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06/07/2017

Today, there is medication that prevents pregnant HIV-positive women from passing the virus onto their babies. So why are children still being born with the virus? 

Dr Rosemary Chimbala-Kalenga, Director of NMMU’s HIV and Aids Research Unit, said the main reason is the stigma still associated with the disease.

“In the early 1990s, HIV-testing of pregnant mothers was compulsory. If the mother was found to be HIV-positive, she was put on medication to protect her baby. But now, a mother can decide if she wants to be tested or not.”

Dr Chimbala-Kalenga said the change in legislation came about because men were using the HIV tests of their pregnant partners as a form of “secondary testing” for themselves. “They think: if she’s HIV negative, I’m HIV negative. If she’s HIV positive, I’m HIV positive – and it’s her fault.”

The result was that men tended to blame and leave their partners, so many women today prefer not to know their status, even though it could mean sparing their children from the disease.

Not all babies born to HIV-positive mothers will contract the virus – even if the mother does not take medication – however it is estimated that 2,7 % of babies are still being born with the virus in South Africa, according to Medical Research Council data.

Dr Chimbala-Kalenga said children born with HIV typically had huge battles to contend with later in life.

“In many cases, grandparents are looking after their grandchildren. To protect them from the stigma, they don’t tell them that they have HIV. Each month, the grandparents go and collect their anti-retroviral (ARV) drugs from the clinic and administer them, saying it’s for ‘flu’. But as they get older, they start asking questions.

“In some cases, the child learns about HIV and ARVs at school, and realises their grandparents have been lying to them.

“And so they find out they are HIV positive – but they know that being HIV positive is not tolerated by the community, that people think you are promiscuous or classify you as a prostitute … They look at you and they are numb ... There is such a strong stigma. People would rather die.

“One young woman [now at university] said: ‘Why should I tell my boyfriend I’m HIV positive, when I’ve never had sex with anyone?’ Another youngster said: ‘I’m not responsible for being HIV positive. My mother gave me HIV. Maybe I should just die and follow her.’

“Another problem is that people living with HIV must access ARVs at their local clinics. That’s not what they want. They want to access ARVs secretly. At the local clinic, everybody knows them, so out of desperation, they go to other areas where nobody knows them. Unfortunately, they must produce proof of address before they can be treated. When the administrators see that they have come from another area, they refer them back to where they were running from. Therefore, we continue to have AIDS-related deaths, despite ARVs, because of the stigma.”

She said the stigma attached to the virus was prevalent across the continent and globe.

The ‘blesser’ phenomenon

Dr Chimbala-Kalenga’s other research projects have focused on the sexual behaviour and attitudes to HIV and AIDS, of students, prostitutes and homosexual males living in the townships.

One of her findings has been the rise of “transactional sex”, where mostly women, who in her study have ranged from 16 to 55 years, have sex with usually older men – the so-called “blessers” or “sugar daddies” – in order to obtain something, which could range from money and clothes to cell phones, rent money or even school fees.

“In some cases, a young woman will have more than one blesser. There is one giving her clothes, another shoes. What I have also found is that women will ‘share’ their blessers with their friends, so their friends can also benefit. To me, this idea of referring a sex partner is part of a new culture that has been created. And this culture has thrown our values of intimate relationships out of the window.”

Men who have sex with men (MSM) are also contributing to the increase of HIV.

“The African culture, unlike other cultures, is not very tolerant towards homosexuals. Therefore, many men marry and have children but have affairs with other men. And this is the same for homosexual women.”

In terms of her research with prostitutes, she has found that many will agree to sex without condoms, for more money. Her work with prostitutes has also revealed a number of married women in the sex industry. One of them said: ‘If I become HIV positive, I will take the ARVs and still be alive to feed my children. But with hunger, I will die in a few days.’”

One married prostitute said she just enjoyed “having lots of sex”, while another was forced into prostitution by her husband, who runs a brothel. “Another said her boyfriend had no job and they needed money to survive, to feed their baby.”

With students, she has found that even though most have sufficient knowledge about HIV and its prevention, they will still engage in risky behaviour “because everybody’s doing it”.

“The HIV and AIDS epidemic is not something South Africa has under control.”

According to Statistics South Africa, an estimated 6,2 million South Africans are living with HIV, which is about 11% of the country’s total population.

Dr Chimbala-Kalenga has published 18 articles in peer-reviewed journals, delivered 10 conference presentations, and supervised 10 masters students. She is currently supervising two master’s students and one doctoral student.

 

Contact information
Dr Rosemary Chimbala-Kalenga
Director: HIV and AIDS Research Unit
Tel: 27 41 504 2344
rkalenga@mandela.ac.za