Women After All: Sex, Evolution, and the End of Male Supremacy (33 page)

According to the
Bangkok Post
of December 21, 2012, Mechai Viravaidya, who led the campaign and is known as “Mr. Condom,” now warns, “The government has fallen asleep at the wheel.” New infections are up again, threatening the general population. But in the 1990s, his “100 percent condom program” made all the difference (despite not getting that perfect score); the World Bank estimates that 7.7 million infections were prevented in Thailand by 2005.

Yet, as pointed out by Elizabeth Pisani, the brilliant epidemiologist and author of
The Wisdom of Whores,
something else was going on in Thailand in the 1990s. Young unmarried women were having much more sex—a tenfold increase over the decade. If you are scratching your head, I was too. How does more women having sex translate into less HIV? What has happened in country after country is that as young women became more sexually liberal, the percentage of young men paying for sex dropped precipitously. So, paradoxically, the last thing you want is a “Just say no” campaign for ordinary teens. And it’s not a no-brainer to figure out how to subvert this epidemic or how to protect women in particular.

Today, for humanity as a whole, the proportions of men and women with HIV are even. But since women represent 60 percent of new cases worldwide, they will soon surpass men in total cases. Sex workers make up a small fraction; most women get it from their
husbands. Men bring it to women, who get it more easily; the vagina is a cozy spot for germs. The heterosexual epidemic is worst in sub-Saharan Africa, but many men throughout the world decline to use condoms, and many coerce their wives to have sex on their terms. In Africa, public health campaigns in some countries, notably Uganda, were extremely successful for a time, but as in Thailand, there is backsliding.

According to a 2012 survey in Uganda, condom use is inadequate and new infections in that country are now rising. Meanwhile, in Madagascar, Mozambique, Zimbabwe, and elsewhere in southern Africa, some men want not only condom-free but “dry sex.” This means putting abrasives or other substances in the vagina to increase friction; these widespread practices raise the likelihood of vaginal microtearing, which raises the risk of HIV and other sexually transmitted infections. As “Coca Colo” put it in her
Feminomics
blog,

Dry sex aids are the inverse of lube.  The idea is that it makes sex feel hot, tight, and rough, and presumably increases the enjoyment for the man.  In practice, it can also make sex extremely painful for women, create vaginal swelling and peeling, and lead to a reduction in the body’s natural protection from HIV.

Coca’s points are consistent with research. However, men’s infidelities and sexual pressures, although important in the African AIDS epidemic, did not start it. At the root, experts are finding, are health-care personnel. Today and since before the epidemic began, health workers in Africa, lacking resources, have reused unsterilized needles and surgical tools on patient after patient. This, along with the fact that the virus evolved in that continent, may be what initially made Africa the worst place in the world for HIV/AIDS.

So women need protection from incompetent health workers as well as pushy men. Bill Gates, as impressive at global health philanthropy as he was at software development (partly because of his wife Melinda’s counsel),
assessed their foundation’s progress in 2012. He doubts the enduring success of behavioral change but writes,

A second approach is male circumcision, which reduces HIV transmission by up to 70 percent. . . . The cost is quite low and the protection is life-long. Over 1 million men ages 15–49 have been circumcised in 14 Southern and Eastern African countries with large AIDS epidemics, but that is only 5 percent of the total number who could benefit from the procedure. . . . Botswana, Kenya, South Africa, and Tanzania are starting to show leadership by getting the message out to all young men. . . . Kenya has made the most progress, circumcising 70 percent of eligible men. I will be very disappointed if, by 2015, any fewer than 15 million young men have chosen to protect themselves and their partners by getting circumcised.

Notice the word “chosen.” This is voluntary. Yet there’s a certain poetic justice in a man showing up to have his penis clipped as a way to curtail an epidemic that wouldn’t exist, or at least would be much less serious, without the strong forms of male sexuality. (Incidentally, it’s essential that men refrain from sex until their circumcision wounds are completely healed, or they will actually increase their partners’ risk.)

