Breaking taboos, dispelling myths in HIV/AIDS fight

EENHANA, Namibia – “No condoms, No sex!”&

That was the mantra of the after-school HIV/AIDS club I started during my summer working in a Namibian school.

While Namibia has aggressive media campaigns about HIV/AIDS prevention, there is still something that is not quite clicking. According to UNICEF, 20 percent of all Namibian pregnant women are HIV positive, and almost a third of children in Namibia have lost one or both parents to AIDS (228 out of 556 at my school had), meaning Namibia has one of the highest rates of HIV/AIDS in the world.

The prevalence of HIV has declined from a high of 22 percent in 2002 to the current 15 percent thanks to the government’s aggressive HIV/AIDS education program and better medical care.

Yet, if the Namibian government provides information, free testing, and free treatment, why aren’t more young Namibians following this advice? Upon my arrival at Eenhana Secondary School, I was surprised to find that the kids could recite the ABCs of AIDS (Abstinence, Be Faithful, Condoms), but these appeared to be empty words.

To get a firsthand look into the culture of HIV/AIDS in this small town in the north, I went to the free HIV/AIDS testing center, New Start, located next to the school. There are many New Start locations around Namibia where testing is free, confidential, and takes about 20 minutes.

While many young business professionals get tested, the centers don’t often see teens or adults from rural villages. This is because the teenagers at our school live in a (relatively) “modern” town with looser sexual practices, while most of their parents and grandparents come from small villages, where talk about sex is taboo, explained Mrs. Shipa, the principal at my school. “We try to teach kids about HIV/AIDS in school, but the education should start at home,” she said. Even with such a staggering number of AIDS orphans, she said that a great many were not told how their parents died.

Thus, although most kids know the AIDS ABCs, they don’t abide by them, as they seem like abstract rules. Talk about HIV/AIDS only seems permissible in an educational context. Some kids are hesitant to carry condoms for fear of their family’s judgment.

Some teachers have other ideas. “Ignorance,” the grade 11 English teacher said. “These kids are still engaging in risky behavior because they think AIDS won’t happen to them. And if it does, they see many ‘healthy’ looking people who are HIV positive.” Even if kids are worried they might be HIV positive, there seems to be a “what you don’t know can’t hurt you” mentality about getting tested. The Namibian government has tried to dispel this mindset by airing commercials promoting HIV testing in an admirable light as part of the “Take Control” campaign and has national “Get Tested” days.

People here appear to pick and choose what they want to believe about AIDS. Some girls believe their partner is monogamous, others are afraid to ask their partner to wear a condom as it might imply they think they are infected or unfaithful. Since everyone knows someone who is infected or has died of AIDS, it seems a very commonplace, almost normal, way of life. “Why is she so upset that he finally died of AIDS?” a girl reflected about a neighbor mourning the death of her husband. “They were only married 4 years.”

Observing these perceptions of HIV/AIDS in northern Namibia (where towns are more rural, have less access to education, and are more closely tied to village ways of life) helped me tailor an HIV/AIDS after-school club that I hoped would be fun and effective.

I lured the kids in with promises of singing and competitions with prizes. Then I got down to business. We talked about the meaning of “stigma,” dispelled myths about HIV/AIDS, and talked about different ways to tell someone “no condom, no sex.”

At first, the kids were taken aback that they could stand up to someone who was trying to get them to have sex without a condom. Through talks about “healthy” and “equal” relationships, de-mystifying the biology behind HIV/AIDS, and learning how HIV positive people can live normal lives, the kids have responded well and exceeded all expectations of the club. They have taught their friends the HIV/AIDS slogan, and have even written poems and dramas about their experience with HIV/AIDS.

Namibia has made great progress in the fight against HIV/AIDS. In the past several years the prevalence has declined, maternal-fetal transmission has plummeted, and ART therapy is widely available. Perhaps through these therapies and the government’s media campaign, making “condomizing” cool, and promoting more education of children and adults in rural areas on HIV/AIDS, the fight against this disease can begin — and be won — at home.

More resources:

• UCSF HIV Namibia stats
• WHO fact sheet