Opening Our Eyes: Addressing Gender-based Violence in South African Schools
Workshop 6 Background Paper:
Gender-based violence and HIV/AIDS
Although the AIDS/HIV epidemic has become a global crisis, the situation in South Africa is particularly acute. According to recent figures, the national rate of HIV prevalence is 22.8% and infection rates are rising at an alarming rate1. With the highest percentage of new infections occurring in the 10-24 age group, young people are now recognized as the best resource for changing the course of the epidemic. In countries that have worked with youth to reduce risk behaviour, levels of HIV infection have been dramatically lowered. Young people are a promising target group for HIV prevention programs because their unsafe behavioural practices are less established than those of adults2. This means that teachers are in a key position to stop the spread of HIV infection by becoming informed about the disease and delivering quality education programmes to learners.
Quality education programmes are those that deal with the complex and sensitive issues related to AIDS. The simplistic "just say no to sex" focus of many programmes ignores the real causes of the spread of the disease. Factors such as poverty, abuse, and lack of hope for the future are additional risks for youth3. As noted by UNAIDS (2000), "AIDS is not an equal opportunities disease"; it feeds on the social inequalities of gender, social status, race and sexuality4.
There is strong evidence that gender is a key factor in vulnerability to AIDS5. Statistics show that women are disproportionately infected; the HIV incidence rate among girls is three-four times higher than boys6. AIDS is rapidly becoming a major cause of death for women of reproductive age7. What are some reasons for the gender-based impact of this disease?
Gender and HIV/AIDS
A combination of biological and social factors increases female vulnerability to AIDS. A single episode of unprotected intercourse is risky for women who may be receiving infected semen from a male partner. In addition, sexually transmitted diseases can go undetected in women leaving them more susceptible to HIV transmission8. Women's reproductive roles, particularly the pressure to bear children, heightens their compromised HIV status.
Women's biological susceptibility to AIDS is compounded by their limited economic and social power, particularly in relation to sexual relationships with males. Currently, the level of violence against women in South Africa is higher than any country not at war9. There is a growing awareness of the link between violence against women and the growing rates of HIV/AIDS infection. Understanding this link is key to tackling the underlying causes of this fatal disease. This is particularly important for educators who are working with learners for whom preventive activities can still work10.
A number of attitudes and behaviour have contributed to the relationship between sexual violence and HIV infection. Most have to do with the ways our thinking about sexuality is connected to issues of gender and power. According to Suzanne Leclerec-Madlala, an anthropologist at the University of Natal, our beliefs about women's bodies and sexuality have a serious impact on the spread of AIDS11. Many of these attitudes are tied to traditional roles of masculinity and femininity which are often played out in sexual behaviour.
In many societies, physical force and intimidation are equated with masculine behaviour. This equation is operating in South Africa where a history of oppressive political practices has embedded violence as a normal part of gender-based relations. A legacy of apartheid has resulted in heightened forms of aggressive manhood that are often directed at women.
For many males, sex is perceived as a way to prove one's masculinity. When faced with a future of economic insecurity, young men may use sex to gain a sense of control in their lives12. Having sex with multiple partners is one way to express male virility, especially when a sense of masculine identity is at stake13. As highlighted in the UNAIDS strategy document "Men and Aids - gender-based approach: 2000 World AIDS Campaign," these attitudes have made coercive, unprotected sex a common practice: "extra challenges for HIV prevention arise from traditional expectations that men should take risks, have frequent sexual intercourse (often more than one partner) and exercise authority over women. Among other things, these expectations...encourage men to force sex on unwilling partners, to reject condom use and the search for safety as `unmanly', and to view drug-injecting as a risk worth taking. Changing these commonly-held attitudes and behaviours must be part of the effort to curb the AIDS epidemic."14
Undoubtedly, the high incidence of rape in South Africa contributes to the spread of the AIDS virus. But the dangers of AIDS infection are not limited to rape survivors. Women in committed relationships may find it hard to negotiate safe sex, especially when physical and sexual violence is a threat. Men's refusal to wear condoms, even in situations of consensual sex, heightens the risk of infection for themselves and for their female partners.
There is evidence that young girls may be particularly vulnerable to AIDS. Desperate economic circumstances can pressure young women into survival sex with paying clients who demand unprotected intercourse15. The myth that the virus can be cured by having sex with a virgin increases the risk factors for girls. Some older men will seek out young girls for unprotected sex because they believe they are safe from HIV infection16.
Teachers who have relationships with their learners are making schools dangerous places for young women. In addition to the risks involved in the sexual activities, discussions about safe sex and body integrity become meaningless when learners are being exploited by the person in charge of their education17.
Acts of sexual violence are an expression of males' presumed entitlement to female bodies. In the context of the AIDS/HIV epidemic, the repercussions of forced sex can be fatal for girls. President Thabo Mbeki has urged South Africans to work together to tackle the AIDS/HIV epidemic. In his address on World AIDS Day on December 1, 1999 he made the following plea:
To overcome the challenge that this disease poses, every one of us must play an active part. If you are a member of a church or non-governmental organisation or a school that does not as yet have an HIV/AIDS programme, see to it that you come together to draw up such a programme.
Given the complexity and sensitivity of factors related to AIDS, it is understandable that many teachers feel unprepared to undertake this work. Disagreements about the best approaches to doing AIDS education and the problem of already overcrowded curricula are additional limitations. School Governing Bodies (SGBs) should take the lead in promoting a holistic approach to school programming on HIV/AIDS by involving teachers, parents and learners in the process. In this way, teachers will feel more supported as they take on this important work in their classrooms.
