The effect of female poverty on HIV/AIDS prevalene in the rural community of the UGU-district

Rodolo, P. N. (2008-03)

Thesis (MPhil)--Stellenbosch University, 2008.

Thesis

ENGLISH ABSTRACT: HIV/AIDS epidemic is a serious health and development problem in many countries, with South Africa amongst the countries that are hit hard by the epidemic and the impacts thereof. HIV/AIDS within Kwa-Zulu-Natal has always been higher than any other province in South Africa, with areas of higher HIV prevalence associated with major transport routes and areas of severe poverty (Susan Erskine 2005) A lot of studies and research has been done and the programs on advocacy, prevention and care are being implemented for the people infected and affected by HIV/AIDS. We are now on the third decade of HIV/AIDS in South Africa, yet there are still the rural communities where the interventions have not reached. South Africa is marked with a lack of political will in its engagement on the fight against HIV/AIDS; this is evident in the stance that the government pulled against the roll out of ARV s, the controversial statements by the Minister of Health and the irresponsible statements by the policy makers. Some of the HIV/AIDS programs hardly reach the poor communities, even if they do, they sometimes do not address the underlying socio-cultural issues of the poor women. The HIV/AIDS programs that would make sense to the poor women in the rural communities are those that are linked with poverty alleviation, rural women empowerment and the issues of gender inequalities. The Department of Social Welfare and Department of Health have taken much effort in empowering the Home Community Based Care organizations within the rural communities, making them drop-in centers, but there is still a lot to be done. The HCBC s need to be capacitated on issues of governance to ensure sustainability of the programs. The study indicated that the underdevelopment, marginalization and the isolation of the poor communities form a barrier to interventions. There is a need for a pro-poor community programs that seek to address the issues of unemployment and the conditions of being unemployable amongst the rural poor women and assisting women to form cooperatives. The study supports the fact that certain types of human behaviors spread HIV/AIDS; therefore, the epidemic can be controlled by the changes in those behaviors (USAID 2001). The risky behaviors that were exposed by this study calls for a need to involve all sectors of society to promote interventions that reduce high risk sexual behavior, control and treat STI s and empower women as they are the most susceptible and vulnerable to HIV/AIDS. Community mobilization may be used to increase awareness among men of how HIV/AIDS can affect the lives of their daughters, wives, mothers and friends (Kim Rivers and Peter Aggleton, 1999). Heise and Elias, 1995, Ankrah and Attika, 1997 purports that other women have reported that suggesting condom use to a partner may be tantamount to accusing him of infidelity resulting in men being violent when safe sex is requested. The study has exposed the issue of gender inequalities as a factor that increases women’s vulnerability to HIV/AIDS.

AFRIKAANSE OPSOMMING: Die MIV/VIGS epidemie is ‘n ernstige gesondheid- en ontwikkelingsprobleem in baie lande, met Suid-Afrika wat swaar onder die epidemie en sy gevolge ly. Binne Kwa-Zulu Natal was MIV/VIGS nog altyd hoër as enige ander provinsie in Suid-Afrika, veral langs hoofroetes en in areas wat aan erge armoede ly (Susan Erskine 2005). ‘n Groot aantal studies en navorsing is reeds gedoen en programme rakende bepleitings; voorkoming en sorg vir persone wat geïnfekteer en geaffekteer is deur MIV/VIGS word geïmplementeer. Ons het nou reeds drie dekades van MIV/VIGS in Suid Afrika, maar daar is nog steeds landelike gemeenskappe wat nog nie deur intervensies bereik is nie. Suid-Afrika word gekenmerk deur ‘n gebrek aan ‘n politieke wil in sy verbintenis tot die stryd teen MIV/VIGS. Dit blyk veral in die regering se houding in die beskikbaarstelling van ARV’s, die omstrede uitlatings van die minister van gesondheid en die onverantwoordelike verklarings deur beleidmakers. Sommige MIV/VIGS programme het skaars arm gemeenskappe bereik. En indien wel, word die onderliggende kwessies van verarmde vroue nie aangespreek nie. Die MIV/VIGS programme wat deur arm vroue in landelike gemeenskappe begryp word is dié wat gekoppel word aan armoede-verligting, bemagtiging van landelike vroue en kwessies rakende geslagsgelykheid. Die department van sosiale welsyn en die departement van gesondheid het reeds baie gedoen om die “Home Community Based Care” (HCBC) organisasie onder die landelike gemeenskappe as instapsentrums te bemagtig, hoewel daar nog steeds baie is wat gedoen kan word. Die HCBC’s behoort bygestaan te word in regeringskwessies vir die volhoubaarheid van die programme. Die navorsing het aangedui dat onderontwikkeling, marginalisering en isolasie van gemeenskappe intervensie verhinder. Daar is ‘n behoefte aan armgesinde gemeenskapsprogramme wat kwessies aanspreek soos werkloosheid, opneembaarheidstoestande en die vorming van koöperatiewe verenigings vir vroue. Die studie ondersteun die feit dat sekere soort menslike gedragspatrone MIV/VIGS versprei. Gevolglik kan die epidemie beheer word deur gedragswysiging (USAID, 2001). Die riskante houdings wat deur hierdie studie blootgelê is, vra vir die betrokkenheid van alle sektore van die gemeenskap om intervensies te bevorder wat hoë risiko geslagsgedrag sal verminder, seksuele oordraagbare siektes sal beheer en behandel, en vroue te bemagtig, aangesien hulle die vatbaarste en kwesbaarste is vir MIV/VIGS. Gemeenskapsmobilisering kan gebruik word om bewuswording te bevorder onders mans oor hoe MIV/VIGS die lewens van hulle dogters, vroue, moeders en vriendinne affekteer (Kim Rivers and Aggleton, 1999). Heise en Elias, 1995, Ankrah en Attika, 1997, beweer dat ander vroue het gerapporteer dat wanneer aan ‘n lewensmaat voorgestel word om ‘n kondoom te gebruik, gelykstaande is aan ‘n beskuldiging van ontrouheid. Dit lei daartoe dat mans hulle tot geweld wend wanneer veilige geslagsverkeer aangevra word. Die studie het die kwessie van geslagsgelykhede toegelig as ‘n factor wat die kwesbaarheid van vroue vir MIV/VIGS verhoog.

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