Bill & Melinda Gates Foundation

Women and Teenage Girls Break Taboo of Discussing HIV in Church

May 23, 2013

In Zambia, a group of mothers and teenage girls are on a mission to fight HIV discrimination within their church and the community at large.

These HIV activists belong to the Kafwa home-based care group from the Mandevu church in Lusaka. Most of the members in this group are living with HIV and are strong believers in their church doctrine, but have faced significant stigma. They are now shaking things up by breaking the silence of HIV in church and speaking about its impact in the community.

One of the big issues mothers and teenage girls face is accessing crucial HIV and sexual and reproductive health services, an issue being featured at this year’s Women Deliver conference in Kuala Lumpur from 28-30 May.

 It took a lot of bravery for some of us to openly disclose our status to the entire congregation and educate people about HIVCatherine Nakawala, Kafwa chairperson

Catherine Nakawala, Kafwa chairperson, has been on antiretroviral therapy for the past six years. She said: “In church people living with HIV face a lot of challenges; it has been difficult to talk about positive practices to prevent HIV transmission. But there is a responsibility not only to prevent passing HIV to others, but also to protect your own health by not getting re-infected, which is also important.

“Our group formed amid strong opposition to speaking about condoms in church because a person infected with HIV was considered promiscuous and a sinner before God. It took a lot of bravery for some of us to openly disclose our status to the entire congregation and educate people about HIV. Most people thought you could only get infected through unprotected sexual intercourse with a person who is HIV positive, they were not aware of the other ways.”

The courage of the Kafwa women has paid off. Church leaders play an important role in community life and, influenced by Kafwa, the leadership of Mendevu church has started addressing some of the challenges faced by members of the congregation who are living with HIV.

The church has now introduced ‘HIV Sunday’, a quarterly service to exclusively preach, sing, give testimony and raise funds to support people living with HIV, which helps prevent unnecessary deaths among church members.

Teenager Margret Kasamu is also part of the Kafwa group, she said: “Young girls don’t discuss issues of how to practice safer sex and it used to be taboo to discuss sexual and reproductive health in church.

“Although services are available in most health centers, they are not youth friendly and we feel shy or afraid to go there. Often teenagers are turned away by the counselors and older women attending the health centres as they think teenagers are too young, so we can’t get things like condoms, lubricants and counselling. This means teenagers are left with no option but to have unprotected sex, some practice anal or oral sex to prevent unwanted pregnancies but they remain vulnerable to HIV infection.

“Teenage girls’ rights and privacy are being violated at all levels. This is why I decided to join the group as we have a chance of discussing these issues without fear, and the mothers and older women are role models for us.”

Zambia’s National Reproductive Health Policy from 2008 states that its goal is to achieve the highest possible level of integrated reproductive health for all Zambians so as to promote quality of life.

Safe motherhood, male reproductive health, family planning, adolescent health and development, sexually transmitted infections, HIV and AIDS, abortion, infertility and other reproductive health issues including cervical cancer are all meant to be addressed by the policy. However, five years on it has not yet been fully disseminated or implemented.

Sister Monica, a nurse at a public health centre in Lusaka, said: “To the best of my knowledge this policy is being carried out, but it is not being noticed by the general population because the Ministry of Health faces the challenges of low numbers of healthcare providers as well as poor infrastructure. The current government has embarked on building more health centres and training more health professionals to sufficiently provide these services to people.”

 
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