Gates writes, too, about the quest for a vaccine and treatment for prevention—early treatment that reduces the risk to others. This works especially well in preventing women from passing it on to their unborn children. But treatment—the contrarian Elizabeth Pisani again—however much it is the right thing to do, will not suffice for prevention. That’s because the decades-long maintenance therapy has inevitable interruptions: people run out of medicine and can’t afford the next refill, or they feel good so they skip their meds for a while, or they become resistant to the ones they’ve been taking. They feel good, they look good, they party, but they may not have a low enough viral load to prevent transmission.

The Gates Foundation is also active in family planning; some 200
million women around the world say that they don’t want to have a baby in the next two years
and
that they don’t use contraception. Gates funds implants and injectables and wants to develop forms of those that women can give themselves. You can see what this has in common with male circumcision: you make one decision, do one thing, and get long-term protection without further use of willpower. For women, this is particularly important, since their problem is often not their own willpower but men’s will imposed on them.
If he won’t use a condom, at least let him be circumcised.
Or:
At least I have my implant, so I don’t have to beg him to wait while I put in a diaphragm or a sponge.
Protection from unwanted pregnancy and infection should not depend on men’s goodwill or on a woman’s ability to resist. If sex gets rough, vaginal tears get more common, and germs run rampant. If we can’t protect a woman completely, we can at least improve her odds.

There is another epidemic that overwhelmingly targets women. Two notorious, brutal gang rapes occurred in India within a year—one in December 2012 in Delhi, one in August 2013 in Mumbai. In the first, six young men raped and murdered a student on a bus; they beat her male companion senseless with an iron rod and used it to penetrate her in such a way as to severely damage her intestines, which were surgically removed in a vain attempt to save her. The youngest rapist, a teenager, was sentenced by a fast-track court to the maximum juvenile punishment of three years; a second hanged himself in prison. The other four were sentenced to death, which is reserved by the Indian Supreme Court for “the rarest of the rare” cases; in March 2014, the Delhi high court upheld the death sentences. In the Mumbai case, five men attacked a twenty-three-year-old photojournalist; after tying up her male companion, they took her aside and serially raped her. She spent a month in the hospital. Five suspects were arrested and tried; three, who were repeat rape offenders, were sentenced to death in April 2014.

Together with my wife, a psychologist who works with young girls at risk for commercial sexual exploitation, I spent a month in India between these two events. Everyone we met told us that the December gang rape in Delhi had provoked the conscience of the nation. People from Mumbai said that this was the sort of thing that happened in Delhi but not in their city. When we traveled between Orchha and Agra (the site of the Taj Mahal), I did not know what had happened to a Swiss couple touring by bicycle between those cities in March: the man was tied up and made to watch while eight men serially raped his thirty-nine-year-old wife. Six were convicted and sentenced to life in prison.

These rapes have something of the character of what used to happen in the era of warring tribes and empires. The attacks are partly about sex but mainly about humiliation and violence. The perpetrators beat and immobilized the men and made them watch as the women they should have protected were savagely gang-raped. The men’s humiliation was part of the script.

But most rape in the world is not like this. Most of it is done by a partner or other acquaintance, not by strangers. All of it restricts women’s freedom by intimidation. Rape and other violence against women, including wife beating, “honor” killings, and other family assaults, are part of the structural violence women face throughout the world. In a 2012 WHO ten-country study of women fifteen to forty-nine years old, the number that had been forced to have sex ranged from 15 percent in Japan to 71 percent in Ethiopia. The percentage of women whose
first
experience of sex was rape—a foundation for lifelong fear—was 17 percent in rural Tanzania, 24 percent in rural Peru, and 30 percent in rural Bangladesh.

Social epidemiologist Karen Devries and her colleagues of the London School of Tropical Hygiene further analyzed the data in a 2013 paper. They found that 30 percent of women aged fifteen and older have experienced physical and/or sexual intimate partner violence (IPV). It is everywhere. The lowest regional averages are East
Asia (16 percent) and Western Europe (19 percent). East Africa and Andean South America are very high (around 40 percent), but war-torn central Africa is in a class by itself at 66 percent. South Africa, though, has a model program that cut rural IPV by more than half in two years.

