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AIDS workers struggle to reach Botswana's youth
28 Nov 2002
By Mercedes Sayagues
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Sports are regarded as a way of keeping youngsters out of trouble. Players here wait for their turn at table tennis in Old Naledi community hall.
Photo by MERCEDES SAYAGUES
GABORONE, Botswana (AlertNet) - "Who wants to look at these posters, they are so boring," says Kabo Lesomo, pointing to a wall covered with information about AIDS.They go from the conventional (a nuclear family smiling as in a soap ad) to the incomprehensible ("Unlock AIDS", featuring a huge padlock).Lesomo works with the Peer Approach to Counselling by Teens (PACT), sponsored by the Young Women's Christian Association since 1995. PACT has 1,000 peer educators in schools in Botswana.Lesomo's concern is not about slick posters. It is about getting young people to understand that AIDS is here and they must learn to live with it or die of it.Botswana has the world's highest HIV infection rates. Roughly four in 10 people aged 15 to 49 are infected. In Selebi-Phikwe, more than half of pregnant women aged between 20 and 29 are infected, says the Botswana 2001 HIV Seroprevalence Report by the National AIDS Coordinating Agency.Alarmingly, HIV prevalence among young people in the 15-24 age group is rising after a brief drop in the late 1990s. Half of new infections occur among young people."Young people do not take AIDS seriously enough to change their behaviour," says Baatweng Motladiile, training coordinator at the Scripture Union, which runs "positive parenting" workshops for teenagers and their parents.Among those aged from 15 to 29, there are three HIV positive women for every HIV positive man, according to the Botswana Human Development Report 2000, published by the U.N. Development Programme (UNDP). The ratio stabilises at one-to-one in older age groups.The disparity suggests that girls are infected at a younger age than boys are and that HIV is transmitted across generations through sex between older men and younger women.Teenage pregnancy here is among the world's highest. Half of teenage girls have been pregnant. Illegal and unsafe abortions are frequent.Keeping the young free of infection and early pregnancy "offers Botswana the best prospects for an AIDS-free generation by 2016", the UNDP report says.How to do it is a million-dollar question."AIDS has become a boring topic, abstinence means nothing to a 14-year-old," Lesomo told AlertNet. He would like PACT to design its own information materials with a cool design and streetwise terms.Hammering that "AIDS kills" does not work either.SCARE TACTICS DON'T WORK"Scare tactics do not make people change their behaviour, " said PACT training coordinator Bawani Mutshewa.PACT has joined a number of NGOs, the U.N. Foundation and the Ministry of Health in a new approach to reach youth in three townships of Gaborone.Through a combination of sport, music, peer education and youth-friendly reproductive health services, the Urban Youth Project is pulling out all the stops to offer young people other choices than alcohol, dagga and unsafe sex."It's about getting young people excited about their lives, their health, their future," says Sarah Kirby, a consultant on adolescent reproductive health with the U.N. Children's Fund UNICEF.Poverty perpetuates the epidemic. Diamond-rich Botswana is the world's fastest growing economy and has made great strides in health and education. However, one in two Batswana is poor.In Gaborone's townships, unemployment and boredom coupled with alcohol and drugs encourage people to indulge in behaviour that increase the risk of infection, such as unsafe sex, sex for money or sex with strangers. Gender inequalities make girls more vulnerable.Rapid urbanisation -- the urban-dwelling population rose from 18 percent in 1981 to 46 percent in 1991 and 50 percent today -- has changed lifestyles in a short time.Parents and children don’t talk about sex."They live in different worlds," says Motladiile.Less than 20 percent of children aged 10 to 14 and 50 percent of older teens have ever talked about sexual issues with an adult.They talk with teachers, social workers and guidance counsellors, not with parents, according to a survey on the sexual behaviour of young people conducted by the Ministry of Health.Myths abound. One-fifth of young people believe that sex with a virgin cures AIDS.The stigma is strong. Half of those aged 10 to 14 believe that HIV positive people should be isolated from society. Older youth are more compassionate. Yet, in focus group discussions, many of those aged 20 to 24 revealed they would be afraid of eating with HIV positive friends.Only about a dozen people have gone public about being positive.FAMILY SHOCKEDOne is Kesego Basha, 30, a civil servant and mother of two, who tested positive in 1997. Her family wanted to keep it secret. Basha withdrew from her friends. In 2001, she decided to go public."My family was shocked but now accepts it," she says.Basha set up the Centre for Youth and Hope (CEYOHO) "to show young people that it is better to live with HIV than deny it".In a room on the 12th floor of the Postal Building in Gaborone's government district, with a splendid view of the sprawling city, eight young women strut as in a catwalk to the music of Shaggy, Ishmael and UB40.They are rehearsing for the Miss HIV Stigma-Free pageant, a fundraising event for CEYOHO. Some of the contestants are HIV positive, some are not.Beauty (not her real name), a long-legged, long-haired 22-year-old, has just completed a degree in accountancy. Two years ago she fell ill and her doctor suggested an HIV test, but she refused. After all, she had had only two boyfriends." I never believed in AIDS. It was for older people, not young ones," she says.Beauty's condition worsened but she l refused to be tested. Finally her persuaded her and Beauty has been on anti-retrovirals since but keeps it a secret."I'm healthy, I'm a new person, and my mother made me the most beautiful dress for the contest," she said.Fear of discrimination prevents many from seeking free anti-retroviral treatment provided by the government. Only 1,600 people have signed up."People are afraid of being rejected by family and society," said Beauty.The government gives orphans a generous monthly food basket, but many do not claim it because their relatives fear being stigmatised.The beauty pageant held on September 13 in Gaborone raised 198,000 pula ($33,000) for the group. The jury alone knew who among the smiling contestants, radiant in evening gowns, was HIV positive. Only one dared be identified as such.Gloria Pilane, 31, received a heart-warming ovation when she told the audience her story. Since 1997 she had ignored warning symptoms and went for a test only when her baby died in 2000. Today, she is open about being HIV positive and has the support of her family.For AIDS to lose its stigma and be seen as a manageable chronic disease, Botswana needs more people like Pilane.
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