Sex & relationships in the lives of young women living with HIV

By Sungano Bondayi

A woman living with HIV hopes to have her own family. She wants her children to be born without the virus and this is now possible with the right treatment. But when that service is non-existent in her local area, where does she stand?

Living in a world where you must rely on the people around you to accept you and your status is difficult. Sometimes you just know that it is never going to happen. For women, it is a necessity to stand together and fight for the rights of women living with HIV. This was the dialogue which was facilitated by Africaid Zvandiri on 3 December 2015, at a session during the International Conference on AIDS and STIs in Africa, focusing on sex and relationships for women living with HIV.

Maximina Jokonya , a young woman openly living with HIV, facilitated the discussion with a panel of young women from countries such as Burundi, South Africa, Uganda and Zimbabwe, who were advocating for those living with HIV. In a move to empower young HIV positive women, they discussed challenges faced by women in their diverse communities and the possible ways forward.

Addressing HIV stigma

In Uganda, the environment is sometimes not welcoming to women living with HIV, especially pregnant women living with HIV. Services for prevention of mother to child transmission of HIV have improved over the past few years, with more attention to and availability of medication for pregnant women living with HIV. However, stigma remains a real issue in the community, including in health facilities where women go to get the care and support they need to stay healthy.

There was a strong call for women living with HIV to involve their partners since for some, it could lessen the burden and helps their partners better understand the different issues women face. Lebohang Motsumi, the South Africa ambassador for non-governmental organisation ZAZI, (a Nguni word meaning “know yourself”), highlighted challenges women living with HIV face in their relationships.

She said: “When a guy asks you out, the first thing you think of is your HIV status.” This should not be the case, and the fact that women have to constantly think of their status in these kinds of situations is due to the stigma.

Disclosing HIV status

Claudia Nizigiyimana from Burundi spoke about women understanding their rights. “If people know your status and they see you in a relationship they start saying that you want to kill your boyfriend with your virus.” Most young women in Burundi want to disclose their status to their partners but they are afraid. Even if the partner accepts it, in the end the relatives will reject the young woman based on her status, as a result these young women opt not to disclose. The fear of being the subject of gossip in the community is not flattering and they end up just flowing with the tide.

The panellists all advocated for changes in attitude towards women living with HIV. But how to make this happen is an ongoing debate.

One point agreed upon, is that the empowerment of young women living with HIV starts by sensitising the communities so that they do not threaten and discourage women from having sexual relationships. More information needs to be provided so that communities have a deeper understanding about HIV, including how it is transmitted and what services are available to support women living with HIV and their partners to enjoy fulfilling sexual relationships. And communities should advocate for youth-friendly services.

Improving sexual and reproductive health information

Young women living with HIV also need to be informed about their sexual and reproductive health, and how they can use preventive measures to avoid the transmission of HIV, the acquisition of sexually transmitted infections (STIs) and unplanned pregnancies. Health workers also need to know that women living with HIV have rights to quality and integrated sexual and reproductive services just like anyone.

Young women living with HIV need support to accept their HIV status, support each other and work together with the community. When holding support groups they should not be more focus only on those infected by HIV as this will cause them to stigmatise themselves but these groups should involve all women, it is important to include other members of the community who are negative because everyone is affected by HIV.

Ending HIV is not an individual concern, it requires a team effort. As Motsumi said: “Do not shut yourself from the world, work with the world.”