds
a client—and “he could be a judge, a
politician, a clergyman or a tourist, and
is usually white skinned"—she takes
him to a room that belongs to a friend.
Her fees include the rent for the room
for the period her client wants to use it
in her company.
“I was abused by my uncle for four
to five years when I was a teenager,”
she revealed, “and when I finally told
my aunt about it, she said I was getting
too big for my boots and threw me out.
Of course, it is not an excuse for the job
I do, but it is a part of my life.”
When a nongovernmental organiza­
tion worked in her area, advocating
safe sex to prevent the further spread
of HIV and AIDS, Rachel took up the
initiative of carrying the baton forward.
Today, in her part of the city, no sex
worker can indulge in unprotected sex

S

12

for payment. “If any girl does that, we
gang up on her and make her leave,”
Rachel said. And, aware of the constant
risk her profession places her at in a
country where over 4.5 million people
are HIV positive, Rachel keeps a stem
eye on her health.
“My doctor is very proud of me,” she
says. “She admires the fact that I keep
a close watch on my body.”
Her frank eloquence and wellgroomed looks belie Rachel’s predica­
ment. “I've been robbed of all my
clothes and belongings five times," she
says. “Each time, I have had to invest
again in good clothes, and it has left me
with no savings. I would love to do
something else for a living; I’ve had
enough of this life," she says, then
adds, with the first hint of sadness in
her voice, “but I have no choice. No sav­
ings. I cannot many my boyfriend
because he has no steady job. I have to
provide for myself.”
Only months ago, Rachel took her
crusade as protector of the younger
girls in her profession to a new plane.
When three policemen beat up some
young sex workers, she moved the
courts against them and got a restrain­
ing order that prevented them from
entering the area. ■

Conveying Concerns: Medio Coverage of Women and HIV/AIDS

MOTHER-TO-CHILD
TRANSMISSION
or many HIV-infected women—who may
learn of their HIV-positive status only when
they become pregnant—choosing whether or not
to have a child is among the toughest decisions
they make. Mother-to-child transmission of HIV
is by far the most common mode of HIV infec­
tion for children below the age of 15.27 More
than a million children are living with HIV or
AIDS around the world, and more than 4 million
have died since the epidemic took hold two
decades ago.28 These numbers will likely rise as
the number of HIV-positive women of childbear­
ing age increases.
Without treatment, 25 percent to 35 percent
of children born to HIV-positive women in less
developed countries become infected.29

F

A baby may contract the virus during pregnancy,
labor and delivery, or as a result of breastfeed­
ing.30 Of the infants who become infected, twothirds are infected during pregnancy and at the
time of delivery, with labor and delivery being
the time of greatest risk.31 Research suggests
that vaginal deliveries may increase the risks of
transmission of the virus from the mother to the
child.32 While Caesarean sections could reduce
this threat, such an option is unavailable to the
majority of women worldwide who deliver their
babies with the help of midwives at home, in vil­
lages, or at small health centers.
Once the baby is born, some women face yet
another tough choice—whether to breastfeed
their babies or provide an alternative milk for­
mula. Given the fact that roughly one-third of
mother-to-child transmissions of HIV occur
through breastfeeding,33 families who have the
means may provide commercial milk formulas.
For millions of families with scarce resources,
however, the alternatives to breast milk may be
too expensive or their communities may lack the
clean water and fuel necessary for the safe
preparation of a milk formula. Moreover, in
places where breastfeeding is common, the deci­
sion not to breastfeed a child may draw atten­
tion to the woman's HIV status and invite abuse
and discrimination.
For some women, anti-AIDS drug treatment is
available.34 The treatment is administered late in
pregnancy and during delivery and given to the
infant for a period following birth. This option is
also limited to those who can afford the treat­
ment. The risk of mother-to-child transmission
has been significantly lowered in high-income
countries, where many HIV-positive pregnant
women, in addition to taking antiretroviral drugs,
later avoid breastfeeding. These measures, along
with delivery of the baby by Caesarean section,
have decreased mother-to-child transmission of
HIV in some places.35
In addition to the provision of antiretroviral
drugs, health experts stress the importance of
prevention efforts, as well as appropriate coun­
seling and testing services for women, and sup­
port for mothers and their infants, including
information on infant feeding options.

Ghana Broadcasting
Corporation, Ghana
July 29, 2000

Report on AIDS
by Sarah Akrofi-Quarcoo
Announcer: The fight against HIV/AIDS
has become a ding-dong battle. Motherto-child transmission, the major cause
of infection among infants and children,
remains one of the greatest challenges
in that fight.
Correspondent Sarah Akrofi-Quarcoo:

More than a
million children
are living with
HIV or AIDS
around the
world.

14

Amid tears, Florence Ngobeni, an
AIDS counselor with the Chris Hani
Baragwanath Hospital in South Africa,
recounted how she had lost her baby to
HIV/AIDS after birth. The infant had
suffered continuous bouts of diarrhea
and other ailments and had finally died,
leaving Florence Ngobeni with the pain
and guilt that she had passed on the
disease to her only child without even
knowing she had it. Elizabeth Chidonza
feels the same way. Elizabeth works for
the United Nations in Pretoria at a proj­
ect called the Greater Involvement of
People Living with AIDS (GIPLA). She
has a six-year-old daughter who was
infected at birth.
Approximately 90 percent of the
1 million children under 15 years living
with HIV/AIDS around the world
acquired the virus from their mothers.
In Ghana, children between 0 and 4
years constituted 2 percent of known
AIDS cases in 1998. Women with AIDS
included an estimated 6.6 percent of
those at antenatal care clinics in major
urban areas in the country and 12.4
percent at clinics outside major urban
areas in 1998. All these women could
have transmitted the virus to their chil­
dren during pregnancy, at birth, or
through breast milk.
According to the UNAIDS Report on
the Global HIV/AIDS Epidemic, released

at the 13th International AIDS Confer­
ence in South Africa, transmission is
reduced when HIV-positive pregnant
women take antiretroviral drugs and
avoid breastfeeding their newborns.
These two measures, combined with
delivery of the baby by Caesarean sec­
tion, have dramatically decreased
mother-to-child transmission. But in
most cases, women only know their
status through their child's ailment
or death.
Apart from ignorance, there are
structural and cultural problems. Dr.
Efua Hesse, a pediatrician at Korle Bu
Teaching Hospital, says it has been dif­
ficult to implement protocol 076 (the
anti-AIDS treatment given to HIV-posi­
tive pregnant women and their babies).
The treatment requires screening preg­
nant women with informed consent, but
the hospital is not equipped to under­
take the exercise. The hospital is cur­
rently not administering AZT to
pregnant women. It is too expensive
and beyond the reach of HIV-positive
pregnant women, who are mostly of low
socioeconomic status.
The stigma and shame associated
with HIV do not make it easy for preg­
nant women who want to test for AIDS
to do so. Sociocultural pressures on
women to have children also make it dif­
ficult for women to opt to stay childless
even when they know they have the
virus. They only hope and pray that the
children do not get infected. One out of
every 20 people is said to be infected
with AIDS in Ghana, and prevalence is
high among youths. Reproductive health
education and information remain the
single most powerful preventive tools. ■

