Authors: Uzodinma Iweala
Tags: #Social Science, #Travel, #Africa, #West, #Disease & Health Issues
She spat with disgust.
“I have a little sister, a friend, that was staying with us. She wasn’t drinking in the same cup that my sister who died was drinking. If we put soup together, she will not eat. She was always selecting the spoons so as not to share spoon that my sister was using. Even when she never heard of it being HIV, she suspected that it should be that. Two of them were best friends, but see, when one was sick, the other could not show that love. She was keeping her far from herself.” Elizabeth shook her head and raised her fingers to massage her cheeks. “So HIV prevent love. It cut relationship of love.”
HIV/AIDS-related stigma severs the connection that one person forms with another. It is so strong that it can even make speaking out about the disease problematic.
“You are the first person I am telling that my sister died on that,” Elizabeth mumbled to me. Her chin dropped to her chest. “But if I use her own example to help somebody, that is, by telling the person that, ‘See, my sister have died on this thing. Please!’ I don’t think that God will punish me for that. I know that God will have mercy on me that I am not abusing my sister.
“I want to talk to people concerning this thing. Me, I wanted even to stand in my village and at least arrange the women, the men, or the youth—all of them—and discuss it with them: ‘See this thing that you people are saying about this girl. Many of you, you have not been tested. Many of you have it. It may be killing some women, married women, they will not know! One two, one two they die. You won’t know if it is HIV.’ That is what I wanted to do. That is what I have determined in my mind because I feel that people are dying in that village and they don’t know what is killing them. Maybe it might be AIDS that is killing them and there are drugs to prevent the thing. Another of my sister said, ‘No! Before you will start saying those things, they will say we done carry am.’” Elizabeth sighed and crossed her arms. “I just left. They buried her, and I just left. I left.”
Elizabeth’s friend need not have died. But HIV/ AIDS has such power that it can cut people off from one another, leaving those who most need support isolated and vulnerable. Its stigma and the resulting fear of abandonment and discrimination make extremely difficult a greater openness that can help treat its symptoms and prevent its spread. An ordinary sickness does not cause so fraught and convoluted a reaction.
Elizabeth stopped speaking. We sat together on the warm concrete, our bodies separated by two bottles of Coke I had retrieved from the fridge in my room. Insects buzzed about the fluorescent light above us, their shadows floating across our bodies. Somewhere beyond the hotel compound, the highway pulsed with the horns of tractor-trailers warning cars, motorcycles, and pedestrians as they sped down an unlit road.
“When I think about my sister, I feel it very well,” she said after some time. “There is no day I don’t think about her since I lost her. There is a place we worshiped together where there’s a particular lady that sings ‘Everything You Find Is in Jesus.’ If you find money, that it’s in Jesus; if you find health, it’s in Jesus; if you find life, it’s in Jesus. If they pray such prayers or sing such chorus now, I really feel. I will be in the church crying. I cry for her own. I do feel her. I’ve not forgotten about her. I feel her very well.
“I shed tear for my sister each time when I see people surviving with this thing. In fact, when I was sick with ulcer, I went to Nnamdi Azikiwe Teaching Hospital, and if you see the lineup of people with HIV to collect drugs, that’s why I say, ‘How can you just lost your life like that?’ You understand? Because people go there and take drugs free! Then how will you just stay and lost your life like that? I don’t think God has designed that she has to die. She doesn’t have to died.”
’m actually going to a brothel
, I remember thinking as my friend Doc and I drove to a truck stop about an hour west of his village clinic. He had set up services there for a number of sex workers patronized by the intercity truck drivers who stopped for a few hours’ rest. At the truck stop, fields of tall brown grass and low shrubs stretched outward from the junction and its impromptu settlement of zinc-roofed, mud-brick buildings. Around us large trucks rested as their engines clicked while cooling and their drivers propped themselves against their large tires or in the shade beneath their chassis. The men were almost catatonic from a full day’s work of driving. Their only motions were to raise plastic cups of water to their lips. Not too far away, a line of women sat silently against a low cement wall, some of them eating roasted corn, others fanning themselves against the heat.
“Those women are sex workers,” Doc said, thrusting his chin in their general direction.
