Stigma and sex

Of ten women interviewed in Kenya for a television documentary, the majority of them would rather contract HIV than fall pregnant. Despite being openly promiscuous, and or regularly having unprotected sex, they say that they trust the men that they sleep with. They regularly use the morning after pill (MAP) to avoid becoming pregnant, and do not take any other sexual precautions. Why? They say that the stigma they feel for being pregnant outside of marriage, and the social sanctions that they face are more extreme than those they would face if they were HIV-positive. Their greatest worry is thus that they’ll fall pregnant. That’s because even if you trust your man, he can still make you pregnant, but they seem to believe that trust prevents him from giving you HIV. To avoid exclusion from their families the women in this study take MAP repeatedly, unaware that it loses efficacy the more you take it.

Part of the problem with pregnancy is that it is a visible condition, you can see the body changing and thus it is more difficult to hide than HIV. With ARVs and a healthy lifestyle there are no visible symptoms that a person is HIV-positive. But after four months or so, you’re not going to be able to convince anyone that there’s not a baby inside you.

Why do these women do these things? Stigma.

Stigma is one of the most powerful forces when it comes to sex and sexuality. The idea of being thought of as sexually deviant, dirty or dangerous is something that many people fear, and unfortunately many people describe others with these same life-threatening labels. The fact that these women, and many others across the world are afraid to talk about their sex places them in danger. They are pursuing risky sexual behaviour, with unpredictable consequences.

The commentary on the article has followed a similar line to that which I took when I spoke about masturbation last year. Young girls are scared to talk about sex because parents have effectively forced them to silence. They are too scared to talk about their own sexual safety, and so too scared to practise it. They are more trusting of their pharmacist and sexual partner than of their parents.

So what then do we do to convince these women that there are safer options out there? We start talking to young girls and boys about sexuality. If we don’t talk to them and we let them use public figures and television campaigns as their only source of knowledge about sex we are going to end up in deep trouble.