In this post I shall try and attempt to critically evaluate the statement that “with HIV/AIDS, the body has become the site of struggle between those with power and those without”. This statement assumes that people without power are at higher risk to contracting HIV, for a number of reasons. I agree with this to a certain degree and I shall discuss my reasons for this in the next paragraph but I shall also discuss further on in my essay why HIV doesn’t only affect people without power but also those with power.
Some factors that can render people powerless are geographical factors. People living in rural areas and that live far away from health clinics or people that live reasonably close to a clinic may have problems getting transport, especially if they are economically disadvantaged, these people are in a less than ideal situation when it comes to HIV. The fact that they don’t have access to clinics means that they do not have a means of finding out their HIV status and this would be a contributing factor to the spread of HIV infection. Also these people who are rendered powerless by geographical constraints have trouble getting anti-retro-virals, this would spread the transmission of HIV from mother to child. Age is also a factor that can render an individual powerless. As some people in the Walker reading state that when they go to the clinic and ask for condoms they are laughed at and asked what they are going to use the condoms for and are told that they are just wasting them ( Walker. L. et al, 2004).
“In sub-Saharan Africa, 55% of HIV-positive adults are women. In South Africa twice as many women between the ages of 15 and 24 are HIV positive than men in the same age group. And in South Africa as a whole twelve to thirteen women are currently infected for every ten men” (Walker. L, Reid. G. & Cornell.M. 2004, pg22). In order to make sense of this we need to look at the social context and power dynamics that inform sexual behaviour, and understand sexual relationships and gender inequalities between men, women and children.
In South Africa it can be seen that within a poor community, for example, Soweto, there can be clear divides between rich and poor in that community. In other words there are different levels of inequality. In this environment sex becomes something to be exchanged for material goods. For women who are desperate in is a way of acquiring commodities. Transactional sex flourishes in this setting. It is often the only available currency. This transactional sex puts those women without power who are dependant on these often called “sugar daddies” at high risk to contracting HIV (Walker. L. et al, 2004 ).
One of the reasons that this sexual transaction is occurring is because a large number of poor women have no means of income and have trouble getting jobs because of high unemployment rates. These women often have to provide for sick parents, which is common because of the HIV pandemic, or they are single mothers or sisters who have to take care of their children or younger siblings, “the burden of responsibility for looking after younger siblings often rests on the eldest female child” (Walker. L. et al ). “As the AIDS epidemic ravages households it transforms the position of household members, whether or not they themselves are infected. One would expect to find an increasing number of households headed by females. By the elderly, or that consist of children only. HIV/AIDS-related morbidity and mortality also cause changes in the division of labor between households, with direct implications for children. To cope with the change in income and the need to spend more money on healthcare, children are often taken from school to assist in caring for the sick or to work so as to contribute to household income” (Booysen. F. & Arntz. T. 2002, pg 171). This is a situation that creates a high-risk situation for children, as when they are left to take care of entire households the option of acquiring a “sugar daddy” to survive and to provide for the family becomes often a last resort. This leaves them completely powerless and vulnerable to the will of their “sugar daddies”.
The risk of HIV for these women is very high especially because of traditional African beliefs. When men spend money on women there is an expectation that they can demand “flesh to flesh” sex .The more they spend, the greater the expectation. As an interviewee in the “Sex and Power” reading said “He has been spending a lot of money, so he will go for it, flesh to flesh”. Another problem posed for these women is that condoms are seen as an awkward interruption in the “heat of the moment”. The perception is that men lose control during sex, making condom use a secondary consideration. Condoms are about rationality, whereas sex is about passion and desire. HIV risk is much higher for women who are dependent on “sugar daddies” for their survival because the men they are with are often older and economically independent and therefore have considerable power and access to girls (Walker. L. et al, 2004 ).
Another problem for these women who are dependant on these men is that condoms have been stigmatized because of the connotations of disease associated with them. In African culture people assume that if you want to use a condom you’re sick. Wanting to use a condom is also seen as a lack of trust between partners. Partners are often asked to express their love and trust by having unprotected sex. The problem here is that these women need to maintain the relationship for their survival, so they do not have the power to oppose their partner and negotiate condom use (Walker. L. et al, 2004 ).
Gender inequalities play an important part in the HIV pandemic. Men often hold greater power and dominance in most African communities. Being a victim of violent attack is almost an unremarkable part of being women in South Africa, and violence is a contributing factor to HIV transmission. For example, if a woman is forced into sex with an HIV infected partner, her risk of infection is also great. This is a common case as rape or sexual coercion is not stigmatized in African culture as it is believed that it is a mans job to initiate sex and when a women says no its his job to convince her otherwise and that if his sexual appetite is deprived he is not a man. “ Common to both young men and women is the belief that a man has a right or even a duty, to force himself onto a women who displays reluctance and shyness” (Walker. L. et al, 2004 ).Another example in which men abuse there power to attain sexual satisfaction is evident in the cases where women are forced to have sex with indunas( leaders of worker gangs) if they want to get work on farms ( Jewkes. R. & Abrahams. N. 2002).