Conveying Concerns: Medio Coverage of Women and HIV/AIDS

22, Romania
July 18-24,2000

(TYanslated from
Romanian)

HIV/AIDS—Silence and Deafness: The Hlabisa Hospital
by Gabriela Adamesteanu

he way to the Hlabisa hospital in
South Africa passes through an
ordinary village, with round houses and
cone-like ceilings and a market where
people sell goods displayed on the floor:
cheap clothes and sports shoes, pineap­
ples, bunches of bananas, household
tools. Unpaved roads, widely cut in the
brown-reddish soil, lead to the hospital.
We pass through the waiting room,
crowded with women and men, sitting
on benches, waiting to see the doctor or
to be admitted to the hospital. The hos­
pital has low-ceilinged pavilions, like all
the ordinary South African buildings,
and the smell of disinfectants and
human fluids becomes more and more
pungent as we enter the maternity
ward.
The maternity ward is the most visit­
ed part of the hospital. There is no evi­
dence of the HIV-positive pregnant

T

women, because no tests are taken.
Only pregnant teenagers—and there
are many of them—have separate
rooms. Early motherhood and the lack
of sexual and medical knowledge are
among the causes of the HIV epidemic.
According to UNAIDS, without ad­
equate treatment for pregnant women,
15 percent to 35 percent of the children
born to HIV-positive mothers are likely
to have the disease. Breastfeeding also
carries risks. Doctors and HIV/AIDS
activists revealed the dilemma of the
HIV-positive mothers: The decision to
breastfeed can lead to infection, but the
alternative may lead to the infant’s star­
vation, since artificial formulas and safe
drinking water are limited, if available
at all. Even at Hlabisa hospital, the
powdered milk is sometimes missing or
is not enough, so that all the mothers
then have to breastfeed their babies. ■

Conveying Concerns: Medio Coverage of Women and HIV/AIDS

15

YOUNG PEOPLE AND
HIV/AIDS
he AIDS epidemic inflicts a heavy toll on
young people. About 50 percent of all new
HIV infections around the world occur among
people ages 15 to 24, the age range within
which most people begin their sexual lives.36
When children under the age of 14 are added,
the total increases to 60 percent of new infec­
tions. The vast majority of these young people
live in less developed countries where AIDS is
concentrated.37
Young people are especially vulnerable to HIV
exposure because of physical, psychological, and
social factors. For one thing, while youth is a
time of exploring and discovering feelings and
behaviors, young people often lack the social
skills, services, and information necessary to
avoid the risks associated with such activities
as unprotected sex and illicit drug use.
The context within which young people live
influences their exposure to HIV. Among the
most vulnerable groups are those who live on the
edges of society, including orphans, refugees, and
street children, those who grow up in urban
slums, or those who face isolation because of
their sexual orientation.38 These young people
often have limited access to education, health
information, and health services. Some may
increase their risks by selling sex to survive;
others may be abducted and sold into the sex
trade. Many take up injecting drug use and
expose themselves to high HIV risks by sharing
needles.
The number of parents dying from AIDS also
has dire consequences for young people, especial­
ly young children. Worldwide, more than 13 mil­
lion children under the age of 15 have lost either
a mother or both parents to AIDS, and an estimat­
ed 92 percent of these children live in subSaharan Africa.39 Many of these AIDS orphans
are forced to run households even as they grieve
for dead parents and cope with the isolation and
social stigma associated with the epidemic.
Individuals, groups, and governments face the
challenge of breaking down the barriers for
young people to seek the information, services,
and supplies required to reduce the risk of infec­

T

tion or to treat the illness. Media campaigns,
information on sexual health and on AIDS, as
well as the provision of male and female con­
doms and other prevention services are all
geared to giving young people the means and
the confidence to cope with the risks.

SeptemUll.ll

(translated from
Romanian)

Current Problems
by Gabriela Adamesteanu
he Children’s Department of the
Immune Deficiency Section at the
Hospital for Infectious Diseases in
Romania looks impeccable on the out­
side. It has recently been renovated and
includes a green park for the children.
Inside, it is clean. There are computers,
charts, a room for drawing, another
filled with toys for preschool children,
as well as young staff, and beds for the
sick children, who are usually accom­
panied by their parents.
It is here that the National Anti-AIDS
Committee is headquartered. It is the
workplace of Dr. Adrian Streinu and his
partners. A notice on the wall says that
the Princess Margaret Foundation has
been providing food for the children who
are hospitalized here. Food from the
Foundation arrives periodically, as do
additional donations from other sources.
I can imagine the women holding their
children by the hand while a nurse enters
information about each family’s housing
and income. They then receive the donat­
ed packages: toothpaste, rubbing alcohol,
cotton, bandages, soap, and medicine.
With vulnerable immune systems, the
HIV-infected children can have conditions
such as anemia, tuberculosis, otitis,
thrombosis, and diarrhea. Once they are
hospitalized, some children become anx­
ious and may start to have psychological
problems. It is a time when the mind is
affected by the physical deterioration,
says young psychiatrist Corina Jalba.
In a situation where 90 percent of the
parents do not tell their children about
the disease and where the more serious
cases are isolated, children lose confi­
dence in their bodies. “When the parents
hide the truth, we deal with only 50 per­

T

cent of the information,” says Jalba. If a
child has pneumonia and he is told about
it, the child starts to fight it.
Some parents have abandoned their
children since 1990-1991. The children
are now the concern of the Princess
Margaret Foundation, which has de­
veloped a special psychotherapy pro­
gram for them. As part of the program,
the children express themselves through
modeling, drawing, and collage.
I can see the sculptures they have
carefully made of plasticine. Some of
the children are very talented, as
Corina Jalba tells me. I randomly
choose two pictures. One of them, cre­
ated by a dying child, shows faded, red­
dish pink shapes next to green spots
and is meant to depict children walking
through the woods. The other picture is
a huge butterfly with colorful spots on
grey wings. The dull colors are inter­
rupted by brighter shades. The picture
has a story of its own: The butterfly
stays in the hospital because it has
injured a wing and its mother does not
have enough money to take it home.
The picture is the creation of a Gypsy
child who was abandoned by his par­
ents. Though his parents still come to
see him, they have a large family and
cannot afford to take care of him; the
child is envious of his brothers at home.
Hospitalizations for the infections
provide opportunities to leam about the
disease. The child is supposed to take
monthly medical treatment and see the
doctor every three months. Many sick
children who have been diagnosed fail
to follow up with treatment, mostly
because their parents are too busy or
too poor to combat the disease. ■

Conveying Concerns: Medio Coverage of Women and HIV/AIDS

The butterfly
stays in the
hospital because
it has injured a
wing and its
mother does not
have enough
money to take
it home.