The year before, during the Nigerian gubernatorial elections, I had interviewed a local Lagos politician about Nigeria’s HIV/AIDS epidemic. During our meeting in his dimly lit office, he had suggested that the disease was a problem of interstate truck drivers and female sex workers.
“For instance,” he had said, “a tanker driver is supposed to leave from Lagos all the way to Kano to deliver fuel. Because of the kind of person he is—he’s very promiscuous—he stops at Ore. He has a ‘friend’ in Ore, and let’s say he picks the HIV virus up in Ore along the way. He’s infected. From Ore, he now gets to Lokoja, where he’s also promiscuous. There he has unprotected sex with somebody, casual sex. He leaves. He has infected a community there. He gets all the way to Kano, where he has another show and a shot of it, casual sex again. He has infected someone in Kano. Then from Kano he heads back again to Lokoja and Abuja, and the person he had sex with is not available at that point in time, so he has sex with another person. A single carrier can do such damage. Along the routes of transportation, different cells and communities of infected people begin to spread.”
I found his words interesting because they seemed to externalize both the epidemic and its primary means of transmission—sex. By focusing on these groups of people that Nigerians traditionally consider promiscuous or of lax morality, he seemed to suggest that normal people with normal monogamous sexual relationships exist outside the reach of the virus. Or as one woman I interviewed, who had recently graduated from college, put it: “Everybody wants to believe that they’re very good and they’re too clean for all of that; that people that die of AIDS or have HIV are dirty people, people that sleep around or do rubbish and stuff, not our kind of people.”
“Some of them are positive,” Doc said about the sex workers. He had just started offering testing and counseling services to the women along with education on safe sex practices and free condoms. The previous week, he said, some of the women had tested positive.
As we stood watching, every so often a man would walk toward the women and the pair would disappear through a nondescript door in the side of a low cement wall. It was almost too perfect. It seemed that right before my eyes, this politician’s theory was being borne out.
I followed Doc across the street to that same narrow door in the side of the wall. He opened it and we stepped inside. Behind the door was a labyrinth of corridors open to the sky with smooth concrete walls broken at regular intervals by metal doors, some shut tight, others covered by limp and grungy curtains. At the end of one corridor, a youngish woman swept rhythmically, stopping every so often to slam the head of her broom against the ground and even out its bristles of stiff, dried grass before starting her motion again. Otherwise it was silent. I’m not sure what noises I expected, maybe even wished to hear in some realm of my imagination—heavy breathing, moaning, the universal indicators of illicit activity. But there was nothing. There was no intrigue here, no color, no vibrancy—-just a bunch of dark rooms, each with a mattress and neatly arranged personal effects at its base.
At the end of one corridor, Doc introduced me to two women he had come to know very well through his advocacy work. His words were quick and almost apologetic: “This is my friend. He has come to do research on HIV. Can he ask you some questions?” Then he disappeared into the maze of corridors.
My new companions sat down on low stools in the corridor, their backs supported by the cement wall. I took a stool facing them and stretched out my legs as they had.
One of the women puffed her cheeks wide before smiling at me. She was naturally radiant, the woman at the party who makes everyone feel comfortable and looked after. She wore a red and orange rappa (a sari-like garment) wound around her legs and torso. The knot holding up the fabric sat in the dead center of a bright red T-shirt stretched tightly over her chest. A black scarf covered her hair. Her companion was a darker-complexioned woman with wrinkled skin on her fingers, her exposed arms, and in the corners of her lips and eyes that made her look like the peel of a desiccated yam. She didn’t say much except to chime in for emphasis.
Our conversation began rather benignly with the usual pleasantries, after which the women shared with me their comprehensive knowledge of HIV/AIDS.
“We were taught,” the first woman said at one point. “We went to lectures with the doctors, and they told us there is a tablet for it, but it cannot cure. This tablet can only subdue the various diseases. This is the worst disease we have in Nigeria. If you pregnant, then it will affect the baby.”
“The worst!” her companion agreed.
But things changed dramatically when, in an attempt to shift the conversation, I asked softly, “How many men do you see in a day?”
Immediately the woman wearing the red shirt changed. Her natural ruddiness paled. Her smile became synthetic. The second woman sucked in her teeth with disapproval. “That question has no answer,” she responded. “This is a road. Million of men can pass here in a day.”
