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The effect was greatest when the sisters were of a similar age or from a poorer background.
‘Sister effect’
The researchers said the probability of the younger sister having a teenage pregnancy went from 20% to 40% if the elder sister had a baby as a teenager.
Regular visitors to TalkAfrique.com may have noticed that a disproportional amount of space is dedicated to the issues affecting women in Africa. The reasons are obvious, to say the least. The issues affecting women in Africa are enormous, and they begin the very day the doctor or mid-wife says “It’s a girl”. Today, I discuss two disturbing statistics that are prevalent across the continent, at least, in most countries.
Senegal:
According to the UN World Health Organization, seventy percent (70%!) of teenage girls in Senegal are married. You would probably doubt this figure if the source was any other than the WHO. A report by the United Nations Children Fund early in the month showed that in Senegal, teenage pregnancies are responsible for 40% of maternal deaths in the country.
Teenage pregnancies account for up to 40% of maternal deaths in some African countries
African women are under-represented in all sectors of society except in the poverty department. Figures such as indicated above continue to be real adversaries that need to be tackled bluntly. The situation in Senegal is not an isolated incidence but rather a pervasive war of attrition that needs to be won sooner than later. In Niger, 50% of girls are married before they are 15. A couple of month ago, we posted an article here with similar disturbing facts: nearly, 5000 schoolgirls in Johannesburg, South Africa, became pregnant in just one school calendar year. It is regrettable to say that most of these girls would never become what they dreamed of becoming: teachers, pastors, parliamentarians, ambassadors, or doctors.
Namibia:
In Namibia, it’s even perhaps more shocking. Reports coming to light show that baby-dumping by teenage girls is at all-time high. Most teenage girls admit that the plausible balance between carrying an unplanned pregnancy, the stigma attached to it, the rejection by family and the society and the difficulty in obtaining or affording abortion, is to simply dump the baby. According to media reports from the state health department, about 40 bodies of newborns are found each month in human waste flushed down toilets.
I would love to hope that these incidences are unique to Senegal and Namibia but I’m afraid it rather the opposite. It is estimated that 80 women die each day in Africa from procedures they adopt to terminate unwanted pregnancies. We have a society that sweeps thorny issues under the carpet and hope they go away. Like it or hate it, teens are having sex, an exercise that is not meant for the ignorant, because the consequences could be the difference between life and death, graduation and fallout, and success and failure. When a girl is brought up in a male-dominated society where the powerful man gets whatever he desires, equipping the poor girl with ignorance is essentially sentencing them to a life of a nightmare.
It is time to close the curtain on the era when mere mention of sex in the family or school was a taboo. African teens need know more; in fact they want to know more, about sex and how to protect themselves from teenage pregnancy, HIV and other sexually transmitted diseases. Whatever we’ve been doing for the past years is not working, at least, not as we expect. The figures don’t lie.
Volunteers who participated in a study on reducing the risk of HIV infection in women listened as the test results were announced during a meeting in Vulindlela, Kwazulu-Natal, South Africa. Photo by (Joao Silva for The New York Times)
K. Amponsah-Manager
Among the estimated 22.5 million people living with HIV in Sub-Saharan Africa, women and girls continue to be disproportionately represented. In South Africa, for instance, it is estimated that one-in-three women aged 25-29 are living with HIV (Human Sciences Research Council (2009). Another estimate puts the proportion of maternal orphans – those who have lost their mother – orphaned by AIDS as over 70 percent (Budlender, D. et al., 2008). This is surely a dispiriting statistic. Several reasons can be attributed to this trend including rape and other sexual abuses, cultural practices and societal expectations of women. There are also biological factors that contribute to this inclination. For instance, the female genitals have a more exposed surface area than the male genitals have. Also, there are higher amounts of HIV in semen than in vaginal fluids while again more semen is exchanged during sex than vaginal fluids. These together with the social and cultural factors above precipitate a situation that places the woman at a more disadvantage point of view.
There are several steps communities and policy makers can take to reduce the women’s vulnerability to the epidemic and reverse this distressful trend. These include:
Involving men: In a typical African relationship, the man controls when and how sex happens. The man decides the frequency of sex and whether any protection is used during sexual relationship. The current education targeting men to use condoms should continue but it should place a bigger accent on educating men to respect the women’s choice and needs in sexual relationships. Gender-based violence and stereotypes should be core of any anti-HIV campaigns in African communities.