Femina, India
November 1, 2000

Are You Positive?
by Sathya Saran
look long and hard at the grubby face
at the car window. The girl must be
about 10 or an undernourished 12 at
best. In a faded frock, plastic earrings
and a gay, pink satin ribbon in her hair.
I cannot help wondering if she is HIV
positive.

I
Sexual abuse
is one of
the primary
causes of HIV
infections
among street
children.

Fact: Thirty percent of the approxi­
mately 25,000 street children of
Vijayawada, Andhra Pradesh, are infect­
ed with HIV Being a major transporta­
tion hub, Vijayawada is one of 377
high-risk locations in the state and a
potential HIV/AIDS transmission centre.
Sexual abuse of children is one of the
highest causes of HIV infections among
street children. In Mumbai, where the
streets are surrogate homes to thou­
sands of children, abuse is as common
as the day. With crowded slums, migrant
male labour, and a marked lack of educa­
tion, the scenario as well as the figures
are probably much worse.
Young and Immortal

A car zooms past and comes to a
screeching halt at the traffic lights.
Levity and high spirits rise like vapour
from the windows. The boys in front are
dressed for the night, the girls at the
back more so. What will the night
bring? I look at them and wonder if any
one of them is HIV positive. Will he or
she, in turn, infect the others?
The car zooms off into the night.
“Don’t be silly,” my companion tells me.
“Why do you imagine the worst? More
people die in road accidents and of
heart attacks than of AIDS.”
A Discriminatory Virus

how she can think that she is safe. “Do
you really think HIV affects other peo­
ple?" I ask. I want to tell her that just by
being a woman, she is at greater risk.
Fact: Vulnerability to sexually trans­
mitted infections (STIs) and HIV is sys­
tematically patterned so as to render
some young people more likely to
become infected than others. Gender,
sexuality, and age are as important as
socioeconomic status and can increase
the risk potential of any urban, educat­
ed young woman who is not necessarily
promiscuous.
I look at my young friend. She’s
looking into the distance, her eyes soft
with some thought. Is she thinking of
her boyfriend? I wonder if, in her home,
sex is a word that ever is spoken
between her and her mother.
Facf: In most countries, the obstacles
that make it difficult for young people to
protect their sexual and reproductive
health include:
• lack of access to information;
• lack of health services to meet their
specific needs, as health workers
seldom receive special training in
issues pertinent to the sexual health
of adolescents;
• hesitation among young people to
seek medical help even if they are
able to diagnose an STI, and a
tendency to treat themselves with
over-the-counter medication;
• lack of communication and advice on
sexual matters within the family; and
• peer pressure that dismisses sexual
abstinence as deviant behaviour. ■

She’s young and pretty, this colleague of
mine, and I take her point. But I wonder
18

Conveying Concerns: Medio Coverage of Women and HIV/AIDS

MIGRATION AND HIV
s poverty, poor health systems, and limited
information fuel HIV infection rates in some
regions, recognition is increasing that migrants
face greater risks of infection than less mobile
populations.40 As the role of migration in the
spread of HIV claims increasing attention, much
of the focus is on such highly mobile groups as
refugees, truck drivers, traders, military and
other uniformed forces, business people, airline
workers, and seasonal agricultural workers.41
Migration and mobility have long been a fea­
ture of human existence, but people are moving
more than ever in response to cheaper and bet­
ter transportation, increased international trade,
or simply the urge to better their lives. Migrants
may move from rural to urban areas, from areas
of poverty to countries with better opportunities,
and from areas of war and conflict to areas of
relative political stability. Permanent and tempo­
rary migrants, short-term visitors, and migrant
workers can be found in most communities.42
UN estimates show that 120 million people vol­
untarily cross borders or move to cities within
their own countries every year. Another 38 mil­
lion people are displaced in their own countries
or are refugees in foreign lands.43
Separated from family and regular sexual
partners for long periods, migrants may face
loneliness or even a sense of isolation in a coun­
try or region where the language and cultural
practices are alien.44 Such persons often become

A

part of new peer groups, including sexual net­
works. Young people may also become sexually
active earlier, unaware of the risks of HTV and
other sexually transmitted infections. Migrants
who contract the virus may also contribute to its
spread when they return home.
Some refugees and migrant workers are sub­
ject to stigmatization and discrimination and
suffer from an overwhelming sense of powerless­
ness. Many live and work in poor conditions and
may even lack permission to remain in the host
country. Refugee women and girls are easy tar­
gets for sexual abuse, including rape. Undocu­
mented migrants, who live in constant fear of
deportation and avoid contact with official gov­
ernment agencies, represent one of the most vul­
nerable groups with respect to HIV infection, as
they have little access to health and welfare
services.45 Lacking knowledge of their rights,
the women are especially vulnerable to abuse,
violence, and forced prostitution.
Health workers and governments face the
challenge of designing HIV prevention and care
programs that do not appear to single out or
stigmatize migrants. Much may therefore
depend on successful community outreach pro­
grams that take into account linguistic differ­
ences and are coordinated by persons who share
the same culture as the migrant community40
Programs may also take special note of the rea­
sons for migration, intended length of stay in the
new place of residence, socioeconomic status,
and the educational level of migrants.47

Philippine Daily
Inquirer, Philippines
July 30, 2000

Filipinos and AIDS: It Could Happen to You
by Pennie Azarcon Dela Cruz

Migrants face
greater risks of
infection than
less mobile
populations.

t particular risk for HIV are the six
million overseas Filipino workers
(OFWs), the majority of whom are
women, says Malu S. Marin, executive
director of Achieve and Caram Asia, two
nongovernmental organizations working
for the welfare of Asian migrant
workers. Already, 22 percent of all
reported HIV cases in the Philippines
are former OFWs, says Marin. This is
not surprising, she adds, citing recent
research by the women’s group
Kalayaan Inc., and Caram Asia which
noted that OFWs are particularly vul­
nerable to HIV/AIDS because of their
work circumstances abroad.
Vulnerable Migrants

Titled “Breaking Borders: Bridging the
Gap Between Migration and AIDS,” the
study shows that many migrant workers
are below 30 years old and are sexually
active or sexually curious. Many of the
workers are single or have left their
families back home. Young, alone, and
socially isolated, they tend to seek com­
fort in intimate relationships developed
while abroad, or engage in casual or
paid sex.
According to the report, most young
Filipino women deployed abroad are
inexperienced and vulnerable to sexual
abuse by their older male employers.
Forced sex, because of the possibility of
vaginal tearing, may facilitate entry of a
sexually transmitted pathogen, includ­
ing HIV. Some workers, who choose to
remain in other countries despite their
illegal status, are drafted into prostitu­
tion or sex trafficking where they are
exposed to STDs and HIV.

