Gender, Culture and HIV Positive Women in Swaziland: Women Have No Voice or Choice on How They Can Live Their Own Lives

Dr Gail Andrews
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The purpose of this research was to conduct an in-depth analysis of the sexual and reproductive health rights (SRHRs) and needs of HIV-positive women in Swaziland. While the objectives of the main study were extensive, this paper will present only the results relating to the experiences and perceptions of HIV positive women regarding SRH services and the key barriers to accessing these services. Specifically, it will highlight how stigma and discrimination, gender, unemployment and poverty fuel the HIV/AIDs epidemic in Swailand, a country in sub-Saharan Africa with the highest rate of infection in the world.

Data Collection: Study sites were purposively selected and the main methods of data collection were in-depth individual interviews and focus group discussions (FGDs) with HIV positive women. FGDs were also held with key groups such as HIV positive men, traditional leaders and healers, religious leaders, health workers, policy makers, and workplace HIV coordinators.

Research Outcomes revealed that HIV positive women face many challenges: stigma and discrimination; a patriarchal culture that allows polygamy; poverty; low levels of education; violence; lack of a rights culture; and significant oppression. All these impact on their access to SRH services. The majority of HIV positive women interviewed were not engaged in an income generating activity, leaving them fully dependent on their male partners or relatives, without any “voice or choice on how they can live their own lives”. Given the high rate of HIV infection, urgent steps need to be taken to address these challenges. This paper will conclude with some recommendations for policy makers and planners.

Keywords: HIV/AIDS Stigma, Gender, Culture, Poverty, Access Services
Stream: Interdisciplinary Perspectives on Gender
Presentation Type: Paper Presentation in English
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Dr Gail Andrews

Director/Head, Social Aspects of HIV/AIDS Research Alliance (SAHARA), Human Sciences Research Council
South Africa

Gail holds a PhD in Public Health from the University of the Western Cape which she obtained in April, 2004, and Master of Public Health degree from the University of Wales, College of Medicine (1990). Prior to her position in SAHARA, she was head of Health promotion in the School of Health Systems & Public Health (SHSPH) at the University of Pretoria, and has more than 15 years experience in academia and research, including the supervision of masters and doctoral students. Gail also has extensive experience in planning, researching, and monitoring & evaluating sexual & reproductive health and HIV/AIDS programmes. In 2004, she led the inception phase of the DFID HIV & AIDS Multi-sectoral Support Framework Programme (MSF). Leading a team of four Advisors she assisted a range of partners in Government, at National and Provincial levels to develop plans aimed at supporting the South African Response to HIV & AIDS.
Gail also has extensive experience of the South African health system, having worked as a midwife and frontline provider, and later as director for Women’s Health and Human Genetics in the South African Department of Health. In the latter position she was responsible for the development, implementation and monitoring of priority health policies and programmes related to Women’s Health, Maternal Health and Human Genetics. This included working with the HIV and AIDS cluster to oversee the integration of HIV/AIDS into the maternity care guidelines, and to develop the programme for PMTCT of HIV/AIDS.

Ref: I06P0450