CAMBODIA: Wives at Risk of HIV
Infection
PHNOM PENH, 3 January 2007 (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.
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. Credit: David
Swanson/IRIN | |
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."