Girls’ education and, for both sexes, microfinance loans and school-based prevention programs work in various settings, and legislation to punish rapists and
not
victims has been adopted in many countries. India passed a new national law this year to increase prosecutions and severe punishments for rapists, including fast-tracking trials. However, it remains legal there for a husband to rape his wife, and during the 2014 Indian elections, the head of a recognized party in the state of Uttar Pradesh responded to the gang-rape convictions by saying, “Boys make mistakes. They should not hang for this. We will revoke the anti-rape laws.” An associate and sitting state legislator, asked a few days later about the party head’s remarks, went further: “Any woman, whether married or unmarried, who goes along with a man, with or without her consent, should be hanged. Both should be hanged.”

Perhaps this outlook on hanging women for being raped was in the minds of the men who in May 2014 gang-raped two girls, fourteen and sixteen, near a village in the northern state of Uttar Pradesh, because after the rape they hanged the girls from a mango tree using the girls’ own scarves. The abduction of the girls was witnessed; three brothers were arrested and confessed to the rape but not the murder, and two policemen were charged with complicity. Like hundreds of millions of rural people throughout the world, the girls did not have access to a toilet, so they were in the fields relieving themselves when they were attacked. The chief minister of the state, pressed by journalists, said, “You’re not facing any danger, are you? Then why are you worried? What’s it to you?” A home minister in a neighboring state said that rape is “a social crime which depends on men and women. Sometimes it’s right, sometimes it’s wrong.”

The UN estimates that 600 million women today live in countries
where intimate partner violence is not even nominally a crime. But lest it be thought that things are better in the United States than India, we should note the U.S. led the world in reported rapes in 2010 (about 85,000), while India, with four times the population, was a distant third, with only around 22,000 reported. However, experts say that almost one in two rapes gets reported in the United States, while only one in ten does in India. In addition, marital rape is not included in the statistics in India, while it is in the States. So given all the problems with getting accurate statistics, it is probably fair to say that the rape rates are not so different in the two countries.

Nor is the dismissive sort of official attitude we saw in India limited to faraway places with strange-sounding names. Consider that the U.S. Department of Justice was in 2014 investigating prosecutors in Missoula, Montana, for reportedly saying to an alleged rape victim, “All you want is revenge” and telling the mother of a five-year-old raped by a teen, “Boys will be boys.” In 2012, in Steubenville, Ohio, the rape of a drunk, unconscious sixteen-year-old girl caused a scandal when her rapists used social media to brag about their crime and mock their victim. Because the two rapists were football stars on the local high school team, football fanaticism combined with what has been called a “rape culture” in the United States led to public defense of the criminals by town and school officials and to a partial cover-up and lies about what those officials knew and when they knew it. The coach testified as a character witness for the boys who’d committed the rape, said he was proud of them and saw no reason to bench them, and in one episode shouted expletives at journalists and threatened them and their families.

Little wonder that a worldwide response to such things has been mounted. Eve Ensler, author of
The Vagina Monologues,
began the V-Day movement—for violence, vagina, and Valentine’s Day—in 1998. On February 14, 2013, Valentine’s Day in the United States, V-Day launched a campaign called One Billion Rising, since almost one in three women, or about a billion, are raped or assaulted in their
lifetimes. The goal was for people of both sexes to call for an end to such violence by assembling, striking, demonstrating, and dancing. Tens of thousands of people did demonstrate on that day throughout the world, and by all reports the V-Day event in 2014 was at least equally widespread and successful. Peaceful demonstrations rolled out for a total of forty-eight hours across the planet’s time zones. UN Secretary-General Ban Ki-moon was quoted as saying, “The global pandemic of violence against women and girls thrives in a culture of discrimination and impunity. We must speak out. . . . I am proud to emphatically raise my voice and join the chorus of all those taking part in the One Billion Rising campaign.” The goal now is to hold the worldwide event on February 14 every year.