CAMBODIA: Wives at risk of HIV infection

CAMBODIA: Wives at risk of HIV infection
30 Jan 2007 08:18:21 GMT
Source: IRIN

PHNOM PENH, 30 January (IRIN) - "I don't know how my husband
contracted HIV - he just did," said Phary, 27, staring blankly out the
window of the two-room apartment she shares with her parents and two
children in the Cambodian capital, Phnom Penh. Answering that question
has never been easy.

Like many Cambodian women in similar circumstances, she is devoted to
the memory of her husband. Few people know about her HIV-positive
status, but her challenge is the here and now: how she will care for
her children if her health deteriorates.

According to UNAIDS, Cambodia has the highest prevalence of HIV/AIDS
in South East Asia, with 1.6 percent of adults aged 15 to 49 infected.
Although the country has made significant inroads in reversing the
spread of the virus - adult prevalence was one-third lower in 2005
than in the late 1990s - the outlook for women remains grim.

Cambodian women constitute a growing share of people living with the
virus - 47 percent in 2003, up from an estimated 37 percent in 1998 -
suggesting that significant numbers of women are being infected by
their husbands and boyfriends, who probably contracted the virus in
commercial sex encounters.

Compounding the problem, a UNAIDS report warned there were signs that
men were ignoring the awareness campaigns centred on the sex industry,
and evidence of increasing drug usage, including among commercial sex
workers, in Phnom Penh.

The traditionally subordinate role of women in Khmer society manifests
in high levels of sexual violence and unsafe sexual behaviour by men,
exacerbated by a culture of impunity, which limits women's ability to
negotiate sex and condom use.

"Women need empowerment if they are to negotiate safer sex practices,"
said Pry Phally Phuong, senior programme officer of the Women's Agenda
for Change, a local NGO.

That is easier said than done. According to a study cited in a
government report reviewing its HIV/AIDS strategy, women do not have
equal access to education, paid employment, land ownership and
property rights: "They are generally in a disadvantaged position in
both family and society."

Prior to marriage, women are expected to be virgins; once they are
married they are often blamed for not having enough sexual expertise
to keep their husbands faithful.

(table width="250" border="0" cellspacing="2" cellpadding="2"
align="right")(tr)(td)(table width="100%" border="0" cellspacing="2"
cellpadding="2" style="border: 1px solid #cccccc")(tr)(td)(img
src="http://www.irinnews.org/images/200611733.jpg"; height="188"
width="250" border="1" alt="")(br)(font size="1" face="Arial,
Helvetica, sans-serif")Sophal Kheng, executive director of the
Positive Women of Hope Organisation, a local NGO dedicated in
providing training and support for women living with HIV/AIDS.
(br)Credit: David Swanson/IRIN(/font)(/td)(/tr)(/table)(/td)(/tr)(/
table)The report also found that many women believe male sexuality
necessitates several partners - men who are away from home seek sexual
services, and their wives accept this as normal; marriage needs to be
maintained at all costs, regardless of suffering and humiliation; and
it is not possible for women to talk with their husbands about the use
of condoms. The researchers said educating men to use condoms when
they have extramarital sex seemed to be the best solution.

A visit to a centre for HIV-positive women, funded by ActionAid and
run by the local NGO, Positive Women of Hope Organisation, underlined
just how vulnerable women are in Cambodia.

"I would never dare insist that my husband use a condom," said an HIV-
positive housewife - one of the few who would speak openly. "He would,
of course, question why, and even think that perhaps I was sleeping
around instead."

Most women at the centre were concentrating on rebuilding their lives.
"When I learned that I was HIV positive, I thought my world had
collapsed. I wanted to die," said a woman who has lived with the virus
for at least a decade. Her husband passed away in 1999, followed by
her two-year-old daughter shortly afterwards. Since then she has
relied on the close circle of friends at the centre, where she is
learning handicraft skills.

The NGO was set up in 2004 to provide training and support for women
living with the virus, and to help with school enrolment for their
children. "It's very difficult for HIV-positive women to maintain
themselves and their children," said Sophal Kheng, executive director
of Positive Women of Hope Organisation. "Most of the women will never
reveal their HIV status to their community, forever conscious that
they will be stigmatised."

There are currently 20 women at the centre, most of whom were
unknowingly infected by their husbands. The colourful handbags they
make are now sold in the local markets and exported as far away as
Australia, providing a flicker of optimism. "I want to stay here
forever," one housewife said. "Here people understand each other."

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