African wives hide HIV status, sapping AIDS progress

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MELBOURNE, Australia — In a busy Mozambique clinic, a 25-year-old mother says she won’t tell her estranged husband she has HIV for fear she will be blamed and beaten.

“Very often here women won’t tell their partners or ex-partners that they’re HIV-infected,” said Sifronia Filipe, an educator at the clinic where the mom is being treated for AIDS. “She is scared he will leave her or will tell the neighborhood and the neighbors will discriminate against her.”

It’s a scene oft repeated across sub-Saharan Africa, where young women account for a quarter of new HIV infections and where AIDS remains a devastating scourge. The problem is especially acute in southern nations like Mozambique, where 7 percent of all teenage girls are HIV positive. That number doubles to 15 percent by age 25, according to a report by the Joint United Nations Program on HIV/AIDS released last week.

Protecting young mothers will be critical if the world is to meet a UN target of eliminating new HIV infections among children by 2015. At an international AIDS meeting that started in Melbourne, Australia, on Sunday, public figures from Myanmar’s political activist Aung San Suu Kyi to Virgin Group founder Richard Branson will lead a call to fight stigma and discrimination, which has blighted progress in poorer nations.

“Some people, if they find out they’re HIV-positive, they will change hospitals or scratch out their test result on their medical records,” said Aleny Couto, head of the HIV program with the Mozambique government’s Ministry of Health. “We still have stigma in this country, which is still a very big obstacle.”

It’s been three decades since AIDS began ravaging populations around the globe. While new infections have fallen to the lowest level this century and AIDS-related deaths are at a seven-year low, a “youth bulge” experienced by many countries with the highest HIV prevalence means that the number of young people living with HIV or at risk of becoming infected will increase in the next five years, the New York-based Population Council said last week.

More than 2 out of 3 of the 35 million people living with HIV are in sub-Saharan Africa, according to the report by UNAIDS. The 86-page document lists human rights violations, stigma and discrimination as the No. 1 reasons why people with HIV are being left behind.

A so-called Melbourne Declaration prepared for this week’s meeting affirms that stigma and discrimination “have no place in any effective response to HIV,” said Francoise Barre-Sinoussi, the conference’s co-chair, who was awarded a Nobel prize in 2008 for discovering HIV.

As the meeting opened Sunday, Ms. Barre-Sinoussi invited dozens of representatives of HIV research and advocacy groups to the stage as she paid her respects to the passengers and crew who died on board flight MH17 from Amsterdam to Kuala Lumpur. Former International AIDS Society president Joep Lange and his partner, Jacqueline van Tongeren, were among the dead.

In South Africa, the country with the most people living with the virus, women sometimes spurn lifesaving antiretroviral therapy to hide their HIV infection from partners, said Elsie Mbedzi, a social worker with Witkoppen Health & Welfare Centre, which fields about 100,000 visits from low-income patients a year on the outskirts of Johannesburg.

That fear can be a barrier to virus-suppressing treatment, which itself helps halt the spread of HIV. For every 10 percent increase in treatment coverage, there’s a 1 percent decline in the percentage of new infections among people living with HIV, according to the UNAIDS report.

Transmission from mother to newborn can also be avoided with antiretroviral therapy, though two in five pregnant women with HIV in sub-Saharan Africa don’t take preventive steps, according to a study published in March.

“If a woman knows she was infected when she’s pregnant, she initiates treatment, but it is difficult for her to let her husband know that he might be infected and would also need treatment,” UNAIDS’s Mr. Bonilla said. There is also a risk that a mother will stop taking her medication and won’t have her baby tested, “so the health service has lost contact with this possible HIV-infected newborn.”


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