In-depth: International Women's Day - Gender and HIV/AIDS
ANGOLA: Empowering girls at heart of AIDS strategy
Vanya and Dr Maria Isobel Massocolo Neves
Johannesburg , 8 March 2004 (IRIN In-Depth) - One pristine building stands out along a dusty street in the Angolan capital, Luanda.
With its sparkling tiles and laboratory technicians in spotless white coats, the Centro de Apoio aos Juvens (CAJ), or youth support centre, looks like a clinic, but the laughter and noisy debate sound more like a youth club or boisterous classroom - in fact, it's a combination of all three.
In Angola, where 60 percent of the population are under the age of 18, teenagers shoulder a massive responsibility in helping to rebuild the country after a devastating 27-year civil conflict. And it is the Angolan youth who are again on the frontline in the battle against HIV/AIDS.
"We all need to be aware of what adolescents are doing. If it wasn't for them, we would be steps behind in the fight against HIV/AIDS. They are the best advocates," said Melanie Luick, HIV/AIDS project officer at the UN Children's Fund (UNICEF).
UNICEF partners the UN Population Fund (UNFPA) in running this centre, 10 others in Luanda and another nine in the southern provinces of Benguela and Huila, where youngsters aged 10 to 24 are tested for sexually transmitted diseases, including HIV/AIDS, and receive counselling.
The support programme does not stop there. "An important part of our strategy is debate. We're not here to lay down the law," explained Doctor Maria Isobel Massocolo Neves, one of four doctors who work at the centre.
"We adopt a peer group strategy, so we have youth talking to youth about all kinds of issues – relationships, equality, safe sex, unwanted pregnancies and general reproductive health," she said.
Studies at the centres show there is an urgent need to encourage teenagers to be tested; to equip them with the knowledge they need to protect themselves, and remove some of the stigma surrounding HIV/AIDS.
Ironically, Angola's civil war may have helped curb the spread of the disease, but with the end of the conflict allowing greater mobility, the danger is that people are taking the virus with them.
Humanitarian organisations and NGOs have been saying for some time that Angola must grasp this window of opportunity and prevent a leap in the relatively low prevalence rate, which four-year-old figures put at 5.5 percent.
A low level of knowledge about the disease, coupled with a high fertility rate – the average Angolan woman has seven children – create ideal conditions for an epidemic on the scale of neighbouring Botswana, where UNAIDS estimates that almost 39 percent of the population is infected.
Neves believes the rate in Angola is already climbing - figures from a 2003 survey by the US Agency for International Development, the US Centres for Disease Control, Population Services International, the National AIDS Control Programme and UNICEF would appear to reinforce her fears.
Of around 14,000 people tested for the disease at voluntary counselling and testing (VCT) sites, a startling 10.4 percent were HIV-positive. UNICEF's Luick acknowledged the numbers could be artificially inflated, with many of those seeking VCT doing so because they suspected they might have the disease - but they nevertheless illustrate a need to move fast.
The hope is that the young will create a virtuous cycle, helping to ease the problem rather than exacerbating it. Changing the behaviour of girls and their way of thinking form the crux of future strategy.
In the past, the ABC of HIV prevention – Abstinence, Be faithful and consistent, and correct use of Condoms – was the message, explained Antonica Hembe, national programme officer for UNFPA. "But now we're moving onto D and E – Delay and Empowerment of girls," she told PlusNews.
"If we can give girls alternatives - provide them with enough information to make their own decisions, then they have a choice," she said.
They will have their work cut out in Angola, where becoming a wife or a mother is often considered the ultimate achievement; where it is not uncommon for young girls to have sex as young as aged 14; and where women typically give up the most for the good of the family.
"Girls in Angola, and across the region, are traditionally the first to make sacrifices for the betterment of the family. That often means they are the first to miss out on education; they are the most vulnerable; they only look at their personal concerns once everyone else in the family is taken care of," said UNICEF's Luick.
Eighteen-year-old Vanya is an example: she is pregnant, thanks to a burst condom, and has had to put her ambitions on hold. "I wanted to be a doctor - then this happened," she said, pointing to her bump. "At first I was sad, but now I'm okay about it, and my boyfriend is helping. And I can still be a doctor later, I'm sure."
That Vanya now feels on an equal footing with her partner and, perhaps more importantly, has not let go of her goal, indicate changing attitudes.
"When girls have dreams for the future, that changes the game. They stop saying 'I want to have a baby by the time I'm 18, so I that have my place in society as a mother,'" said Luick.
"That can change to 'Yes, I would like kids one day, but I want to do x, y, z first.' It's not so much about their position in society as a wife and a mother, it's about their own merit and doing something for themselves," she added.
As the 2003 survey showed, women are both more infected and affected by the HIV/AIDS virus - of the 10.4 percent of people found to be HIV-positive, more than two-thirds were women.
"There is this sense that somehow it is all the girls' fault: they are associated with prostitutes and promiscuity," said Luick.
"But the truth is, they're not having more partners; they're not having more sex, but they are more affected because they are more biologically at risk, and they live in a country where traditionally women don't have the same opportunities as men."
Neves argues that inspiring girls, who make up 86 percent of attendees at the clinics, and changing the way they and their partners think, are key objectives, but lack of funds may yet hamper their activities.
With adolescents' interest piqued by community-level youth centres, run by UNICEF as part of the UN's "Telling The Story" programme, as well as a twice-monthly national TV programme on the project, Neves hopes that intense in-country fundraising and support by the Southern African Youth Initiative for HIV/AIDS (SAY) will allow their work to continue and expand.
"We try to be a motivation. In our society, girls don't have the power to make decisions - women do what men say," she said.
"We have more girls here because the men think reproductive health is the sole responsibility of the woman. But now we're beginning to see that more girls and boys are coming to the centre together, acknowledging that it is the couple's responsibility.
"That's already a big improvement, but we have to keep working at this, and for that we need more money," she said.