Lesotho: The silence that kills

When Nkamoheng married her husband in 2003 she did not know that he already had a common-law wife. Neither did she know he was HIV positive. An HIV test after she had a baby came back positive. As soon as she disclosed her status to him, he left her. Nkamoheng says that there should be a law forcing men and women to disclose their HIV status when entering into marriage.

 

In Lesotho, the stigma surrounding AIDS keeps many women like Nkamoheng silent. They are afraid that their husbands will leave them, as hers did, if their status is discovered.

 

After completing her Firm C in 1994, Nkamoheng began working as a domestic helper when she was 17. In 1997 she was sexually assaulted by the son of her employers. She was taken to the hospital and tested for sexually transmitted diseases and pregnancy. Both tests were negative.

 

She found other domestic work with another family until 2003 when she began working in a factory. She met her husband in the same year and they were married in December.

 

When Nkamoheng moved into her husband’s rented room she discovered he had a common-law wife who soon came to remove her possessions – including furniture and utensils – from the room they shared. Shortly after, her husband lost his job and she became the sole breadwinner. A little while later she discovered she was pregnant.

 

Complications after giving birth to her child meant that she “had to undergo a lot of tests and was encouraged to do a CD4 test.” The tests revealed that she was HIV positive. Nkamoheng says she was not surprised, angry or bitter.

 

Today she is living openly with HIV and goes for counselling and testing twice a year at the Sankatana Clinic. The factory where she works has a programme that supports people living with HIV/AIDS and management provides ARVs to employees who require them. HIV positive employees are also given time off during the work day to have their meals. But Nkamoheng feels it would help if management also provided the meals as many simply cannot afford the proper nutrition they need to stay healthy.

 

Despite her lack of bitterness or anger towards her husband, Nkamoheng insists that there should be laws to compel people disclose their HIV status upon marriage. If she had known her husband’s status, would she still have contracted the HI virus?

 

Research published by Family Health International indicates that couples counselling facilitates HIV disclosure and couples who have disclosed are very protective of each other’s health and do not want to re-infect each other.

 

In Lesotho family health clinics could assist in curbing the spread of HIV and AIDS if they encourage pregnant women to come to clinics with their partners and to undergo voluntary counselling and testing (VCT). But the fear of their partner leaving them if they disclose their status is deeply rooted in cultural and social practice that makes it taboo to talk about matters related to sex and sexuality.

 

It is therefore essential that AIDS education be integrated into the school curriculum at primary school level so that as adults, men and women are able to communicate effectively with each other about their HIV status.  VCT services could include couple counselling which is aimed at helping couples to talk freely about sex in order for them to support each other. Counselling should form an integral part of health services at clinics so that women feel free to ask questions related to the sexual and reproductive health of their partners that will inform decisions about their own sexual health.