Accessibility to healthcare needs: Past anti-HIV and family planning campaigns have focused on the man, but it is time to pay attention to the needs of the woman if we can really cut the percentage of women that continue to be afflicted by the HIV epidemic. While the female condom (FC) is available to most women in the developed countries who want to use it, FC is merely another indulgence that the African woman cannot just afford. The situation gets even more challenging as the female condom can be several times more expensive than the male condom. It is therefore crucial for health policy makers and private organization to step in and offer to make these products accessible to the women at a cost that they can afford. Also, women who are abused sexually should have free access to blood tests and other medical services to determine their status. This will halt the further spread of HIV and other sexually-transmitted diseases (STDs) they might have contracted during the assault. Studies show that women with other untreated STDs are more likely to contract the HIV virus than their STD-free counterparts or those who have access the reproductive healthcare needs.
Economic Opportunities and Education: It is sad fact that in the African society, the bread-winner is automatically self-empowered to call the shots and since in most cases, it is the man who holds that title, the women in these societies are the always at the receiving end when it comes to decisions affecting sexual intercourse. A journey to economic empowerment will be relatively long, but in the long run, it is the surest strategy that will place women in positions that they can influence decisions that affect their own lives. According to the UNAIDS, women without education are four times more likely to have the belief that there is no way to prevent HIV. These women do not expect and do not demand any protection during sex even when they know their partners have multiple sexual partners. Early sexual intercourse and early marriages are big factors in predicting a girl’s vulnerability to HIV. In Niger, for example, 50% of girls get married by the age of 15. However, studies show that girls with more education tend to delay marriage and tend to delay their first sexual intercourse. Providing every girl child with at least the basic education will certainly make a dent.
Campaign against social and cultural practices harmful to the woman: Some practices are ‘universally’ classified as sexual violence but are accepted practices in some communities across African and other parts of the world. These include female genital mutilation or female circumcision, marital rape and girl trafficking. In a survey in Kenya, 14% of women said their own husbands (most of whom have multiple sexual partners) had raped them in the past. All these practices disproportionately expose women and girls to HIV and other sexually transmitted diseases. According to the UN, women who have experienced any of such abuses are three times more likely to be infected by HIV.
Reducing the woman’s vulnerability to HIV is vital in curbing the prevalence and saving the unborn. In fact 390 000 out of the global 430 000 children newly infected with HIV during 2008 were from sub-Saharan Africaas a result of mother-to-child transmission (USAIDS). Why should we wait any longer in tackling the woman’s sexual health needs?
I have written a few of articles here in the past about some societal feelings towards our neighbors living with HIV or AIDS. My comments have centered on stereotypes and stigma associated with the disease and those who live with it. I did mention a friend of mine who contracted HIV and who, in the latter stages of his life, was completely abandoned by his own family for being sinful, perhaps.
If any of my articles appeared preachy to you, do not get mad at me yet, for I also had HIV problem. Mine was not the virus but I used to have the same troubled, prejudiced mindset about HIV and other sexually transmitted diseases, and I lived with the destructive and erosive ulcer of my thoughts for years.
As I mentioned in one of my previous articles, I heard about HIV for the first time 1986 and it was in a church, a common avenue in Ghana for the government to disseminate information to the public. The educators were a team of nurses and public health professionals from the Ministry of Health in Ghana sent by the government to tour communities and educate them about the new discovery, HIV. At that time, the information available to the instructors was scanty and only partially accurate. There is no doubt we’ve learned quite a lot about HIV in the past 25 years. The health-care professionals came to sow the seed and it was left to the laymen of the church to continue the campaign in order to keep their flock saved from this evil. I was young, but looking back I am embarrassed by how much misinformation we were fed then and the years that followed.
Week after week and month after month, HIV was presented to us as a disease that affects sinners, and individuals who disobey the Word of God. It was nothing less than God’s retribution to deviant lifestyles and a warning for us to return to God. I imbibed this into my spirit and, for years, I also saw people living with HIV as simply paying for their trespasses. Then I began to ‘grow’ and got to know ordinary people like me who are living more decent lives than I do but who are unfortunate to be living with HIV. The result is that I lay off the childish thoughts (I Corinthians 13.11). There are many who contracted the virus through the ‘sinful’ way we know, and there are many more that got it through the many things we all do in life and take for granted. One of these people is a girl, Elizabeth from South Africa. To cut my story short, I paste here, again, a quote from Elizabeth own words:
“My mother passed away when I was five and my father when I was 10. I have been staying with my grandmother since then. I tested HIV positive in 2008 when I was 16 after being sick for a long time. I developed sores all over my body that wouldn’t heal even after taking medicine. My grandmother and I were always in and out of hospital. I missed a lot of school. At first doctors thought I had diabetes since the sores were not healing.