20

While some workers indicate a mod­
erate to high awareness of HIV/AIDS,
their misconceptions about the disease
hinder behavioral change, according to
the findings. The view that HIV/AIDS is
a foreigner's disease could lead over­
seas workers into thinking that risky
sex is permissible with someone of the
same nationality, the study said.
Compounding the misconceptions
about the disease is the low incidence
of condom use among migrant workers
for the following reasons: the inacces­
sibility of condoms, uncertainty about
the protection that condoms provide,
and reluctance to use condoms in inti­
mate or steady relationships.
“Among migrant workers, using con­
doms is an indication of the lack of trust
in one’s partner,” the study said. Another
reason cited for low condom use was
that “it diminishes sexual pleasure.”
Most OFWs also hesitate to seek
medical help until they are convinced
that they are seriously ill. The tendency
is to consult family members, endure
the pain, and resort to self-medication,
all of which prevent the early detection
of illness. Getting sick abroad also
means spending money that migrant
workers would rather remit home. In
addition, undocumented workers do not
access public services for fear of detec­
tion, arrest, and subsequent deporta­
tion. Other migrant workers would
rather keep quiet about their illness as
this might be used by their employer
as grounds to dismiss them. Most
employers, in fact, find it cheaper to
send the worker home than spend
money for his or her medication.

Conveying Concerns: Medio Coverage of Women and HIV/AIDS

Lonely, homesick, working nonstop,
and sometimes mistreated, some
migrant workers compensate for their
hard work by letting go—having drink­
ing binges, engaging in paid or casual
sex, spending time with their lovers.
Financial Crisis

The research noted that the Asian finan­
cial crisis that began in 1997 has con­
tributed to the vulnerability of migrant
workers. To discourage foreign workers
from competing with their nationals for
scarce jobs, many receiving countries
restrict the entry of migrants’ families.
Thus, for years to come, the labor mar­
ket is bound to be restricted to the
young and single worker, some of whom
are lonely and sexually adventurous.
Another adverse effect of the Asian
crisis is the shrinking of the market for
domestics in those countries that no
longer allow families with nonworking
wives to retain a household helper. This
could lead to syndicates using domestic
work as enticement to lure prospective
Filipino women workers abroad. Prosti­
tution itself might be considered by
women OFWs unwilling to come home
despite the absence of job prospects
abroad.
Homegrown Risks

While millions of OFWs face the risk of
HIV transmission abroad, their spouses
are exposed to as much danger when
they get home, says Marin. The same
Kalayaan-Caram research reveals that

most wives cope with their fears by deny­
ing the possibility of their husbands’
casual affairs. “Their husbands are differ­
ent. They are God-fearing and faithful,
the women say of their spouses,” says
Marin. Or, she adds, the wives shrug and
accept the casual affairs “as part of a
man’s nature and thus unavoidable.”
Even among medical practitioners,
the lack of information about HIV/AIDS
has proven to be a damper on efforts to
curb HIV transmission, says Dr.
Dominic L. Garcia of the AIDS Society
of the Philippines, citing recent research
involving 77 physicians from both public
and private hospitals in three regions.
“Although the Commission on Higher
Education has incorporated basic
HIV/AIDS education and prevention pro­
grams in the medical curriculum, these
did not translate into good practice,”
says Dr. Garcia.
With Republic Act 8504 or the
Philippine AIDS Law in place, the gov­
ernment has made it mandatory for all
OFWs to undergo HIV/AIDS education
as part of predeparture orientation
(PDO). But for all the good intentions,
there is hardly any attempt to monitor
the implementation of the law, observes
Marin. “Most PDOs consist of a 15minute video with no discussion whatsoever to link HIV/AIDS and migration.
We need to get together the different
migrant support groups to do preven­
tive education throughout the migration
process—from predeparture, on site,
and upon return,” suggests Marin. ■

070 41
Conveying Concerns: Medio Coverage of Women and HIV/AIDS

Many migrant
workers are
below 30 years
old and sexually
active or
sexually
curious.

22, Romania
July 18-24,2000

(TYanslated from
Romanian)

HIV/AIDS —Silence and Deafness: Rural Africa
by Gabriela Adamesteanu
Rural South Africa

hen the bus stops, women and
young boys stick their faces on
the windows, trying to make the tourists
buy their products: oranges, pineapples,
and bananas, offered on trays or in plas­
tic bags, carried on the head.
Population mobility is remarkable,
especially after the political change six
years ago. An estimated 60 percent of
the men go to the cities for work and
return to their families only once a
month or a few times a year, depending
on the distance. After apartheid was
abolished and black people did not need
a passport to work in the white dis­
tricts, the social mobility increased,
but, ironically, this had the effect of
hastening the spread of HIV7AIDS.
As these men move away from their
homes and into urban areas, many par­
ticipate in drinking alcohol and visiting
sex workers. Some of these sex workers
are provided with condoms free of
charge by various clinics or organiza­
tions, but they do not always use them.

W
Sometimes
migrant men
use condoms
during casual
relationships
but never with
their wives.

22

Sometimes migrant men use condoms
during casual relationships, but never
with their wives at home. In this way,
migration is an important risk factor for
all sexually transmitted diseases.
Left alone at home with their chil­
dren, some women (40 percent get
pregnant before age 18) may also have
casual relationships with men from the
area, especially truck drivers. Thus,
they are not only victims, but also
agents of infections. The lack of educa­
tion and money, the psychological com­
plications (the suspicion of infidelity)
make them incapable of negotiating
their sexual relationships; consequent­
ly, they do not use condoms, the most
common means of protection.
This is one of the conclusions
reached by a team at the African
Centre, a demographic center based in
the city of Mtubatuba. The center
opened in February 2000, is financed by
the Wellcome Trust, and it focuses
some of its research on the highest-risk
category—adolescents. ■

Conveying Concerns- Media Coverage of Women and HIV/AIDS

"Milijuli" Radio
Magazine, Nepal
July 25, 2000

Improve Our Behavior Ourselves

/Translated from
Nepali)

by Harikala Adhikary

n the village district Hlabisa in South
Africa, men migrate to other parts of
the country or other districts in the area
for work. There, they would engage in
sexual relationships with casual part­
ners. Women living with their children
at home were also known to engage in
sexual relationships, especially with
truck drivers, in order to generate extra
income.
These situations show that the ac­
tivities of both men and women could
increase vulnerability to HIV Within
famihes, the men started to get sick,
and wives and newborn infants fol­
lowed. Some suffered from tuberculosis,
others from diarrhea. They visited the
hospital but did not find relief from the
diseases. They tried traditional medi­
cine, but the deaths did not end. No men
were available for funerals. No coffins
were available. Some blamed the wives
for the death of family members.
Death rates increased. Even those
wives who never engaged in casual sex
became ill with HIV They began to ask

