How Aids kills Africa's battered women
By Fiona O'Brien

Nairobi - You can learn about condoms, know that fidelity or
abstinence can protect you from Aids, but if your husband is HIV-
positive, violent and wants sex, there is not a whole lot you can do.

HIV/Aids is ravaging sub-Saharan Africa. It is one of only two
regions - the other being North Africa and the Middle East - where
more women are infected than men.

The United Nations estimates that 29,4 million people in sub-Saharan
Africa are HIV-positive. About 58 percent are women and girls.

'Even when he was HIV-positive he still wanted sex'
It is not that African women sleep around. Subjugated in marriages
where many have no economic or legal independence, infection is often
unavoidable: if you have nowhere to go, having sex with your infected
spouse is not a matter of choice.

HIV/Aids has long been seen as a health issue, while domestic
violence is classed as human rights. A new report by Human Rights
Watch says that if governments are to fight HIV/Aids, they must start
seeing that the two go hand in hand.

"I was commonly the one who was beaten," Ugandan woman Sules Kiliesa
told the report's author. "He would beat me to the point that he was
too ashamed to take me to the doctor. He forced me to have sex and
beat me if I refused.

"This went for every (wife). Even when he was HIV-positive he still
wanted sex. He refused to use a condom. He said he cannot eat sweets
with the wrapper on."

A combination of factors heighten vulnerability to HIV. Cultural
perceptions of women's sexual and reproductive obligations, paying a
bride price, unequal property and child rights can make it impossible
to leave an abusive marriage.

'There is a high incidence of infection among faithful wives of
errant husbands'
Husbands may have several wives, lead promiscuous lives outside of
their marriage. Women often see violence as innate to marriage,
accepting it as part of their role as a wife.

"There is a high incidence of infection among faithful wives of
errant husbands," Sheila Ndyanabangi, at Kampala's ministry of
health, told Human Rights Watch.

Billboards advocating condom use, cheaper treatment or encouraging
fidelity and abstinence - all key to initiatives such as those
proposed by US President George Bush - have little impact on what
happens inside an unhappy home.

Women cannot negotiate condom use, are unable to resist forced sex
and without equal legal and economic rights have no chance of
leaving - where would they go, how would they live?

For report author Lisa Karanja, it is crucial that governments enact
laws to prohibit discrimination against women. Land acts must provide
for spousal co-ownership, widows must be able to inherit, marital
rape must be recognised.

Women must be given a way out.

"It is crucial now that governments intervene," she told
Reuters. "Using culture and tradition to allow women's violence to go
on is now becoming fatal. You can't just brush this under the carpet
anymore, it is killing women and creating orphans."

Karanja chose to write her report, called "Just Die Quietly", on
Uganda, because it has often been held up as the continent's Aids
success story - prevalence has dropped greatly in the last decade due
to a courageous government campaign.

But if she could prove a link between domestic violence and HIV/Aids
in Uganda, Karanja said, the implications for the rest of the region
would be frightening.

Neighbouring Kenya has made far less headway in dealing with Aids. A
parliament AIDS act has been pending for a year, and the lack of
public debate has not helped reduce the stigma of a disease which
kills around three Kenyans every five minutes.

"It is almost inevitable that those women are going to get infected,
as long as their husbands stray and as long as they have no voice,"
said Judy Thongori, who chairs CREAW - a centre for abused women in
Nairobi.

Faced with unwanted sex with a husband who has HIV, a woman with no
financial independence has two choices, Thongori said. She can either
leave and starve today, or choose to stay with a roof over her head,
putting off death for a few more years.

Karanja said that for a country like Kenya, where a new government
says it is eager to change bad old habits, the time is ripe to
address women's rights. If leaders truly want to tackle Aids,
domestic violence must be a priority.

While polygyny, male property rights, sex as a marital obligation,
the payment of a bride price and the lack of rights over children
remain customary in many African societies, it is time to stop hiding
behind tradition.

"If tradition is subjugating and trying to harm someone, we have to
change it," Karanja said. "We have to evolve, we have to be
progressive."

Changing laws is only one part of the battle. Africa needs more
shelters, more social education, more legal assistance for female
victims of domestic violence. But a sound legal framework could
provide the basis for those things to happen.

The frightening implications of HIV/Aids for the African continent
have been clear for some time, but Karanja said the enormity of the
impending disaster for women is still unfolding.

In her report she quotes the UN secretary-general's envoy for
HIV/Aids in Africa, Stephen Lewis, who in 2002 described the disaster
as "annihilating a gender".

"The toll on women and girls is beyond human imagining," Lewis said.

"The practice of ignoring gender analysis has turned out to be
lethal. For the African continent it means economic and social
survival. For the women and girls of Africa, it's a matter of life
and death."