IN ZIMBABWE, when a woman married to a truck driver dies of AIDS leaving two small children to be cared for by grandparents, the story is at least partly political.
Politics is about power. Women in Zimbabwe have little power, in government, in business, in the bedroom.
Priscilla Misihairabwi, 34, is an exception, an elected member of Parliament in a nation where fewer than 10 percent of the seats are held by women.
Priscilla exudes power. Perhaps it's her elegant navy pantsuit or her confident stride in narrow heels. Most likely, it's the plain way she talks about leadership and about the relationship between women and men.
|"I actually think in Zimbabwe, the greatest risk factor for AIDS is marriage. Most women in Africa they’re just sitting ducks." |
PRISCILLA MISIHAIRABWI, MEMBER OF PARLIAMENT
"You can't separate issues of governance from issues of HIV infection," she says. "In Zimbabwe, we knew there was HIV as early as 1985, but the leadership decided HIV was not going to be spoken about. Prevention strategies did not start at a smaller level. If we concentrated on the commercial sex workers then, it could have been contained in that core group. By the time we started dealing with the issues, it had spread to the entire population: pregnant women, married women, young girls with sugar daddies. We had lost the battle."
Consider the contrast in Uganda, where the minister of public health passed out condoms on the street. The HIV infection rate there has dropped from 33 percent to 5 percent. In the U.S. and Europe, AIDS has been largely contained in targeted high-risk populations.
Priscilla launched her political life with a petition drive to register the female condom. In 1989-90, a research group had conducted an acceptability trial of the female condom. When the study was over, the condoms went away.
Women wanted them back. But the product was not registered with the ministry of public health. So Priscilla crisscrossed the country, educating women about HIV and female condoms and asking them to sign their support. She and others from the Women in AIDS Support Network collected 52,000 signatures; the female condom was registered for use in Zimbabwe on Dec. 1, 1998, World AIDS Day.
Priscilla continues to hold workshops for women all over the country. She encourages them to know their bodies, to refrain from using herbs vaginally, to get tested, to tell their husbands condoms are for contraception a less inflammatory purpose than protection. Talk about sex and HIV before trouble starts, she urges.
"It's amazing how the same issues pop up whether she's a poor woman in a rural area or an educated professional woman," Priscilla says. "I actually think in Zimbabwe, the greatest risk factor for AIDS is marriage. Most women in Africa they're just sitting ducks."
Sub-Saharan Africa is home to 11 percent of the world's population. It is home to 70 percent of those infected with HIV.
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IN INDIA, an estimated 3 million people have HIV/AIDS.
Global health workers are racing to keep it from becoming the next Africa. The Gates Foundation recently promised $100 million to fight AIDS in India because the epidemic on the subcontinent is at a tipping point, which means there's still a chance. This summer, PATH researchers cruised drugstore aisles in India, loading their shopping baskets with 170 different vaginal products. These will be tested to see if any can be effective as a microbicide against HIV.
The Global Campaign for Microbicides says scientists may have a working microbicide as early as 2007 and likely by decade's end. Even if it's only 60 percent effective, it could avert 2.5 million HIV infections in three years if distributed in 73 countries.
In Asia and the Pacific, 7 million people have HIV/AIDS. Cambodia, Myanmar and Thailand have HIV prevalence rates of about 1 percent among 15- to 49-year-olds.
In Haiti, 8 percent of adults in urban areas and 4 percent of adults in rural areas are infected.
In Eastern Europe, 250,000 people were newly infected last year, bringing the total number of HIV-positive people to 1 million. Eastern Europe is home to the fastest-growing HIV/AIDS epidemic in the world.