Religion and Stigma Fan HIV Epidemic in Malawi


In a first for
Malawi, Mary Shawa, secretary for nutrition, HIV and AIDS in the president’s
office, has initiated a heated debate on the rights of gay men in Malawi.
During her opening address at a two-day conference on HIV/AIDS, Shawa advocated
for a human rights approach to the delivery of services for people living with
HIV/AIDs. Her opinion that the fight
against HIV will not be won without a change in attitude towards risk groups,
such as men who have sex with men, has unsurprisingly sparked controversy in
the conservative African country.

Malawi has some
of the harshest laws in all of Africa criminalizing homosexuality. Sex between
men is punishable by up to
14 years imprisonment, although it
appears that female-to-female sexual relations are
legal. Only several months ago, in August
of this year, the National Assembly passed a constitutional amendment
banning same sex marriage. The ban
follows an
anti-gay campaign, jointly
initiated by Christian and Muslim leaders, in response to advocacy by Malawi NGOs demanding
repeal of the Penal Code criminalizing homosexuality and pushing for gay
marriage.
A member of parliament, Edwin Banda, even
proposed that the constitution should include a
clause stipulating
that Malawi is a "God fearing nation", with homosexuality deemed
ungodly, a proposal that was later rejected. Other stories from Malawi evidence
how religion acts as a barrier to better protections for the rights of
homosexuals. According to one
report, when Anglican
Bishop Nick Henderson was sent to head a diocese in rural Malawi, he was
rejected by the congregation for his pro-gay stance and subsequent protests led
to the death of a church member.

Unfortunately,
what this new debate means is that homosexuality is once again being discussed
in the context of sexually transmitted diseases, possibly furthering
pre-existing negative perceptions and notions of deviance that exist towards
homosexuality in Malawi. At the same time, it is unquestionable that the higher
risk facing Malawi’s homosexual population, formerly named as “
invisible,” means this
group must be included information campaigns and guaranteed enhanced access to
services.

In November of
last year, Malawi held its third annual
testing week. Malawi has
one of the highest HIV prevalence rates in the world.
Estimates range from an
11.8 per cent adult prevalence rate found in the 2004 Demographic and Health
Survey to a 14.1 per cent prevalence rate estimated by UNAIDS in 2005. Yet, a
study released in
Copenhagen in July at the
World
Outgames
, involving 200 Malawi men, 75 per cent of whom had
multiple male sexual partners, revealed a prevalence rate among respondents of
around 21 per cent, an obvious difference with the national rate. The study’s
findings provide significant evidence to back Shawa’s comments about the need
to better target homosexual men. Among respondents, only 1.5 per cent had ever
been told by a health professional that they were HIV positive, with 77 per
cent never having been asked by a health professional to undergo an HIV test.
The impact of criminality and stigmatisation is also revealed by the fact that
only 10 per cent has informed a health professional that they have sex with
men. The 2007 study also revealed that politicians and leaders in Malawi prefer
to promote the idea that homosexuality does not exist in Malawi, making Shawa’s
comments all the more remarkable.

More generally,
according to
Doctors Without Borders (MSF), there are
around 930,000 people living with HIV/AIDS in Malawi, accounting for 12 per
cent of people aged between 12 and 49 years of age in Malawi. 60,000 people die
from the disease every year. It can only be hoped that Shawa’s comments foster
increased, open public debate about some of the cultural causes that continue
to spread the virus among men and women or foster stigma against people living
with HIV/AIDS. This includes
early marriage between young
teenage girls and older infected men as well as other forms of sexual
exploitation against young women, including
forced sex in exchange
for passing school imposed by male teachers. It is, in fact, particularly
important that the rights of women living with HIV are not lost in this debate,
given that
2004 figures reveal that
women represent 56.8 per cent of the adult HIV positive population. The 2004
report of the
UN Secretary General’s Task Force on
Women, Girls and HIV/AIDS in Southern Africa
reveals that
marriage
is
a risk factor, with 17.5% of married Malawi men having had extramarital sex in
the 12 months prior to the study. The lack of recognition of marital rape also
does not help. Many Malawi women are brought up to believe that a woman should
not refuse to have sex with her husband. Additionally, as
Avert notes, the practice of ‘wife
inheritance’, where a widow is married to a relative of her husband upon his
death, also increases risks of HIV infection were AIDs was the cause of death
of the previous husband.

It remains to be seen
whether Shawa’s comments will have an impact on the rights of gay men in Malawi
or the lives of people living with HIV in the country more generally. Unquestionably,
given the climate, Shawa deserves high praise for putting on the table for
public discussion the centrality of human rights to the fight against HIV/AIDS.

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