Dying To Be a Woman in South Africa. 8/8/2016

Published by HEALTHE

From violent male partners to vaginal
bacteria that make a woman more likely to get HIV, it is dangerous to
be a women in South Africa.

A woman sits on a crate in Cape Town’s CBD. Credit: Hans-B. Sickler/ Flickr

For women in this country, every day can pose a threat to our well-being and our lives.

It seems as if everything we do, want to do or are biologically built for, makes us vulnerable to death and disease.

Tomorrow we celebrate national Women’s Day, but there is little to
rejoice. Society’s framework, our very physical frames and the way these
intersect, translates into a reality where ‘safe’ is not our normal.
Even our homes are danger zones, only as safe as the disposition of the
men who concurrently occupy them allows them to be.

We are told to protect ourselves from the dangers in the world. Don’t
walk alone, and especially don’t walk alone at night – it could kill
you. But in South Africa, it is coming home that can pose a greater
danger to our lives if we live with a male partner.

Gendered violence

The SA Medical Research Council (MRC) estimates
that three women are killed by their intimate partners every day. For
women who escape death, the threat of violence is constant. Reliable
national data showing the extent of gender-based violence in South
Africa is hard to come by. But some localised research, like one 2010
study in Gauteng, has estimated that a quarter of women are rape
survivors. This is likely to be an under-estimate.

Gender-based violence is one of the reasons why a quarter of new HIV
infections happen in young women between the ages of 15 and 24 years
old, according to a 2015 Centre for the AIDS Programme of Research in
South Africa (Caprisa) report published in the South African Medical Journal. The health department estimated that 2000 women in this age group are infected with HIV every week.

In theory, women are protected by the laws of the country but in
reality, gender inequality undermines this, affecting every aspect of
our lives – including our health. The often-violent nature of sexual
abuse ensures that women are at a higher risk of HIV infection as tears
to the vaginal lining allow the virus to enter the body more easily. And
in these circumstances, it doesn’t matter how much we know about safe
sex – we are unable to negotiate it.

Biological risk factors

If that isn’t enough, a woman’s very anatomy places her at higher
risk of HIV infection. Research has shown that a woman has a fourfold
greater risk of becoming infected with HIV during unprotected
penile-vaginal sex than men. Reasons for this elevated risk include the
bigger surface area of the vagina compared to the penis and the fact
that semen may stay inside the vagina for hours while the penis is only
exposed to vaginal fluids during sex.


If that isn’t enough, a woman’s very anatomy places her at higher risk of HIV infection  

Also, because we do not see inside the surface of our vaginas, painless
infections and sores (an easy entrance for HIV) can remain hidden for
years – unlike a lesion on a penis.


Older women are also disadvantaged: changes to the vagina after menopause further increase the risk of HIV infection during sex.

Caprisa also released data at the International AIDS Conference in Durban last month identifying that a common vaginal bacteria, Prevotella bivia, made women much more susceptible to HIV. A woman who had Prevotella was almost 20 times more at risk of inflammation and HIV than other women, according to Caprisa.

Caprisa also found that another kind of common vaginal bacteria, Gardnerella,
“ate up” a vaginal gel that contained an antiretroviral drug,
tenofovir. This explained why recent trials of a tenofovir-based
microbicide failed in so many women.

Finally, menstruation apparently ups the risk of HIV infection too.

Dangers of motherhood

Through the ages, pregnancy and labour has posed health risks for
women.  Although there has been a significant decline in maternal deaths
in South Africa, 155 women out of every 100,000 still died from
pregnancy-related complications in 2013, according to the MRC. The
leading attributor to deaths in pregnant women is HIV, followed by
bleeding and high blood pressure. About 60 percent of these deaths are preventable with proper care.

A portion of problematic pregnancies are related to maternal obesity.
Most South African women – 70 percent – are in fact classified as
overweight or obese compared to a third of men. The World Health
Organisation links obesity with heart disease, diabetes, high blood pressure, stroke and certain types of cancers.

Pregnant women who are obese are more likely to have a miscarriage, infections, bleeding and death.

To sum it up: Walking outside could kill you. Going home – to your
partner – could kill you. You will likely be at high risk of, and
disproportionately susceptible to, a host of diseases – which could kill
you. Even the joy of child birth, at least for women in some contexts,
could kill you.

It is not my intention to purvey doom but the reality for women, and our health, in South Africa is dangerous. – Health-e News.