“After the diabetes test came back negative the doctor recommended an HIV test. At first my grandmother was against the idea but after some time she agreed. I was shocked when the result came back positive because I had never had sex. My grandmother cried too, she was very sad but the doctor explained that I may have been born HIV positive. I was very angry and blamed my parents for giving me this disease. I was immediately put on antiretroviral drugs [ARVs] and my sores healed… I feel very strong and healthy… all I want is to continue helping other people affected and infected by HIV/AIDS in my community.”
Will this change the way you see that friend, family member or neighbor with HIV? I don’t know but I hope it does. It surely changes mine.
Earlier this week, a news story containing a disturbing statistics came to light that will shock most readers. Nearly, 5000 schoolgirls in Johannesburg, South Africa, became pregnant in just one school calendar year. Before you attribute this mass teenage pregnancy to rural illiteracy, lack of electricity, lack of television and all those excuses, let us call to mind that, three weeks ago, it was also reported that 90 girls were known to be pregnant in a single school in Tennessee, United States. This did not happen in a slum in Nairobi, Accra, Abuja, or Harare. It happened in the heart of the United States.
I am neither a sociologist nor a psychologist and so I will not attempt to ascribe rationale for these mass pregnancies. Some have referred to them as Pregnancy Pact, Pregnancy Covenant, and others.
The unfortunate situation is that some (may be most) of these girls would never become what they dreamed of becoming: teachers, pastors, parliamentarians, ambassadors, or doctors. Those who will ever get there will do it by the hard, tortuous way. As for the boys, on other hand, no problem. They can achieve whatever they want to achieve in life with minimal drag from the children who will result from these pregnancies. Some of them will later look down upon these girls as failures and fools.
I need to admit that I do not have data to base this on, but from my personal experience and assumptions, I would assume that most the boys or men involved in the adventure that led the girls into these situations knew of the plastic material called the condom. The never used it. On the other hand, and of course, this is my personal assumption; it is likely that most of the girls were oblivious of whatever options they had that could have prevented what they carry in their immature wombs.
How do we help young girls avoid these situations?
Give Women The Necessary Information:
As usual, many of the parents of these girls perhaps assumed their children were innocent. Well, they are not. In an interview with one of the South African to-be moms, this is what she said
“It’s fashionable to have a baby. You are like a fool if you don’t have sex”
As I have said here a few times, it is vital that parents, teachers and authorities provide young girls and women with the information they need and tell them they too have an option.
They can say NO and IT IS OK TO SAY NO!
If they cannot or do not want to say no, then they have an option, the female condom. The female condom is over 95% effective in preventing HIV/AIDS, other sexually transmitted diseases, and unwanted pregnancies. Most women have never heard this nor seen it. It’s shame and irresponsible that several years of campaigns have focused solely on the man and the options he has in sexual encounters. In the above unfortunate situation, it is easy to focus only on the teenage pregnancy, but it is important to realize that some of these girls that are not lucky may contract other STDs like Human Papiloma Virus/HPV, Herpes Simplex Virus/HSV, Chlamydia, Gonorrhea and Syphillus.
By equipping these girls with ignorance, we are in essence, cursing their the futures.
An estimated 22.5 million people are living with HIV in the part of African below the Sahara – around two-thirds of the global total. In Ghana alone, there are approximately 260,000 people living with HIV/AIDS with 140,000 being women and 27000 being children. Ghana can count close to 160,000 orphans as a result of HIV/AIDS. In fact, Ghana is not among the worst hit countries; South Africa and Uganda for example, have worse numbers.
To some readers, this is just one of those statistics, but it is life and death to hundreds of families and institutions. The social and economic consequences of the AIDS epidemic are far and wide felt: in the African health sector, in education, industry, agriculture, human resources and the economy in general.
In terms of preventive or ‘prophylactic’ measures, the anti-HIV/AIDS campaign hitherto has riveted on promoting the use of the male condom.
