the
City of Hope

A Video CD by TEMAK, now available for US$13 (inclusive of shipping costs).

Running time: 25 minutes

By Godfrey M. Kimega

As seen in the Video CD of the Teenage Mothers & Girls Association of Kenya. Produced in July 2004 and first presented at the International Conference on HIV/AIDS, held in Bangkok, Thailand the same month. Order a disk to see the interviews plus footage of the socio-cultural factors behind the persistence of HIV/AIDS in a particular part of Africa. Please use the addresses at the bottom of this page for ordering.

Testing positive for the Human Immune-Deficiency Virus (HIV) is devastating news for anyone, for life seems to change irrevocably, dreams shattering in a flash, visions of pain, suffering and loneliness dominating the thoughts of one in that situation.

The spread of HIV continues incessantly despite campaigns by governments, churches, schools and individuals to stop, or slow down the spread of this mutant virus. Organizations working at global, regional and at the village level have emerged to fight the spread of HIV, pouring in money, time and other resources in HIV/AIDS projects. Perhaps HIV cannot be contained because its mode of transmission, unlike that of other deadly diseases, touches at a core element of human existence: sexuality. For sexuality is vital in reproduction and key to the continued existence of man on earth. Without sex, there would be no offspring, but with sex comes the risk of HIV/AIDS transmission.

The question commonly heard outside Africa is: "why do Africans keep getting infected in spite of all the information available about HIV and AIDS?" There has been racial rationalization of the spread of the HIV virus, with Africans claiming that its part of a Western conspiracy at population control. Westerners hit back criticizing Africans for being "over-sexed." However, as youth in Kenya point out, sexuality has many facets to it and explanations tinged in stereotypes cannot adequately explain the continued plague of HIV in this part of the world. As one girl in the Kenyan town of Kisumu puts it, "anyone engaging in sex is at risk of getting infected," regardless of race, tribe, nationality or marital status.

Youth the world over are fun loving and adventurous (even in relationships). The town of Kisumu, on the shores of Lake Victoria, is well known for its night life - small neighborhood pubs host live bands that play to packed floors more so during the weekends. For a night, age becomes irrelevant: so long as you have the energy and cash to spare, you can pop into any entertainment joint and have a good time. The young mingle with the old, and the old with the young. It's the equivalent of a mini-carnival, with everyone dressed the part. Middle aged men in brightly colored African prints, women in elegant flowing robes, and of course the youth; seeking to emulate the likes of Jennifer Lopez, Eminem, Justin Timberlake and Beyonce.

"We go to night clubs with friends where there's heavy drinking, smoking and drug use. Also the styles of dancing are very suggestive and often, we find ourselves caressing, touching and kissing. This can lead to sexual acts that spread HIV," says Christine Osula, a young woman living with HIV in Kisumu. "Some types of clothing are meant to provoke sex," says Christine, "tight jeans for girls, skirts with long slits that expose the thighs and spaghetti tops for the breasts."

Christine learnt of her HIV status early 2004. She is now a youth counselor with the Teenage Mothers and Girls Association of Kenya, (TEMAK), holding sessions with other HIV positive youth, sharing experiences and providing support to each other.

Youth sub-culture has its own code for communicating sexual desire among its members. "Certain finger signs mean it's alright to have sex," says Christine, "and licking ones lips with the tongue sticking out indicates a desire for lovemaking." Peer pressure comes in the form of such slogans as "FANTA", meaning "Foolish Africans Never Take Alcohol." This, according to Christine, pushes many to take up drinking in an attempt at appearing civilized.

Pop stars glorify multiple relationships and casual sex in their music and through their real life personas as reported in the media. A number of youths have emulated their idols by engaging in casual love affairs with several people at the same time, a sure channel of HIV transmission. The exaggerated narration of their sexual exploits imposes pressure on their peers to outperform in a bid to set records, so to speak.

Another reason for engaging in multiple relationships is economic. Young people from poor backgrounds and orphans, more so girls, seek relationships with older, richer people who can pay for fashionable clothes, mobile phones and cosmetics. For a long time, this has been described as the sugar daddy/sugar mummy phenomenon, referring to the affluent man or woman who provides sweet goodies to young lovers. This phenomenon serves to transmit HIV across various generations as older married lovers also pass on HIV to wives and husbands.

"Don't Africans care about the dangers posed by unprotected sex?" goes a repeated response to the persistent spread of HIV in Africa. Undoubtedly, everyone knows about HIV and AIDS, even small children in elementary school are aware of the disease. Awareness campaigns conducted in schools and in the media have achieved the objective of imparting knowledge about the disease to the majority of the population. What hasn't been achieved, to a desirable degree, is behavior change. Youths have insulated themselves from the fears of HIV infection through myths created by their own subculture. Without these absurd myths, everyone would be too scared to sleep around.

"Some people believe withdrawing the penis before ejaculation will reduce the chances of transmitting the HIV virus," says Christine. This belief holds that HIV virus is passed on through semen, though it has been established that minor cuts during sex can open up windows to infection. To add to this myth, it's believed that boys only release semen during the day, so sex at night is safe! "It's thought that drinking beer after sex will wash out the HIV virus through urine flow," adds Christine. Other youths say that AIDS is only for middle-aged married people and not for those in school.

