South Africa: Lesbians and HIV: Low risk but not no risk

JOHANNESBURG, 14 July 2009 (PlusNews) - Women who sleep with women (WSW) are not at risk of HIV transmission – or are they? AIDS advocates warn that it is time for a wake-up call about who is and is not at risk.

HIV prevention among WSW and lesbian women remains off the prevention agenda, said Beverley Palesa Ditsie, a founding member of the Gay and Lesbian Organization of the Witwatersrand.

"When it comes to same-sex relationships other than male-to-male, [HIV] transmission is something we think we don't have to talk about," she commented at the launch of a new book on same-sex sexuality and HIV, published by the Human Sciences Research Council.

Zethu Matebeni, a fellow at the University of Witwatersrand's Institute for Social and Economic Research (WISER), who spent three years studying Johannesburg's black lesbian community, agreed that myths about the risk of female-to-female transmission were not being adequately addressed.

Rape as punishment

No data exists on HIV prevalence among lesbian women or WSW globally or in South Africa, but limited research by the gay and lesbian organization, OUT, indicated that the high rates of HIV in the WSW interviewed could be attributed mainly to rape, transactional sex and sexual violence.

Lesbian women in South Africa are being raped by men who believe it will "cure" them of their sexual orientation; women in townships in Johannesburg and Cape Town report a rising tide of brutal homophobic attacks, murders, and the widespread use of "corrective" rape as a form of punishment, notes a report published earlier this year by the international NGO, ActionAid.

According to OUT's research, only about 40 percent of WSW knew their HIV status, which often carried the same burden of stigma and silence it would in any relationship, Matebeni told IRIN/PlusNews. "Some women say it makes your partners think you have been sleeping around when it's not the case."

She said negotiating safe sex could be difficult for women even in loving, consensual relationships. It was also difficult to access barrier methods like finger condoms or dental dams - thin squares of latex rubber placed over the vagina or anus during oral sex to prevent sexually transmitted infections.

"Often, we don't know how to talk about safer sex because there aren't protection methods and, of the ones that are out there, many of them are extremely unpleasant – they make you feel ugly, and feeling beautiful is very important in sex."

Matebeni called for more attention to the HIV-prevention needs of women in same-sex relationships.

Dakar: Report from ICASA

by IRMA member Lourence "Larry" Misedah of Kenya (pictured above)

It was a first in the history of the International Conference on AIDS and STI in Africa (ICASA). At the 15th ICASA held in Dakar, Senegal from 3-7th December 2008,there was high visibility and a wide presentation of LGBTI issues.

The LGBT pre-conference brought different participants together to unearth the truths and face realities as an emergence for the African LGBTI rights movement’s response to the HIV and AIDS epidemic. This led to a well-laid-out strategy and coordination to ensure strong representation through out the conference session, embodied by the pink book put together by Joel Nana (IGHLRC). Besides, the IGLHRC (International Gay and Lesbian Human Rights Commission) and the Africa Gay booths provided space for a healthy interaction with the public and a display of different material about same sex practices in Africa.

Notably, building on the key lessons learned of AIDS 2008 to strengthen the epidemic in Africa, it came out strongly on the need to address the epidemics in at risk populations through targeted prevention. This followed different research that has continued to indicate high prevalence rates among MSM even in countries where the rates are lower in the general population.

However, as noted by the Joint Press release by 12 organizations working on LGBTI issues, only 7 countries have included MSM in the strategic plan while only Kenya and South Africa have included WSW (women who have sex with women). Nevertheless the shared experience from Kenya and South Africa showed that inclusion in the National Strategic Plans (NSPs) does not automatically result in programming. There is therefore a need to ensure that the inclusion within the NSPs is accompanied by targeted programs. As well, whereas there has been some research done on MSM in Africa, it was also noted there is barely any study on WSW. A study done in South Africa has shown high prevalence rate in WSW - hence there is a need to carry out further research on the issue.

With the conclusion of the conference, the major challenge remains on if and how the issues of the most at risk groups will be integrated in the different countries national responses.