I

for information about the disease. Until
then, only a mission hospital was set up
in Hlabisa. They went to this hospital
frequently and began to ask what is
HIV and how does it become AIDS?
How does it infect? What could be done
to protect children from being infected?
Once they got knowledge, they started
voluntary services for providing infor­
mation to the others like them. They
found that unprotected sexual relation­
ships are the major cause of the spread
of HIV. Now, they have become con­
scious and careful. They have learned.
Today, we (in Nepal) are at the same
point in the epidemic as the people of
Hlabisa were 10 to 15 years ago. Our
men also leave the villages for work.
Women look after the home and care
for the children. If the men go out and
engage in casual sexual relationships,
society ignores their behavior. This is
most harmful and destructive for us.
Therefore, we have to improve our
behavior ourselves. ■

Conveying Concerns: Media Coverage of Women and HIV/AIDS

Once they got
knowledge, they
started voluntary
services for
providing
information
to the others
like them.

23

PEOPLE LIVING WITH HIV
OR AIDS
ore than two decades after the start of the
epidemic, HIV/AIDS still generates fear,
misinformation, and the erosion of basic human
rights.48 Since the impact of the virus is great­
est in poor communities, the majority of those
infected must contend with the difficulties of
obtaining quality health care and social services
as they cope physically and mentally with a
debilitating and incurable condition. Responses
to the crisis in different parts of the world also
starkly illustrate the divisions between the rich
and the poor.
Those infected face persistent misconceptions
about the virus. Many people still believe that
they may fall ill through casual contact with a
person who has HIV or AIDS. This fear consti­
tutes a major obstacle to care and support for
HIV/AIDS patients at home, in the community,
and even at established health care facilities. To

M

many people, HIV equals death. Few understand
the difference between testing positive for the
virus, yet having no symptoms, and being sick
with AIDS. Someone who has HIV may be seen
primarily as incurably ill even though an infect­
ed adult may be symptom free for years.
Compounding the fear of AIDS as a fatal ill­
ness is the difficulty of discussing the illness as
a sexually transmitted infection. Across cul­
tures, the shame and guilt that often accompa­
ny discussions of sexual practices, preferences,
and desires also inhibit open discussions about
HIV. For this reason, initial responses to the
epidemic dismissed HIV/AIDS as an illness of
sex workers, homosexuals, and intravenous
drug users. Even now, a person living with HIV
or AIDS is often seen as a moral threat to the
community.
Since most HIV-infected women are of child­
bearing age, the challenges for many women
include the need to secure support, including
foster care, for their children. Some women dis­
cover their HIV-positive status only during preg­
nancy and face the risk of giving birth to an
infected child. In some situations, women living
with HIV are forced from their homes and even
blamed for the spread of the virus.
At the same time, medical breakthroughs
offer little hope to the vast majority of people
who have contracted the virus. Drugs that slow
the progression of HIV to full-blown AIDS
remain expensive and beyond the reach of most
of those who need treatment. Some governments
are adopting strategies to secure cheaper,
generic versions of the drugs, but even these
pose an economic burden to less developed
countries, particularly in sub-Saharan Africa.
Policies and programs to stem the epidemic
aim to promote greater access to quality health
care, drugs, and treatment for those infected and
to reduce HIV transmission through culturally
appropriate prevention strategies. Among the
approaches that promote prevention, those that
stress peer support and education have proved
effective and include programs that are run by
youth, women, street children, refugees, and
intravenous drug users. People living with HIV
or AIDS are providing some of the most powerful
messages against high-risk behavior.

Philippine Daily
Inquirer, Sunday
Inquirer Magazine,
Philippines
August 20, 2000

Positive—and Carrying On
by Pennie Azarcon Dela Cruz

ernando Feliz (not his real name)
remembers exactly when his life
changed drastically: “It was eight years
ago, and I had been drinking with
friends. Next thing I knew, I was in
Ermita, where I ended up having unpro­
tected sex with a sex worker.”
Now 36, Feliz wonders if things
would have been different if he had not
been drunk or if he had remembered
everything he had read about AIDS.
“I’m not ignorant about HIV/AIDS. My
friends in the U.S. would regularly send
me magazines, and the company I used
to work for had access to American
pubheations. This was in the early ‘80s.
Back then, you couldn’t touch an
American magazine without coming
across information on the disease.”
But like many other Filipinos, Feliz
never gave AIDS a passing thought. “I
didn’t think it would happen to me. I
was neither a sex worker nor an intra­
venous drug user, and I wasn’t involved
in a homosexual relationship. I was a
college graduate, for Chrissake, and
had a good job in a Makati firm.”
Indeed, he was on the fast track in his
career and had just applied for a job in
the United States. “I already had my
visa, but part of the requirement was a
drug and AIDS test."
Nothing—and nobody—prepared him
for the test results. “Pretest counseling
only became available in 1998, when
RA 8504 (the Philippine AIDS
Prevention and Control Act) was
passed. Otherwise, you were on your
own,” he recalls. When the medical
technician hesitated about giving him
the results, Feliz had an inkling of what
was to come. “I told him, ‘Tell me

F

straight. I can take it.’” Still, when the
technician confirmed that he was HIV
positive, this Visayan felt his knees
buckle. “I felt doubly at a loss. I’d lost
my job prospect in the US, and now I
was going to lose my life.”
Eventually, and thanks to the post­
counseling he received, Feliz realized he
had a whole life ahead of him. “With
proper medication, I could Eve a healthy
life for the next 10, 20 years,” he says.
He also felt that he needed his family’s
support. Where others similarly afflicted
would hesitate, Feliz immediately told
his siblings, his mother, and his best
friend. “My family understood and sup­
ported me because they are wellinformed.” Despite that, he would rather
remain anonymous, “out of respect for
their privacy and to spare them the
stigma attached to the disease.”
Indeed, as Dr. Loreto Roquero of the
Department of Health (DOH) confirms,
“It is often the family that is the last to
know.” In fact, the DOH runs Bahay
Lingap at the San Lazaro compound in
Sta. Cruz, Manila, as a sort of halfway
home for Persons with AIDS (PWAs)
until they are able to disclose their ill­
ness to their families. “Here, the proto­
col is to protect their privacy. We don't
tell even their partners unless they
agree. Even within the medical circle,
there is shared medical confidentiality,”
says Roquero, who heads the National
AIDS and STD (sexually transmitted
disease) Prevention and Control
Program.
Part of protecting his family, Feliz
knew, was protecting himself. “I read a
lot about Magic Johnson and the clini­
cal studies on HIV medication in the

Conveying Concerns: Medio Coverage of Women and HIV/AIDS

Those infected
face persistent
misconceptions
about the virus.

