Widows
without Rights Conference
London
- 6-7 February, 2001
WIDOWS
and AIDS:
redefinitions and challenges
A presentation by
Bridget Sleap
Panos AIDS
Programme
Epidemiology
- marginalised and ignored
One
area in which widows have been marginalised is that of epidemiological
studies which ignore them. The UNAIDS epidemiology team is
unaware of any statistics available on the number of women
who have been widowed due to an AIDS death, or of the number
of widows themselves living with HIV or AIDS . Instead they
remain invisible and we have to rely on a few small, localised
studies, mainly from Africa. We must, however, be wary of
making generalisations; every person, every community differs.
But until more information is available these studies are
all we have to get an idea of the scale of the effect of AIDS
on widowhood.
Widowed
youth - a new generation
For
sociological and biological reasons women are twice as likely
to contract HIV through vaginal intercourse as men. Young
women are particularly vulnerable because their vaginal tracts
have not fully matured, are easily torn and offer less protection
from disease. In sub-Saharan Africa the rates of infection
for young women between 10 and 24 years old are up to five
times higher than for young men .
This
is significant for widows for a number of reasons. In addition
to normal social practice in some communities of older men
marrying far younger women, there is a belief held by some
that having intercourse with a young girl or virgin will cure
men of their HIV infection or protect them from future exposure.
Anecdotal evidence suggests that this has increased the incidence
of child rape and the number of child brides. Such early marriage
does not necessarily bring security, but often risk and vulnerability
to infection. Married 13 -19 year-old women in Uganda are
twice as likely to be HIV positive than their single counterparts
. 94% of the HIV positive women who reported to the main research
hospital in Mumbai in 1998, had been infected by their husbands.
20% of these women, all below 30, had previously been widowed
by AIDS .
Marriage
at a young age therefore does not protect young women from
infection and often means that girls are forced to stop their
education. Lack of education has a bearing on the rate of
infection amongst young women. Better educated girls tend
to start having sex later. They may then have more sexual
partners but are also more likely to use condoms than those
less well-educated . In Uganda the rate of transmission among
secondary-school educated girls between the ages of 15 and
24 has gone down much more than that amongst their less well-educated
counterparts .
Since
disease related to HIV infection tends to progress more rapidly
with age , older HIV positive husbands are more likely to
die before their younger wives, creating a new generation
of young widows. The child bride becomes the child widow.
A 1999 UNIFEM study in Zimbabwe indicated that 92% of those
who had lost their spouses due to AIDS, were women . Only
8% were men. In some African countries up to 50% of adult
women are widowed . Many of these widows will be HIV positive
themselves. A 1997 study in Tanzania revealed that those women
widowed or divorced were three times as likely to be HIV positive
as those who were single or currently married
Whilst
there is no biological evidence for faster progression of
the disease in an individual due to sex, a recent 7-year study
in Zambia showed that women had a poorer survival rate than
men. This was attributed, not to being female, but to the
fact that the majority of the women were younger, less well
educated and in most cases, were widows . Widows also tend
to have less access to medical treatment for economic reasons,
particularly if resources have been used up in caring for
their husbands or other family members.
Not
only, therefore, are young brides facing widowhood at an earlier
age because of older husbands dying of AIDS but are themselves,
if infected, not as likely to live as long as men living with
AIDS.