Racial and ethnic stereotypes have fostered beliefs that members of specific communities are prone to infection. At the same time, some communities still adhering to traditional customs explain away AIDS infection as a curse from gods for breaking one or other taboo. Even Christians aren't immune to falsehoods: there is a suggestion that AIDS is God's punishment to the human race.

While myths exist to alleviate worries of AIDS infection, other myths exist to encourage sex. For instance, boys are told that abstaining from sex will result in serious backache caused by sperm accumulating in the backbone. In certain ethnic groups that regard fat women as beautiful, girls are made to believe that frequent sex will broaden their hips, lighten their skin color and make them fatter. Biologically, there is no basis for such beliefs, as excess sperm produced by men is harmlessly absorbed by the blood stream. A woman's body structure and appearance is determined by genetic factors not by frequency of sex.

Once the devastating news about one's HIV status has been received comes the next crucial part: accepting and learning to live with the infection. Though medical advancements and greater dissemination of relevant knowledge has increased the life expectancy of HIV positive individuals, adapting to a different life after infection is a daunting, emotionally exhausting challenge. One has to adjust to a very strict drug regimen, give up alcohol and drugs, practise safe sex, eat well and at the same time cope with opportunistic infections that arise from time to time.

Sexually transmitted infections such as gonorrhea, syphilis, genital ulcer disease and pelvic inflammatory disease (PID) are among a host of infections that HIV infected persons have to endure. Their immune system, having been attacked by HIV, isn't strong enough to resist anything else that attacks it. For instance, tuberculosis is a big killer of the HIV infected because of impaired immunity. Skin diseases take advantage and further weigh down the infected person. As though the immune system wasn't facing torture enough, fungal infections such as candidiasis and oral thrush strike, thriving in warm, moist areas of the mouth and genitals. Mouth infections curb the appetite of the infected yet adequate nutrition is what they need most in order to stay healthy.

Skin infection gives rise to rumors about one's health status. "I can't wear miniskirts and sleeveless tops because of skin infection. I feel ugly when I look at myself," says one girl whose brown skin is poked with black marks caused by skin ailments, "I have lost my self confidence, my friends gossip, shun me and don't want to share with me anymore. I am lonely."

To their relief, at least physically, medication exists to alleviate the suffering caused by infections of opportunity. Creams and disinfectant solutions can manage skin conditions and genital itching. Genital itching can be so severe as to completely distract one's attention at work, says a youth living with HIV also in Kisumu. Herbal medicine extracted from locally available plants is an affordable option to HIV positive youth, many of whom are unable to find meaningful work due to their health condition. There are tales of people improvising with yoghurt and vinegar as a relief to genital itching.

At youth counseling centres, like that at TEMAK, youth are advised on hygiene standards that could keep pathogens away from their bodies. However, joining support groups and learning how to live with HIV positively can only prepare them for what they can do for themselves. It cannot do anything about the people they encounter at their homes, neighborhoods, churches and market places. Youth living with HIV contend with constant gossip, discrimination and rejection. They are looked down upon as useless and dying. They are given nasty names by colleagues who may not have taken the test themselves. Even the family members of infected youth are stigmatized and ridiculed by neighbors.

Youth living with HIV organize meetings, without the involvement of older persons, in an approach termed, "Peer led Approach to Counseling." Working under a peer leader, selected from among them, youths initiate and maintain HIV/AIDS related behavior change within their group. A peer led approach covers larger areas and attends to more people using minimal resources. At the same time, the sharing of knowledge among infected youths enhances self confidence and self reliance - a hallmark of positive living. "Peers understand and trust themselves so they don't feel threatened by each other," says Nicholas Ouma, a Peer Counselor also living with HIV. Nicholas, popularly known as Nick, is a well known and respected peer counselor in his village of Mambo Leo, near Kisumu. He is reportedly skilled at communicating ideas in the local Luo language.

Veronica Avisa

Living positively with HIV can be learnt through the peer groups and support organizations. However, the choice of coping positively with HIV has to be made at a very personal level, bearing in mind one's own tastes and financial status. "I accepted my HIV status and now I live with the hope that, someday, a cure will be found," says Veronica Avisa, a young woman in the suburbs of Kisumu. Veronica goes on morning jogs along the hilly paths of her neighborhood to stay in good physical shape. Knowing the importance of staying calm, Veronica manages stress levels by seeking spiritual solace in the church. "Involvement in social work helps keep my mind off sex and whenever I am on a date, we discuss the issue of sex in the relationship, like how far we should go," adds Veronica.

The world has woken up to the scale of deaths and social problems occasioned by HIV and AIDS. While efforts go into finding a cure for the virus and towards keeping as much of the population AIDS free, much needs to be done into making life manageable for those living with HIV together with their families. At the same time, there should be a cognizance that efforts into fighting AIDS aren't likely to completely eliminate the disease, only control its spread and ease suffering.

For as long as humans continue to exist on earth, each generation giving birth to the next like as it has happened over the eons, the risk of acquiring AIDS may exist in tandem into the indefinite future

The video CD contains facts on the socio-economic realities surrounding HIV/AIDS in Kisumu: a Kenyan town typical of many urban settings across Kenya. Use any of the contacts below to make your order.

PRICE: US$13 (inclusive of shipping/handling)

The Video is also available as a VHS tape.

Running time: Approximately 25 minutes.

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