Women and AIDS in South Africa: a conflicted history leads to a dispiriting present.

• Author: Suich, Alexandra

TEN YEARS AGO, when Prudence Mabele discovered she had HIV, she was told to abandon her studies. She was working towards her degree in analytical chemistry at a time when HIV was neither understood nor tolerated in South Africa. "There were a lot of problems then", she said. "They didn't understand a lot about AIDS, so they told me to leave what I was doing because I was going to infect staff and students. They thought if I was at the laboratory I would infect people."

In a decade when there was a dearth of knowledge about HIV transmission, there proved an abundance of opportunity for proactive leadership. Prudence joined 59 other HIV-positive women to form the Positive Women's Network (PWN); today it has 2,000 members throughout South Africa. In such a forum, women began to speak about issues that directly affected them, such as how to discuss their HIV status with a spouse or how to cope with stigma. They also taught each other skills like weaving that could help them generate income. In other words, South African women, finding their families and communities unwilling or unable to support them, learned to support themselves and each other.

In South Africa, AIDS has disproportionately infected and affected women, who comprise the majority of participants in community organizations and care activities for the sick, and the majority of people infected with HIV/AIDS in the country. In May 2006, the Joint United Nations Programme on HIV/AIDS (UNAIDS) released the 2006 Report on the global AIDS epidemic, which states that women account for the bulk of the epidemic: 58 per cent of HIV-positive South Africans are women, or 3.1 million out of 5.5 million infected among adults aged 15 and over. A study conducted by the South African Department of Health in 2004 found that almost one in three pregnant mothers who received antenatal testing was HIV-positive. UNAIDS identified South Africa as the country with the highest number of women infected with HIV/AIDS in the world, almost double the number in India and over triple that in neighbouring Zimbabwe.

HIV infection among women worldwide has risen. While the infection rate among both men and women in sub-Saharan Africa in 1985 was roughly equal, UNAIDS estimates that today women comprise 59 per cent of adults living with HIV, (1) while among youth the gender imbalance is even more striking. Young women between the ages of 18 and 24 are three times more likely to be infected than men in the same age...