Education
To be effective, school-based programmes on HIV/AIDS must incorporate the many risk factors affecting youth. Considering the growing rate of HIV infection in girls, highlighting the role of gender in facilitating HIV transmission is crucial. This means dealing with the tough issue of gender violence and all the factors (such as poverty, child sexual exploitation, and multiple partnerships) that support it.
The popular ABC (abstain, be faithful, and condomise) message of many school-based educational programs is unrealistic for young women who are forced into sex or subjected to violence when they insist that their partner use a condom18. The focus on individual decision-making in sexual behaviour ignores these situations and the general role of gender dynamics in the structuring of male-female interactions. Programmes that stress assertiveness and negotiation must consider the ways violence and inequity in heterosexual relationships limit young women's ability to apply these skills.
According to Adams & Marshall, the development of effective AIDS prevention programmes has been stalled by the resistance to implementing sexuality education (as opposed to sex education) in schools. The difference has to do with the foci of the two approaches: sex education focuses mainly on biological information about how our bodies function whereas sexuality education speaks about personal body concepts, body rights and how we express them. Sexuality education is still not implemented in schools19.
Charges that sexuality education may encourage young people's sexual activity appear to be unfounded. In a review of sex and HIV/AIDS education, UNAIDS found that contrary to this concern: well designed programmes...are most usually associated with reduced levels of sexual activity in youth and with enhanced levels of condom use in those who are already sexually active20.
Sexuality education is an important AIDS prevention strategy, which can counter the social messages that young women are not expected to assert their sexual needs or control their reproductive and sexual practices. Such programmes can also challenge aggressive expressions of masculinity which increase the risk of HIV transmission for male and female youth. Educating young men about sexual responsibility and the threat of HIV infection is key to reducing the spread of AIDS. Sports organizations are beginning to take the lead in developing prevention programmes for males. For example, the Shosholoza AIDS project in Kwazulu-Natal is designed to check AIDS by changing the attitudes and practices of male soccer players21.
Preventive education is most effective when young people are involved in the design and delivery of the programme. Peer education has been found to be the most successful means of changing attitudes in youth22. An education advisor who has worked in Malawi, Mozambique, Zambia, and Zimbabwe describes an "impressive" secondary school peer education programme which had a positive impact on learners:
...each class in this large secondary school had appointed two peer educators - one boy and one girl...these two young people became the knowledge base in relation to all aspects of sexual behaviour, STDs, HIV/AIDs, etc. They worked on a weekly basis with the whole class, and were engaged in individual discussions with class members about particular issues. In addition...these young people took responsibility for presenting on some aspect of school health to the whole school assemblies. This involved then speaking to around 2,000 students... something they seemed to achieve with great skill and not a little confidence. [The teaching staff] acknowledged...that the young people were doing what they could not do - communicating on very sensitive issues directly with their peers. They indicated that there was some evidence of behaviour change.?23
In general, positive approaches, which outline safe sexual practices and commend young people for practicing protective behaviour, are more effective than messages that are meant to instill fear24. For learners who have little hope for the future, such messages can heighten a feeling of fatalism that can get in the way of positive behavioural change.
Undertaking AIDS work with youth requires courage and a willingness to raise tough issues. School-based programs may be the key ingredient to reducing the incidence of HIV infection. While AIDS is a grave threat in South Africa, through education, the spread of the disease may be prevented.
Endnotes
1 Anthropology News, 40 (7), October, 1999.
2 UNAIDS (2000). Global strategy framework on young people with HIV/AIDS. Author.
3 Ibid.
4 Ibid.
5 Tallis, V. (1998). AIDS is a crisis for women. Agenda, 39, 6-13.
6 Brown, M.M. (2000, January 11). United Nations Development Programme, The New York Times.
7 Sewpaul, V. & Thobile, M. (1998). The power of the small group: From crisis to disclosure. Agenda, 39, 34-43.
8 Rees, H. (1998). The search for female-controlled methods of HIV prevention. Agenda, 39, 44-49.
9 Human Rights Watch. (1995). Violence against women in South Africa: The state response to domestic violence and rape. New York: Author.
10 Klugman, B. (2000). HIV prevention isn't as easy as ABC. Reconstruct.
11 Anthropology News, October 1999.
12 Ibid. 10.
13 Morrell, R. (September 20, 1999). End violence. Rape in South Africa. Beijing Plus 5 Discussion Group.
14 UNAIDS (1999). Women, HIV and AIDS. Available at: http://www.avert.org/womenaid.htm.
15 Campbell, C., Mzaidume, Y. & Williams, B. (1998). Gender as an obstacle
to condom use: HIV prevention amongst commercial sex workers in a mining community, Agenda, 39, 50-57.
16 Ibid. 2.
17 Ibid.
18 Ibid. 10
19 Adams, H. & Marshall, A. (1998). Off target messages - poverty, risk and sexual rights. Agenda, 39, 87-92.
20 Ibid. 14.
21 Makhaye, G. (1998). Shosholoza's goal: Educate men in soccer. Agenda, 39, 93-96.
22 Ibid. 20.
23 Allsop, T. (Mar. 23, 2000). Personal communication.
24 Vergnani, T. & Frank, E. (1998). Making choices: Sexuality education. Life Skills Curriculum; UNAIDS (1999).