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In Benin, help for women confronting HIV and stigma

Today, 8 March, is International Women’s Day, which promotes gender equality and celebrates the achievements of girls and women. Below is a story illustrating some of the challenges confronting women around the world, as well as their strength in overcoming these challenges.

VIDEO: UNICEF correspondent Alex Duval Smith reports on efforts to fight the HIV/AIDS epidemic in Benin.


By Alex Duval Smith

ABOMEY, Benin, 8 March 2012 – “Shh! Please, there should be no mention of 'it' in the street,” said 20-year-old Leonie Sossou* as she led visitors to her home.

In this West African country, the silence around HIV is as stifling as the Harmattan wind blowing from the desert.

At 1.2 per cent, HIV prevalence in Benin is one of the lowest in African but entrenched stigma against people living with HIV have forced UNICEF and the Government of Benin to find innovative ways to combat the disease and support those affected by it.

A disproportional burden

Ms. Sossou was five months pregnant when her 22-year-old husband died in a motorcycle accident. Soon after moving back in with her parents, she was diagnosed as HIV-positive.

© UNICEF/NYHQ2007-1578/Asselin
A nurse draws blood from a pregnant woman for an HIV test in Adja-Ouere, Benin.

In many ways, women like Ms. Sossou bear a disproportional burden in the HIV/AIDS epidemic. Globally, women account for half the people living with HIV, but in sub-Saharan Africa – the region worst affected by disease – women comprise nearly 60 per cent of new HIV infections. Around the world, HIV is the leading cause of death and disease among women between 15 and 49 years old.

Much of this can be attributed to inequality: Many women are not empowered to refuse sex or demand protection, and many are subjected to sexual exploitation or violence that can increase their vulnerability to the disease. Girls and women are also more likely to encounter barriers to adequate health care and information about HIV prevention.

And female family members are disproportionally affected by the caretaking responsibilities associated with the epidemic, caring for loved ones with the disease and children of those lost to it.

Life-saving support

“After I received the result, I was scared,” Ms. Sossou said. But she was lucky: her family was supportive. “My parents embraced me with both arms. They said I was not to worry, and so I started taking the tablets. By the grace of God everything was fine.”

She received a course of anti-retroviral drugs designed to prevent the mother-to-child transmission (PMTCT) of the virus. Her son, Jean, was born HIV-negative.

Under the guidance of healthcare professionals, he was exclusively breastfed for the first six months of his life. Now 7 months old, he will soon be tested again to determine whether he has contracted the virus since birth, but Ms. Sossou’s rigorous adherence to medical advice suggests the outcome will be good.

A dangerous silence

The stigma associated with the disease has dangerous consequences, not only for those currently living with HIV, but also for those at risk of becoming infected.

© UNICEF Benin/2004/Pirozzi
A midwife uses a rapid HIV test to determine a pregnant patient's HIV status in Cotonou, Benin.

UNICEF HIV/AIDS Specialist Tharcienne Ndihokubwayo said, “Benin has a low prevalence of HIV, but high rates among certain groups... At the same time, in some villages, people are not informed or, if they are, they believe HIV does not concern them.”

But dedicated health workers are helping those in need, despite the challenges.

Health extension worker Marie Bagri – who has been a lifeline for Ms. Sossou this past year – says discretion is a key part of her job.

“With Leonie it has been easy. The neighbours think I am a family friend. With others, it is more complicated. Once you have been to see them once or twice, they will tell you not to go back to their place. Some do not even want their husbands to know. And if they live in polygamous households, they do not want the other wives to know that they are HIV-positive. You have to arrange secret meetings.”

The dried blood spot test, a test for paediatric HIV infection, is also helping. Introduced in Benin in 2010, it allows health workers to confidentially test infants for the virus.

“UNICEF pays for regular collections of the cards and they are brought here for analysis,” said laboratory engineer Sophie Tafeti. “The system means we can test more children, further away, more economically, and the samples do not get spoilt by the heat as they would if they were in test tubes. This approach is also discreet because midwives can take the sample during routine visits.”

Spreading the word

The Government and UNICEF are also working to raise awareness of the disease and its prevention. With UNICEF support, 400 primary schools in 18 local communes now hold regular contests with ‘Stop AIDS’, a board game that promotes HIV-prevention.

At a primary school in the town of Zogbodomey, principal Maxime Gnacadja said his 380 students enjoy the game. “Parents do not talk about HIV. It's seen as something shameful. But through the game, the children learn what behaviour to adopt to avoid catching AIDS.”

This game came too late for Ms. Sossou. But her mother, Eleonore, a retired market trader, is very clear that her daughter and grandson deserve nothing but love and support.

“This boy is my grandchild and Jean may be my daughter's only child. Nothing else matters,” she said.

* Names have been changed.



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