KENYA: The downside of door-to-door testing
Photo: Glenna Gordon/IRIN  | | Just 22 percent of Kenyan couples know the HIV status of their sexual partners
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TESO, 17 March 2010 (PlusNews) - While the public response to Kenya's national HIV testing drive has been enormous, many women are not keen to be tested, knowing that a positive result could mean the breakdown of their marriages, loss of home and more.
Isabella Omoto, who lives in western Kenya's Teso district, was recently forced by her husband of seven years to go for an HIV test; the result was positive.
"I revealed it to my husband and he just started beating me; he said I had been sleeping with other men," she told IRIN/PlusNews at her mother's home, where she now lives. "He threw my things out and told me to go back to my mother with all our children.
"He won't take me back because to him I am a prostitute," she added. "Today he has another wife and he has inherited another - I don't want to interfere with them."
According to Teso District AIDS and sexually transmitted diseases coordinator Nelson Andanje, men in the area - too afraid to go for HIV tests themselves - have been forcing their wives to get tested, believing their status will reflect their own.
"Here, like in many areas, it is women who come for HIV tests and you will see very few men," he said. "The man believes that if his wife is positive or negative then the same results apply to him."
 The man believes that if his wife is [HIV] positive or negative then the same results apply to him |
Rights issues
In December 2009, Human Rights Watch warned of the possibility of human rights violations during the mass testing drive.
"It a gross violation of a woman's human rights to force her to go for HIV tests and then use the same tests to decide whether she should continue to live with you or not when, ridiculously, you don't even know your own status," Andanje said.
Statistics from the district AIDS coordinator's office show that over the past year, 10,838 women were tested; only 183 were accompanied by their husbands. According to the Kenya AIDS Indicator Survey, an estimated 45 percent of women have been tested for HIV, against just 25 percent of men.
"The high number of women who test more than men could be attributed to antenatal testing, but even in this you never see their husbands accompanying them, which should ideally be the case," he noted.
Teso district's HIV prevalence is 24 percent; health authorities have identified high levels of polygamy and wife inheritance, aided by strong cultural beliefs, as some of the key drivers of HIV transmission.
"Strong cultural beliefs make men believe it is beneath them to go for voluntary counselling and testing and women are solely responsible for HIV transmission," Andanje said.
Discordance
"Many people still do not know about discordance," he added.
An estimated 6 percent of Kenyan couples - about 344,000 - are HIV discordant, while just 22 percent of couples know the HIV status of their sexual partners.
According to the Kenya National Strategic Plan for HIV/AIDS, "social norms regarding relationships, gender roles/imbalances, stigma and discrimination, fear and risk-perception, and fertility intentions present difficult prevention challenges”.
Andanje says the district authorities are trying to sensitise the community about discordance and to encourage women to speak out if they are being forced to take a test.
"We are using the local administration to reach out to men and let them know the benefits of individually going for an HIV test; we want them to know that they may be in a discordant union," he said. "When a woman comes alone or a man comes alone, it is difficult to know whether they are in a discordant union and you can't therefore give them services adequately.
"Men must be made to know that there is nothing feminine or masculine in testing for HIV. It is purely a health issue," he added.
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