The girls face an increased risk of HIV exposure because of the unequal power relations between them and their partners and the fact that the older men generally have a larger sexual network. The threat of violence makes condom negotiation extremely difficult. Also the expectations that children should be able to negotiate sex safely are inappropriate and impossible. Thus it is apparent that for women, the norms that define acceptable behavior, economic dependency and violence have said to make them vulnerable to HIV (Walker. L. et al, 2004 ).This shows the point of the statement regarding people without power being left helpless and vulnerable to the AIDS/HIV pandemic sweeping the country. But in the next few paragraphs I shall challenge the initial statement “with HIV/AIDS, the body has become the site of struggle between those with power and those without” and show that those that hold power are also at risk of contracting HIV.
It can be shown that men’s greater social power places them in a position of vulnerability regarding HIV infection. Many men are under social pressure to behave in a domineering and sexually aggressive way. I shall show how norms and expectations for men surrounding masculinity put them at risk. One of the norms regarding masculinity dictates that men should be knowledgeable and experienced about sex, this increase the risk of most young men to HIV infection because such expectations prevent them from seeking information about safer sex. Traditional notions of masculinity are strongly associated with risk-taking behaviour such as increased alcohol consumption, intravenous drug use, multiple sexual partners and violence. All these factors contribute to HIV (Walker. L. et al, 2004 ).
One of the biggest problems and factors putting men at risk is the concept of men having multiple sexual partners. Some men express their maleness by having sex with many different partners. There are numerous reasons for this. Some explanation using African cultures beliefs suggests that it could be a mark of virility or a product of uncontrollable male sexual urges. It can also be explained through ideas about the traditional practice of polygamy (Walker. L. et al, 2004).
“Political economy approaches towards AIDS often downplay masculinities and issues of sexuality seeing them as peripheral to health concerns. Yet resting heavily on the symbolism of polygamy, and with long, unsettled history, it has been argued that the isoka masculinity has been significantly reworked in the era of high unemployment. Men celebrating multiple sexual partners, widely seen as an “innate” feature of African sexuality, are in their present form, a product of an economic crisis that has ripped the core out of previous expressions of manhood – working, marrying and building an independent household. Today’s tragedy of AIDS cannot be separated from the crisis of development in contemporary South Africa” (Hunter. M. 2004, pg 145). This shows how men who cannot attain power through money, so they try reinforce there power and traditional hegemonic masculinity by having many sexual partners, this helps them feel successful with regard to attaining their traditional ideals of being a man but puts them at greater risk of HIV infection.
Amongst most youth violence and drinking is an important part of being a man. This coupled with the belief that real men take risks makes it so much easier for a man to have unprotected sex with a woman. “ If a guy does not drink he will never be accepted by his friends. They will call him a moffie” (Walker. L. et al, 2004, pg 30 ). Another example where the concept of masculinity increases the risk of HIV infection for young men are beliefs regarding condom use. For some teenagers condoms have a stigma. Condom use challenges the image of an “up-and-coming man”. As discussed earlier it is also a belief that women must be monogamous and that it is the mans duty to ensure she is monogamous (often using the threat of violence) and men believe because there girl friends are monogamous they stand a lower risk of HIV infection, but as multiple interviews have shows most women do not agree with traditional values that women must be monogamous while men can have multiple partners. This increases the risk of HIV infection of men. “ ‘love’ is used to manipulate people into having unprotected sex. The assumption here is that relationships are monogamous, although this is often not the case. In sexual networks men often use condoms with their secondary partners but not with their main partners” (Walker. L. et al, 2004, pg 33).
From the above mentioned points it should be noted that both men and women are active in creating masculinities and femininities that make them vulnerable to HIV. Men conceptualize women as objects to be bought ad used, and forms of sexual coercion that undermine women’s power put them at greater risk to HIV infection because they are not in the position to negotiate safer sex. In a culture of patriarchy: men’s dominance, promiscuity and sexually assertive behaviour are encouraged; many men define their power by their ability to affect their will, especially over women. They hold positions of power in society but ironically this power and expectations that traditional hegemonic masculinity demands puts them at high risk of HIV infection. Statistics show that HIV prevalence is highest in men in middle and high income (3rd and 4th quintile) positions. In conclusion it should be evident that even though those without power are at significant risk to contracting HIV, those with power are too ( Selikow. T.A., Zulu. B. Cedras. E. 2002). “While there is clearly a biological basis to human sexuality. Most sexual behavior seems to be learned rather than innate. Sexual practices vary widely within cultures” (Giddens. A. 2006). I believe that the largest factor contributing to such high rates of HIV morbidity and mortality is that of cultural beliefs and even though opposing cultural beliefs is a controversial action, I think readdressing such concepts as hegemonic/isoka masculinity would reduce HIV prevalence in South Africa.