RAPE CASES FROM KANGOYA
Rape has made women more vulnerable to HIV/AIDS in most societies, particularly in the traditional ones.
The behavioral change communication (BCC) initiatives envisage that to promote safe sex practices, the first logical step are to build an understanding of the issues related to sexual health and sexuality. This change can best be achieved by creating an enabling environment and opportunities for the people to freely deliberate, seek and validate information on these and related issues. Interpersonal interaction i.e., dialogue with in and between the sexes has been identified as an ideal strategy to initiate and/or facilities this process of learning. In the context of sexual health, Family Health International (FHI) has defined it as follows; dialogue is a human process through which individuals, families and communities begin to talk and exchange ideas in ways that result in mutually beneficial decision and creative situation for action.
Dialogue provides opportunities to people to talk freely with the people of same and/or opposite sex. It also enables men and women to seek and articulate information. These processes help in building an enabling environment for demystifying sex and sexuality. Dialogue is ideal for BCC initiatives to create awareness and educate people on various aspects of sexual health, STD, HIV/AIDS and to promote safe sex practices, including use of condom.
Dialogue is likely to be more effective in community setting because in these situations, social pressures for normative behavior, behavioral change and adoption of safe sex practices (in case of risk behavior) are more pronounced.
This paper presents the findings of an operations research project undertaken with the following objectives;
- To assess the perception and behavior of men and women towards sexuality and sexual health, to meet these information needs through dialogue by creating an enabling environment, and to empower men and women to adopt safe sex practices.
This component of the project, 30 married and unmarried men and women sexually active age group of 20-50 years from Kangoya were interviewed.
Group of 9 persons carried out the interviews. A group was split into a team of 3 and from the centre of the village a direction was selected for enumeration using a systematic random sampling procedure. Each team interviewed at least 10 people using a simple random sampling procedure. An interview schedule (interview questions) was used to collect necessary information. At one point, one team had a focus group discussion with a group of student.
Dialogue was the principal intervention tool as well as strategy to create an enabling environment, bridge the knowledge gap and promote safe sex behaviors and practices. This was demonstrated when there was a very hot discussion with the peer group (students)
Dialogue between opposite sex was also attempted, but could not succeed, because women were shy in talking about sex in the presence of men. Further, mother in-laws also disapproved of it. In every locality, 4 groups of women and 2 groups of men (men were less interested in dialogue pretending that they know everything about sexuality and sexual health).
A: Empirical Study
For men, the major sources of information on sex were peers, books/magazines and films. Women learned about it from friends, relatives and spouses.
In response to question on perception about sex, two thirds of men and women observed that sex leads to weakness (table 1).
Only 25 (16 per cent) men maintaining multi-partner sex relationships were using condom (with other partner) as a protection against HIV/STI. Over 85 per cent of these men carried condom with them and used it every time.
With in married unions, 16 per cent men were using condoms. Only 5 per cent men having multi-partner sex relationships were using condom while having sex with their spouse. Use of condom with in married unions was largely to space or limit the number of children.
Though, 20 per cent women have suggested for use of condom (to their husbands), only 5 per cent could successfully negotiate for its use. In 11 per cent cases, condom was used on the initiative of men. Women’s lack of ability to negotiate for the use of condom was associated more with their ignorance (about use of condom), than the socio-economic subordination to men.
Knowledge of STDs, its causes, symptoms and preventive measures was quite large (66 per cent) among men and women. However, many women were not able to differentiate between the symptoms of STIs and RTIs.
The level of awareness of AIDS was between 40-55 percent among men and 11-22 percent among women and 46 percent respectively) were reportedly aware that AIDS can be transmitted through sexual contact. It could be linked to an intensive campaign to build awareness for HIV/AIDS leading to improvement in its level during three years period between the two surveys.
AIDS was perceived as a deadly disease for which no treatment was available. It was believed that it is transmitted through multi- partner sex relationships (particularly with sex workers), use of infected blood for transfusion, and the use of infected needle for giving injection. Very few respondents knew about vertical (from mother to child) transmission of HIV.
Major sources of information about AIDS were; peers, posters, hording, TV, and pamphlets. Women learned about it from their husbands also.
Knowledge of preventive measures of AIDS, particularly use of condom was very limited. There were several misconceptions about the sources of the spread of AIDS.
3. Dialogue helped in building awareness, allaying fears and misconceptions and building a positive perception about sexual health.
5. The dialogue helped in creating an enabling environment for free and open discussion on sex and related issues. It also helped in imparting new knowledge on sexual health.
6. Improvement in the knowledge of sexual health is believed to have contributed to an increase in satisfaction in sex.
The counseling services were administered during the exercise when one interviewee expressed anger and regrets when a man offered cash for sex and later emphasized the need to safe ksh 3,000 for a coffin as he was a victim.
At this point counseling was sought to be necessary although the environment was not conducive. However, small it was, he was happy with the counseling provided.
LESSIONS LEARNED AND RECOMMENDATIONS:
Common men and women in the community have poor understanding of and appreciation for sexual health, HIV/AIDS. They are at an equal risk of STD/HIV infection as `high risk’ groups. High risk behavior is not uncommon among common men.
- Dialogue (inter-personal interaction) is most appropriate strategy to create awareness and promote preventive measures against HIV/AIDS. It also helps in focusing attention on relevant media messages on TV and printed literature.
- Dialogue is an effective inter-personal contact mode to build awareness and appreciation for sexual health and AIDS. Dialogue builds capabilities, creates opportunities and environment for the use of information (such as appreciation and adoption of safe sex practices).
- Women show a greater motivation for new learning and acquiring new skills (particularly negotiation for safe sex practices within married unions). They have played a crucial role in the increased use of condoms (within married union) as a protection against STD/HIV.
- Counseling (individual and couple) significantly contributes to reducing sexual discord within married unions and improvement in appropriate medical care for STDs.
There is a further need to consolidate these experiences for wider use by trying dialogue in different settings and environments.