MORE ON HIV/AIDS in SWAZILAND

Hi everyone,
As promised, here’s part 2 of “HIV/AIDS in Swaziland according to Gail”:
So, how did a little country like Swaziland gain the dubious distinction of having the highest HIV/AIDS rate in the world? Especially given its relative stability politically, high literacy rate, strong family units, and predominantly conservative Christian beliefs, things don’t seem to add up. However, one has to dig a bit deeper into the culture to understand how all this happened, and more importantly, why it continues to be an ongoing tragedy.
I believe HIV/AIDS first came to Swaziland from S. Africa. Due to our proximity and limited natural resources, approx. 10% of the population works in S.Africa. In 1998, approx. 10,000 men worked in the S.A. mines, often remaining there for months at a time before travelling home for brief stays. Prostitution is well documented around those mining areas, and Swazi men are no different from other male populations working in isolated and rough conditions. So, once the men brought the virus home to their wives, how is it continuing to spread? To answer that, one needs to understand a bit of Swazi culture (which I’m just beginning to get a handle on). First of all, it is strongly male dominated, and polygamy is still legally recognized. I see very few multiple-wife family units now, but it was very common just 1 or 2 generations ago. The king currently has 13 wives. In addition, a man traditionally must pay a bride price (lobolo) to her family before a wedding can take place. And yes, this lobolo is traditionally paid in cattle – usually between 10 and 15 cows is what I hear is normal. It can take many years for a man to save enough money for payment, thus engagements are often long and/or marriages delayed until the price is paid in full. That doesn’t mean that either the man or woman is celibate during this time. And, since the relationship is one of commitment, condoms aren’t considered necessary. After marriage, it is very common for Swazi men to have 1 or 2 long term girlfriends on the side. And, although it isn’t readily acknowledged, the Swazi wife will also often have a long term boyfriend on the side. These are called “multiple-concurrent partners”. Just 1 HIV pos. person within this network and ultimately infect 10 or more persons, who in turn can infect 10 or more. Again, since these are long term relationships, few are consistent with condom use, each not wanting to accuse their partner of infidelity. Most statistics show that Swazi’s aren’t more sexually active than other cultures and have fewer lifetime partners than those in the west, they just have several at the same time. And, remember, no one “looks sick” for up to 10 years after they are initially infected, with the first 3 – 6 months being the most “contagious”. Lastly, most males here are uncircumcised. Apparently the HIV virus rapidly grows in the foreskin, making uncircumcised males more likely carriers. There’s a big campaign on now to circumcise males from age 14 – 35. It is going well, but it will take a long time to complete, and even after circumcision, that only reduces the likelihood of transfer by 40%. What we are seeing is that everyone is aware and concerned about HIV, but they often seem unwilling to take the personal responsibility & initiative to protect themselves each and every time they are sexually active.
Part 3 will talk about HIV treatment practices, but we’ll have to take a break so we can tell you all about our Victoria Falls trip. Until then, blessings and love
to all. Gail