25

“My family
understood and
supported me
because they are
well informed. ”
—Fernando Feliz
(pseudonym),
HIV-positive
AIDS counselor

26

U.S. When I learned that the drugs
would cost from P27.000 to P40.000
(US$700 to US$1,000) a month, I vol­
unteered to be part of the clinical stud­
ies at the Research Institute of Tropical
Medicine.” Because of limited funding,
only 20 Filipino PWAs could take part
in the studies, which are meant to
document local experience with the
drugs prior to their approval by the
Bureau of Food and Drugs (BFAD).
Being on HFV medication can be a
risky routine, Feliz explains. “Once
started, the drugs have to be taken con­
tinuously, otherwise the virus becomes
resistant and multiplies.” The medica­
tion consists of a combination of such
antiretroviral drugs as Saquinavir, AZT,
and Zalcitabine. Feliz downs seven dif­
ferent capsules three times a day, or a
total of 21 capsules daily. Fortunately
for him, he has yet to experience the
medications’ side effects that range
from rashes and nausea to body pains.
Feliz recalls that once, when he was
assigned to do field work in Northern
Luzon, he missed his medication for a
whole month. The courier service that
delivered his drugs could not locate
him. “I was in a panic,” he recounts. “It
was time to ask myself what I valued
more: my job or my health?” It was an
easy choice. Feliz dropped his well-pay­
ing job for the more emotionally satisfy­
ing work of being an AIDS educator
and counselor. He became a member of
Positive Action, most of whose mem­
bers are HIV positive, while the rest
are volunteers, donors, and medical

practitioners. The group trained Feliz in
peer counseling and has since become
his main support group.
“I know just how difficult it is to cope
with being HIV positive,” Feliz says of
his choice. “Feel ko ang sakit, ang bigat"
(It’s a heavy burden). The tendency is to
be depressed, and depression weakens
the immune system, which is what the
AIDS virus attacks. A positive attitude
helps; that’s what I learned from a study
tour in Australia," he adds, referring as
much to himself as to other HIV-positive
individuals.
“You cannot imagine how it felt
when this dying PWA held my hand and
said he wanted to hear my voice so he
could die happily. It felt so good to be
there for him,” Feliz recounts. And his
particular circumstance makes for good
counseling strategy, he adds. “When
people think they’ll die very soon
because they have the virus, I tell
them, look at me! I’m robust, I’m
healthy, and I’ve been HIV positive for
eight years now. I’m proof that you
have your whole life ahead of you!"
From peer counseling, Feliz now
trains former overseas contract
workers who became infected and have
lost their jobs. “I train them to become
educators because apparently, most
Filipinos think AIDS is a very distant
risk. I want people to know that HIV
can infect anybody: health workers,
NGO (nongovernmental organization)
staffers, seafarers, and professionals.
We must know what we’re doing right
and what we’re doing wrong.”

Conveying Concerns, Medio Coverage of Women and HIV/AIDS

HIV/AIDS: Another Silence to Be Broken
by Thais Aguilar

abu is just over 40. Dressed in harsh
black clothing, she seeks comfort and
aid from a nurse in the Hlabisa Hospital
—located in the interior of the Kwazulu
Natal province of South Africa, some
300 kilometers to the northeast of this
city located on the Indian Ocean—
because her husband died a few days
before, a victim of AIDS.
She is a Zulu peasant and lives in
one of the poorest and most depressed
regions of this African country. Of its
41 million inhabitants, it is calculated
that 3.5 million are HIV positive, most
of them black, poor, and from rural
areas, areas where the percentage of
HIV-positive people may be as high as
50 percent.
Jabu is a living statistic. She is HIV
positive and was infected by her hus­
band, now deceased, who probably
acquired HIV from a casual, unprotect­
ed sexual relationship during his tenure
as a migrant worker in any of the large
South African cities—Johannesburg,
Cape Town, or Durban. With eight
daughters and sons, Jabu is an excep­
tional case among her neighbors
because none of her children is HIV
positive.
With no way to support herself, Jabu
cries from fear and desolation, leaning
on the desk of the distressed nurse,
who cares for HIV cases and acts as a
psychologist when she has the difficult
task of telling her patients whether
they are HIV positive or not. Jabu does
not even have one rand (local currency,
6.83 rands make one dollar) to feed her
daughters and sons. She does not know
what to do. She is deeply depressed
and afraid because she knows that

J

Servicio Especial
para Noticias de la
Mujer (SEM),
Costa Rica
July 11, 2000

(Translated from
Spanish)

sooner or later, she will suffer the fate
of her husband, and she fears for the
future of her family. As a result of her
extreme poverty, she has no access to
antiretroviral medications, which would
allow her to extend her life some 10
more years.
Hlabisa is one of the few commu­
nities that has the luxury of having a
state hospital with 300 beds and a
stock of medications and palliative
treatments for common diseases—
malaria, diarrhea, poisonings, broken
bones, and agricultural accidents of
some severity—and to test whether
people are HIV positive. It is a difficult
task in an area where educational levels
are low and living conditions modest.
Development Problem

African experts argue that the high
prevalence of venereal disease on this
continent is perhaps one of the principal
reasons for the alarming spread of
HIV/AIDS. Also, the explosive combina­
tion of underdevelopment, poverty, and
marginalization have provided the
breeding ground where in 1999 alone,
4 million Africans joined the list of HIV­
positive people, according to a global
report of the Joint United Nations
Programme on HIV/AIDS (UNAIDS)
presented at the 13th International
AIDS Conference in Durban.
Communities such as Mtubatuba,
some 250 kilometers northeast of
Durban, have serious problems with the
prevalence of HIV especially among
those under 25 years old. Despite the
high incidence of this sexually transmit­
ted virus, it is difficult to speak about
sexuality in this population and in rural

Conveying Concerns: Media Coverage of Women and HIV/AIDS

27

Investing in
treatment and
mass prevention
campaigns can
make a
difference.

areas, according to representatives of
the nongovernmental African Center.
The other South Africa—the white
South Africa—lives out its HIV-positive
status in better conditions, as acknowl­
edged by Edwin Cameroon, a justice of
the Supreme Court of South Africa, who
declared publicly at the AIDS confer­
ence that he is gay, middle-class, and
HIV positive. His position did not pre­
vent him from rubbing salt in the
wound of this inequality of access to
antiretroviral medications. His case and
Jabu’s exemplify what is happening in
developed and developing countries
with respect to the virus.
For him and other international
activists, human rights and health go
hand in hand. One human right relates
to a person’s well-being—-not only to
having access to quality public services
—but to the medications that allow a
good quality of life.
A Question of Resources and
Political Will

Judge Cameroon and many distinguished
scientists stress that the investment of
resources in treatments for those infect­
ed as well as mass prevention cam­
paigns—including such unpopular
policies as acknowledging the active
sexual lives of teenagers and allowing
them free access to condoms—are the
factors that might make the difference.

