Brazilian Women and AIDS
Today in Brazil about 623,000 people are living with AIDS, 34% of which are women. This group is the fastest growing risk group in Brazil and should be given particular care. In 2003 the male to female ratio is 2:1 in adults and in adolescents an even 1:1 (hap.hrs.gov, par. 1).
While the rest of the country has improved a drastically in AIDS mortality, deaths among women have not been quite as drastic, in all parts of the nation. There is a stigma still attached to having AIDS which is that either homosexuals, injecting drug users or prostitutes get them. Even health care providers usually think of women as less likely to contract HIV and the women themselves often do not believe that they would be at risk. Thus, there are often delays in diagnoses which leads to a worsening of conditions among women.
In São Paulo, a study was made regarding how women perceived the virus before knowing that they had it. A shocking 53% of the women spoken to did not see themselves at risk before they found out they had HIV, and of the women who did see themselves at risk, 29% say that it was only after their partners became sick that they thought about possibly having the virus (hap.hrs.gov, par. 3).
Sexually Transmitted Diseases
Common symptoms among women with HIV include weight loss, multidermatomal heres, pneumocystis carinii pneumonia, tuberculosis, vaginal candidiasis, and espophageal candidiasis. Among the same regions that HIV was prevalent, other sexually transmitted diseases were also common. HPV had been contracted by 51.2% of the women, syphilis by 10.8%, hepatitis B by 14.7%, and trichomoniasis by 9.8% (hab.hrsa.gov, par. 6). HPV is an issue often ignored by this society even though its prevalence among women is overwhelming. Cervical cancer is a high cause of mortality in women and is the most frequent cancer in Brazilian women. Each year there are about 6,000 deaths and 20,000 new cases.
Safe Sex
Condom use in Brazil is not as high as it could be. While there has been a lot of advertisement advocating condom use, it is seen mostly as a form of contraception, and not as something used to protect the body from viruses and diseases. Women have little power to convince their partners to use condoms, thus, the government has been enforcing the use of diaphragms, or female condoms, so that the women have the power to choose on their own. In 2002, 4 million female condoms were purchased for distribution. Yet, while this method gives women their own choice, the diaphragm is not quite as effective in preventing sexually transmitted disease as the male condom.
Because of contraception being a priority, particularly among young people, local governments have been providing free birth control pills without prescription needed, thus, once again, the barrier methods have been largely ignored. Most women still report, however, that it is their partner’s desire to not use a condom that account for unsteady use. A study conducted in São Paulo showed that even after knowing that their partner was HIV positive, a shocking 25% of men did not use condoms. Many women with HIV still choose to have children, particularly since the advancement of prevention of mother to child transmission during the pregnancy, thus transmitting the viruses to their partners, if they had not already.Poverty and Social Support
Since AIDS in Brazil originated in the favelas, or slums, it is no surprise that this area brings several other problems in the lives of the people who live there and have HIV, particularly women. In these areas education is very limited and crime rates are very high. Thus, the result of this is that there is no sexual or social education, causing a low rate of condom use and availability as well as high rates of domestic violence.
Several women are unemployed in these areas; suffer from domestic violence and sexual abuse. A quarter of them have lost at least one child to AIDS. In these same areas there are approximately 10 million unwanted pregnancies, with the teenage population being of particular concern. About 25% of pregnancies in the country come from adolescent girls.
Prostitution
Because prostitution is legal in Brazil, there is open, non controversial attention given to prostitutes by the government. While there is still a lot of work to do, the more stable workers, and even workers in the poorest parts of Brazil have learned to always use a condom, and often times are the ones advocating that use. Several journalists around the world have given attention to this nation “Where Prostitutes Also Fight AIDS” (Washinton Post). This, however, is part of the conflict between the United States and Brazil in each nation’s ideology on how to fight the disease.
While Brazil is a nation with 73% of its population considering themselves Catholic, the Ministry of Health considers it no issue to promote not only the use of condoms, but the distribution of that knowledge amongst sex workers. George W. Bush, however, offered money to Brazil on the condition that it condemns prostitution, something that the Brazilian government simply said they would not do. Brazil refused the money and went on with its program of having sex workers promoting safe sex around the places they work.
However, this example is not shown everywhere. In Brazil there are still places to worry about, where younger girls are prostituting and do not have the power to demand the use of condoms, and sometimes do not even know that they should. Some women suffer violence when they refuse to engage in intercourse with a client that demands sex without a condom. Yet, this nation has shown to be a wonderful model for other nations that have this problem. This ideology is that preventing among prostitutes is not encouraging prostitution, it is merely taking care of a realistic situation that will be there whether we like it or not.
All statistics from the Heath Resources and Services Administration:
http://hab.hrsa.gov/publications/womencare05/WG05chap16.htm