Read Scenario 1 and answer questions 1 and 2 SCENARIO: Emil…

Questions

Reаd Scenаriо 1 аnd answer questiоns 1 and 2 SCENARIO: Emily and Dina Emily and her cоusin Dina are stay-home housewives who live in Kwa Mhlanga. They take care of their children, carry out all household chores and look after children, whilst their husbands work in nearby farms. Emily contracted HIV a few years before from her husband, but she had not told anyone about it because she was afraid of her husband who would have rejected her intimately and may have even accused her of infidelity. She could not tell her in-laws because they once said she liked behaving like an immoral person by the way she likes travelling to Johannesburg and Pretoria for shopping. Although she knows that she is HIV positive, she cannot dare talk about using condoms with her husband. This is what she was advised by the community health worker who runs a small project that advises women and children about health prevention and treatment of illnesses. Men are not included in these groups since they are believed to be healthy, superior and should be the ones who make decisions about family matters. Dina on the other hand tried to tell her husband that she does not want another child after the 6th they have just had. The women in the family were very angry at her about this – they told her that it was not for her to decide. She was told that she would be monitored to check if she is using any contraceptives of any kind. Even when she suggested that at least, whilst the last baby was growing, she should be allowed to use condoms to avoid contracting sexually transmitted infections that she had contracted from the husband throughout their 16-year marriage. A community meeting that is usually held to deal with family conflict proved to be worse, since community members found this request disrespectful to the husband. From then on, she was isolated by other women and the community. The political leader in the area decided to discuss this matter at one of the political meetings and they decided that there should be rules put down for women to be chased away from Kwa Mhlanga if they were found to be using contraceptives. They also requested the clinics in the area to not offer contraceptives but to stock only condoms that can be supplied to men if they request for them.   On recognizing that many women who live with HIV experience inequalities with men, particularly in their intimate relationships, that prevent them from achieving optimal sexual and reproductive health (SRH) and exercising their rights, Emily and Dina decided to establish a secret intervention that would help women to overcome this problem. They involved a health care worker to assist with educating women in the area. The material provided by the health care worker was found to be very informative. However, the content of some of the workshops still mentioned that women need to listen to their husbands when it comes to the number of children they should have and whether they can use contraception. Input of the broader family to what a wife can wear was promoted by in the workshops. Nevertheless, within a short space of time health researchers in the area reported a reduction of STI and HIV infections, increased use of contraceptives and increased communication between married couples about sexual and reproductive matters. They found that this intervention improved confidence of women to talk to their partners and family members, and that they have started taking decisions for themselves about whether they wanted children or not. Overall, physical and psychological health of women in the area was found to have drastically improved.

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