28

Peter Piot, director of UNAIDS,
acknowledged his organization’s failures
in the negotiations they have held with
pharmaceutical companies and the
global controls established by the World
Trade Organization with mandatory and
parallel import licenses.
Mandatory licenses to produce ge­
neric medications—which are equally as
effective as the original ones but pro­
duced locally or regionally at a lower
cost to consumers—would allow the
production of antiretroviral medications
at more affordable prices to developing
countries such as poor African coun­
tries, explained Richard Laing, a profes­
sor from the School of Public Health at
Boston University in the United States,
and one of many defenders of access to
low-cost medications. Parallel import
licenses authorize the importation of a
product without permission from the
patent holder. Both mechanisms require
a permit within the complicated system
of international trade.
Those who support low-cost access
to the antiretroviral treatment also
point out the responsibility of govern­
ments to invest in purchasing them, to
eliminate taxes on medications, and
reduce absurd expenses—such as mili­
tary expenses—to invest more in the
treatment and prevention of HIV/AIDS
and in health systems in general.

Conveying Concerns: Medio Coverage of Women ond HIV/AIDS

Parents, Kenya
September 2000

HIV-Positive Florence: The Face of Courage and Hope
by Eunice N. Mathu

all, beautiful Florence Ngobeni,
with a set of sparkling white teeth,
was bom 27 years ago in Alexandra, a
township in Johannesburg. An only child
from her mother’s first marriage, her
mother Julia sacrificed her for her sec­
ond marriage. The man would not marry
her mother with a child tugging along,
so Florence was left in the care of her
grandmother. Her mother was to have
seven other children from this second
marriage, and as a result, Florence was
forgotten at her grandmother’s house.
Although her grandmother, Miriam
Ndlovu, was a loving and caring
woman, she was a domestic worker and
only went home over the weekends.
Florence was left under the care of her
22- and 13-year-old uncles. The older
uncle worked as a furniture delivery­
man, while the younger one did not
attend school. The older uncle was
cruel and abusive to Florence. Although
her grandmother was aware of her
son’s cruelty to her granddaughter, she
could do nothing about it, as she
depended on him for financial support.
At the age of 17, Florence met a boy
who became her best friend. He con­
vinced her to have sex with him to
prove her love for him. For fear of los­
ing her newfound friend, she started
having sex with him regularly at his
parents’ home. The relationship lasted
six months, but Florence was already
pregnant. She was to lose this baby
after a beating from her uncle.
It was after her mother’s second hus­
band died that Florence moved to live
with her mother. However, their rela­
tionship was strained and they always
fought. When her mother became preg­

T

nant with her ninth child with another
man, Florence left to stay with friends
and various boyfriends. She had no
place to call home, and her boyfriends
used sex as payment whenever they
accommodated her. As a result of the
unstable life Florence led, her school
performance failed badly, and she failed
her final exams.
At the age of 19, she was gang raped
by a notorious Alexandra township gang
but did not talk about it for fear of being
killed by the gang. Rape was the pride
of gangs in the townships then. They
called it “jack-rolling.” If the victims
spoke of or reported the matter, their
famihes would be attacked and even
killed, and the police could not help.
At the age of 23, Florence became
pregnant again, this time, with a 32year-old boyfriend. Her baby girl,
Nomthunzi, “shadow" in Zulu, was born
looking healthy but at the age of three
months became ill. When Florence took
her baby to a clinic in Johannesburg,
she was tested for HIV. This was the
first time that Florence was confronted
with the possibility that her sexual
activities could have exposed her to
HIV. Tests confirmed that she was HIV
positive. In great shock and denial, she
went to look for the father of her child
to inform him that their baby was very
sick. That was December 1996, the
same month that both she and her
daughter were diagnosed as HIV posi­
tive. She found that her boyfriend had
died a few weeks before and had
already been buried. It was too much to
handle and the only person she could
turn to was her grandmother. She was
very understanding and supportive.

Conveying Concerns: Medio Coverage of Women and HIV/AIDS

29

Florence advises
patients to
make their HIV
status known in
order to stop the
spread of the
disease.

30

Word had already spread in the town­
ship that Florence had HIV and that her
child was dying from AIDS. People
used to come to her grandmother’s
house to see a child with AIDS. Her
boyfriend’s family accused her of having
infected him with the disease.
Florence only heard of sexually
transmitted diseases and HIV when she
was 19-—almost three years after she
had been sexually active. Neither her
mother, nor her grandmother, nor the
uncles who took care of her had men­
tioned sex or sexuality to her.
Today, Florence is an active member
of NAPWA, South Africa’s National
Association of People Living with AIDS,
which was founded in 1994. She is also
a board member of the Townships AIDS
Project in Soweto. She also works with
numerous nongovernmental and UN
organisations on AIDS projects. She is
a spokesperson for people infected with
HIV, comforting them and striving to
prevent others, especially young people,
from becoming infected.
Florence works as a counselor in the
Prenatal HIV Research Unit at Chris
Hani Baragwanath Hospital in Soweto.
As a counselor, she sees many HIVinfected people each day. Sharing her
personal experiences during counseling

sessions has helped both her patients
and herself. She encourages them to
find the courage to report cases of rape
and violence and to address issues of
gender power by inviting their partners
for counseling. She also advises them
of the importance of making known
their status in order to stop the spread
of the disease and to give a face to
HIV/AIDS.
Disclosure remains an important
issue for discussion during counseling,
as it is often difficult for somebody with
HIV to talk about his or her status.
Many people go into denial when their
status is disclosed. Often, men become
aggressive, fighting with their partners
and blaming them. Many women are
afraid of disclosing their status to their
husbands for fear of being beaten up or
even thrown out of the matrimonial
home. In some cases, fear of commu­
nity hostility and of being shunned by
friends makes it difficult for people
with HIV to come out. Florence has a
way of talking to her patients during
counseling that makes the burden of
disclosure lighter. She knows through
her own experience that with accept­
ance and disclosure comes the first
step toward personal healing.

Conveying Concerns: Media Coverage of Women and HIV/AIDS

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1.

2.

3.
4.
5.