“Why do you ask?” the first lady said. “There is no need of that.”
Why did I ask? It almost certainly doesn’t matter what the numbers are, except for what asking about them suggests. It has taken me some reflection to truly understand the significance of my question—indeed, my whole interaction with these two women—especially within the larger context of the HIV/AIDS epidemic and its relation to sex. The primary issue that has concerned me for some time is why I felt the need to start my exploration of the relationship between HIV/AIDS and sex with sex workers. With 35.6 percent of sex workers in Nigeria testing positive for HIV, there is surely some epidemiological justification for doing so, but if I am honest, there is something else at play, subtly expressed in my supposedly innocent question about how many men each woman was to see that day. It is the same sentiment that caused the politician to associate the HIV/AIDS epidemic solely with the sexual practices of prostitutes and truck drivers. It is the same sentiment that initially led some to look at the scope of the HIV/AIDS epidemic in Africa and suggest that if, as Susan Sontag has put it, “AIDS is understood as a disease not only of sexual excess but of perversity,” then Africans must be more promiscuous and perverse than the general population. This desire to define a type of sex or sexuality that is more closely associated with HIV/AIDS, followed by an overt or implied judgment about the newly defined group, probably speaks more to society’s general anxiety about sex and sexual morality than it does to the practices of the group in question. This anxiety about sex has affected how we consider sexual relationships during the HIV/AIDS epidemic.
From the time of its appearance, HIV/AIDS has been linked with the idea of an unnatural or morally transgressive sexuality. It divided the public into those who have HIV or are at higher risk of contracting the virus and what Sontag called “
disease’s version of ‘the general population’: white heterosexuals who do not inject themselves with drugs or have sexual relations with those who do.” The appearance of HIV helped to enforce the idea of a normative sexuality exemplified and practiced by white men and women, all sex outside of this realm receiving the label
or, still worse,
When HIV first appeared in homosexual populations in the United States in the early 1980s, it was thought that something intrinsic to gay sex was the cause of both the virus and its spread. The medical literature contained references to GRID (gay-related immune deficiency), which then morphed into the popularly used “gay plague.” In the late 1980s, massive efforts to educate the public about HIV/AIDS and strong campaigns by gay-rights advocates drastically reduced the presence of such dehumanizing rhetoric in the West. But rather than disappearing, the connection between HIV/AIDS and “weird” sex simply changed geographical locus as the extent of the sub-Saharan epidemic revealed itself.
The idea of African sexuality as Other in international dialogue begins first with accounts of Arab and Portuguese explorers in precolonial times. Themes of sexual aggressiveness, promiscuity, and strange sexual rituals addressed first in these early accounts have attached themselves to the sexualities of African and black peoples, coloring commentary on the subject for the greater part of the past millennium. Some have suggested that such accounts reflect the projections of European men from societies where the sexual experience was considered to be more strictly governed by explicitly understood social or religious convention, that the fascination and disgust with a perceived limitless African sexuality encountered on the frontier was the result of frustrated sexual expression at home.
More recently such themes have surfaced in the context of the African HIV/AIDS epidemic. For some both on and off the continent, the widespread presence of HIV/AIDS in Africa confirms that there is indeed something untoward about the way Africans approach sex. I am reminded of an encounter I had a few years ago while passing through London on my way back to Abuja when I decided to delay my onward journey by a couple of days to catch up with an old college friend. On a warmish spring evening, after dinner, we found ourselves in front of a nightclub discussing the only thing I seemed able to talk about—HIV. I was just explaining to my friend how prevalence rates in Nigeria—indeed, throughout much of Africa—had recently been downwardly revised, when the attractive young woman in a black blazer, skinny jeans, and heels standing in front of us turned around, a tad tipsy, and asked, “Isn’t HIV the disease that started because someone in Africa had sex with a monkey?” While that statement can initially be dismissed as the silly musing of an ignorant drunk woman, it does reflect a line of thinking that was found in scholarly literature about HIV/AIDS in Africa. Consider this observation by the medical anthropologist Daniel Hrdy—which might be considered one of the more benign explanations for the origin and spread of HIV/AIDS in Africa: