An exploration of the underlying social dynamics that make women vulnerable to HIV infection

English: In South Africa, as in the rest of Sub-Saharan Africa, HIV/AIDS has become a source of national and international concern. After many prevention campaigns and education programmes the viruscontinues to spread at an alarming rate, forcing one to look more carefully at the underlying social organization that could be conducive to the spread of thisdisease. In particular the position of women isbeing investigated in order to uncover the social dynamics that increase their vulnerability to this disease. In the year 2000, almost a quarter (24,5%)of South African women attending antenatal clinics were HIV positive. Physiologically,women appear to be at greater riskof contracting HIV than men. Apart from the physiological vulnerability of women it is important to consider the social aspects that put women at risk.This thesis considers the following social factors that put women at risk: violence against women, rape in particular; the unfavourable economic position of women that threatens the well- being of women as it encourages behaviour that increases the riskof HIV infection: the low educational status of women; a sexual culture which includes practices and expectations that put women at risk. This exploratory study revealed that women lack specific knowledge concerning the disease and hold certain misconceptions about how being in a stable relationship protects one against the disease. Another important finding was that these women, who acquired the disease, were in stable relationships that were generally positive and rewarding and that the overriding motivation to have sex was based on love. This emphasizes the fact that all women are at risk and that the very nature of a stable relationship (that encourages trust and complacency) is what puts women at risk. Some relationships were negative and this involved forced sex. Regarding the non-use of condoms, the main reason cited was that people who trust one another, do not use condoms. Unfortunately the real culture of infidelity coupled with the emphasis on trust (no condoms) was one important reason why these women acquired HIV. In addition to the above, the study revealed that the trans-gender and trans-generational lack of communication regarding sexual matters makes it difficult for women to insist on condom use when they suspect their partners to be unfaithful. This study recommends that action to protect women must be taken on an individual, organisational and ideological level. On an individual level, it is important that all women perceive themselves to be at risk and that they know exactly how to go about protecting themselves. In addition to this, individuals should continuously be motivated to practice behaviour that will protect them from HIV infection. This motivation can come through socialisation agents such as schools, parents, churches and the media. It is also important that women have the power to dictate sexual behaviour. Regarding the organisational level, HIV counselling and anti-retrorviral therapy should be available. Sexually transmitted diseases should be prevented with the help of the health care sector and the mobilisation of organisations that work to combat violence against women. Ideologically, the patriarchal nature of our society must be changed before wide spread behavioural change will occur. The rampant spread of this disease can only be stemmed if the subordinate position of women is acknowledged and addressed.