6.
7.
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9.
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See, for example, United Nations Development Fund for Women (UNIFEM), Progress of the
World's Women 2000: UNIFEM Biennial Report (New York: UNIFEM, 2000).
Adriana Gomez and Deborah Meacham, eds., Women, Vulnerability, and HIV/AIDS: A Human
Rights Perspective (Santiago, Chile: Latin American and Caribbean Women's Health Network.
1998): 2.
Joint United Nations Programme on HIV/AIDS (UNAIDS), “AIDS Epidemic Update: December
2000" (Geneva: UNAIDS, December 2000): 3.
UNAIDS, "1999 World AIDS Campaign" (www.unaids.org/wac/1999/eng/facts%2De.htm,
accessed March 6, 2001).
World Health Organization (WHO), Fact Sheet 10, “Women and HIV and Mother-to-Child
Transmission" (www.who.int/HIV_AIDS/Nursesmidwivesfs/fact-sheet-10/index.html, accessed
February 9, 2001).
Avert, “Women, HIV and AIDS" (www.avert.org/womenaid.htm, accessed June 12, 2000).
Ibid.
UNAIDS, Report on the Global HIV/AIDS Epidemic June 2000 (Geneva: UNAIDS, June 2000): 11.
WHO, Fact Sheet No. 242, “Women and HIV/AIDS" (Geneva: WHO, June 2000).
UNAIDS, Report on the Global HIV/AIDS Epidemic June 2000 (Geneva: UNAIDS. 2000): 13.
HlVInSite, "Monitoring the AIDS Pandemic, Part II" (http://hivinsite.ucsf.edu/social/un/
2098.3cee.html, accessed January 24, 2001).
Chris Jennings, Understanding and Preventing AIDS: A Book for Everyone (Cambridge, MA: Health
Alert Press, 1996).
Ibid.
Martin Foreman, ed., AIDS and Men: Taking Risks or Taking Responsibility? (London: Panos/Zed
Books, 1998).
UNAIDS. “1999 World AIDS Campaign.”
HlVInSite, “Young Women in HIV Crisis: Press Release from the International Community of
Women Living with HIV/AIDS for World AIDS Day," December 1, 1998.
(http://hivinsite.ucsf.edu/topics/adolescents/2098.3f8d.html, accessed March 6, 2001).
Family Health International (FHI), “Preventing Mother-to-Child Transmission of HIV," Impact on
HIVVol. 1, No. 1 (October 1998).
UNAIDS, “AIDS 5 Years Since ICPD: Emerging Issues and Challenges for Women. Young
People, and Infants" (Geneva: UNAIDS, 1999): 6.
UNAIDS. “AIDS Epidemic Update: December 2000": 3.
Ibid.
Ibid.
See, for example, UNIFEM, Progress of the World's Women 2000: UNIFEM Biennial Report.
UNAIDS, “AIDS Epidemic Update: December 2000": 5.
The World Bank Group, press release, "AIDS Blunts Economic Growth, Worsens Poverty in
Hard-Hit Countries" (Durban: June 11, 2000).
United Nations, Platform for Action and the Beijing Declaration, Fourth World Conference on Women,
Beijing, China. 4-15 September 1995 (New York: United Nations, 1996): 60.
Julie Hamblin and Elizabeth Reid, "Women, the HIV Epidemic and Human Rights: A Tragic
Imperative" (New York: UNDP HIV and Development Programme, 1991): 5.
UNAIDS, “AIDS 5 Years Since ICPD: Emerging Issues and Challenges for Women, Young
People, and Infants”: 6.
UNAIDS, “AIDS Epidemic Update: December 2000": 3.
UNAIDS, “AIDS 5 Years Since ICPD: Emerging Issues and Challenges for Women, Young
People, and Infants”: 6.
Ibid.
WHO, Fact Sheet 10, “Women and HIV and Mother-to-Child Ttansmission” (www.who.int/
HIV_AIDS/Nursesmidwivesfs/fact-sheet-10/mdex.html. accessed February 9, 2001).
Ibid.
Ibid.
Ibid.
UNAIDS, Report on the Global HIV/AIDS Epidemic: June 2000: 81.
UNAIDS, “AIDS Epidemic Update: December 1998" (UNAIDS: Geneva. December 1998): 10.

Conveying Concerns: Medio Coveroge of Women ond HIV/AIDS

31

37.
38.

39.
40.

41.
42.
43.
44.

45.
46.
47.
48.

Population Reference Bureau (PRB), The World's Youth 2000 (Washington: PRB. 2000): 1.
HIVInSite, “World AIDS Campaign with Young People" (httpV/hivinsite.ucsf.edu/social/un/2098.3f71.html, accessed
January 29, 2001).
UNAIDS, Report on the Global HIV/AIDS Epidemic June 2000: 6.
United Nations Educational. Scientific, and Cultural Organisation (UNESCO) and UNAIDS, Migrant Populations and
HIV/AIDS (Geneva: UNESCO and UNAIDS, June 2000): i.
HIVInSite, "Monitoring the AIDS Pandemic, Part II."
Broad definition of migrants taken from UNAIDS discussion paper developed for the second ad hoc thematic meet­
ing in New Delhi. “Migration and HIV/AIDS" (Geneva: UNAIDS Programme Coordinating Board, October 28, 1998).
Ibid.
Mary' Haour-Knipe, "Migration and HIV/AIDS in Europe" (Geneva: International Organization for Migration (I0M)
and the University Institute of Social and Preventive Medicine, October 2000): 4.
Ibid: 1.
Ibid: 9-10.
Ibid.
World Health Organisation (WHO), Fact Sheet 6, “HIV/AIDS: Fear, Stigma and Isolation" (www.who.int/HIV_AIDS/
Nursesmidwivesfs/fact-sheet-6/index.html, accessed February 9, 2001).

Acknowledgments
This booklet is one of on occasional series on population, reproductive health, and gender issues pro­
duced by the Population Reference Bureau with funding from the U.S. Agency for International

Development (USAID) under the MEASURE Communication project (HRN-A-00-98-000001-00).

Yvette Collymore of PRB wrote the overview for each section and compiled and edited the articles.
Heather Lilley of PRB created the design. Justine Sass and Sara Adkins-Blanch of PRB co-authored the
global overview. Several other PRB staff members also contributed to the editing and review process.
Thanks are due to the following colleagues who reviewed drafts of the publication and offered valuable
comments: Adriana Gomez of the Latin American and Caribbean Women's Health Network; Ellen Weiss
of Horizons/lnternational Center for Research on Women; and Ellen Starbird, Michal Avni, Gabrielle

Bushman, and Linda Sussman of USAID.

PRB appreciates the cooperation of the editors who participate in the Women's Edition project and whose
media organizations are represented in this booklet. Responsibility for the facts and interpretations pre­
sented in the excerpted articles belongs to the individual authors.
The booklet was printed by McArdle Printing Company, Inc.

Cover photo: © Digital Vision
Women's Special Vulnerability to HIV/AIDS photo (page 6): © CLEO Photography

Mother-to-Child Transmission photo (page 13): © Liz Gilbert, Courtesy of the David and Lucile Packard
Foundation. Photo courtesy of M/MC Phofoshare at www.jhuccp.org/mmc.
Young People and HIV/AIDS photo (page 16): © World Bank/Tomas Sennett

Migration and HIV photo (page 19): © Victor Englebert

People Living with HIV or AIDS photo (page 24): © WHO/L. Gubb
© August 2001 Population Reference Bureau

32

Conveying Concerns: Medio Coverage of Women and HIV/AIDS

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