Regrettably, however, in many communities in Africa, it is a severely stamina-testing exercise to convince some men embrace the use of the male condom. It is a complex issue that borders on tradition, religion and ignorance. This is compounded by the fact that in almost all cases, it is the man who cleaves to power in sexual relationships. Customarily, in the African ‘sexist society’, the man can choose to have multiple wives or one wife with multiple sexual partners. A woman who practices such a modus vivendi is referred to as a prostitute. It is unfair and effluvium for the party who wields the power to also decide on the means of protection in sexual relationships. I regard it a woman’s right issue to guarantee that women have the wherewithal to protect themselves in sexual relations.
But what is wrong with the male condom?
The campaign to promote the male condom has been going on for decades with some progress. Nevertheless, such progress does not well correlate with the efforts that have been expended. Some of the pretexts some African men put forward in opposition to the use of condoms include the following:
Condoms diminish pleasure or enjoyment of sex
Condoms ruins the mood
You cannot feel anything while wearing a condom
If a women loves a man, then she you should just trust him
in order for sex to be real, fresh must come into contact with fresh (of course, condoms make this pre-requisite unattainable)
Some even think it is sin to use the condoms during sex
For these reasons, I advocate that future anti-HIV campaigns adjust the current model and focus more on promoting the use of the female condom. The female condom should be promoted as an alternative to the male condom and should be available to all sexually active women. I believe that there should be a sharpened campaign to give credence to the female condom in African communities until it ultimately becomes a mainstream accessoryin the woman’s purse.
The Female Condom:
The female condom is a thin, soft loose-fitting polyurethane plastic pouch that is used during intercourse to prevent pregnancy and reduce the risk of sexually transmitted diseases. It has flexible rings at each end. Just before vaginal intercourse, it is inserted deep into the vagina. The ring at the closed end holds the pouch in the vagina. The ring at the open end stays outside the vaginal opening during intercourse. And during anal intercourse, it is inserted into the anus.
The penis is directed into the pouch through the ring at the end, which stays outside the vaginal during the intercourse. By covering the inside of the vagina or anus and keeping semen and pre-cum out, female condoms reduce the risk of sexually transmitted infections. Why the Female Condom.
The female condom is more acceptable to most men as it does not constrict the penis as do latex condoms and hence does not result in a significant decrease in sensation.
It gives the woman some amount of power which in most cases is totally vested in the man.
It provides an opportunity for women to share the responsibility for protection with their partners
Research shows that, if women always use the female condom correctly, only 5% of users will report unexpected pregnancy each year. It can even be made more effective if used with a spermicide.
A woman may be able to use the female condom if her partner refuses to use the male condom
Unlike the male condom which is inserted in the heat of the moment and can therefore ruin the mood, the FC or FC2 female condom can be inserted up to 8 hours before intercourse so as not to interfere with the moment.
While the statistic continue remain ugly, it is vital that women take charge over their own health and not depend solely on their partners in making decisions relating to sexual matters.
How Do We Get There?
The main disadvantage of the female condom is that it is three times more expensive than the male condom and therefore beyond the means of women in most African communities where the average income is less than a dollar a day. (The cost of the female condom is between $2.50 -$5.00). This is the gap that the Government, Non-governmental Organizations and Foundations involved in the anti-HIV/AIDS campaign need to fill. By making the female condom easily accessible to all sexually active women in Africa, including prostitutes, we as a nation will make significant advancement in the fight against HIV/AIDS, other sexually transmitted diseases and unwanted pregnancy.
Again, even as we have done in the past and continue to do with the male condom, we need an aggressive campaign to educate our women that they have an option. Empower the ministries of health to provide free samples to sexually active women whenever the visit any health facility. The media should play their role, community leaders should not be left out, and religious organization should recognize that their support is vital.
The statistics are premonition, but it is not too late to apprehend the trend. The cost will be worth it.
I stated: The main disadvantage of the female condom is that it is three times more expensive than the male condom and therefore beyond the means of women in most African communities where the average income is less than a dollar a day. (The cost of the female condom is between $2.50 -$5.00).
Correction:
The cost of the FC2 Female Condom is around $0.60 for governments and donors and lower with increased volume. The $2 price is what FC1 costs on the shelf in a retail drug store in the US. The FC2 was developed to lower the cost of the female condom with intent to increase access to women in Africa. It has same design but different material and different manufacturing process which allows for the significantly lower cost.
