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I briefly did some work with an HIV research organization in South Africa. One dynamic I was shocked to hear was the prevalence of marriages where one partner
by devonsolomon 2y ago
I briefly did some work with an HIV research organization in South Africa.
One dynamic I was shocked to hear was the prevalence of marriages where one partner (always the husband in this context) is HIV positive and the other is secretly on prep. In this context infidelity may be a norm and traditional cultural and gender norms may look negatively or skeptically at anti-retrovirals.
While this isn’t the majority of the HIV experience in South Africa, it’s certainly a sizable group.
Further, adherence more generally is a massive problem. The cost of travel to a clinic in both rural and urban settings can be prohibitive for many and cause major adherence drop-off.
Drugs like this, if made affordable, will go a long way to immediately easing pressure on these groups - and that’s exciting.
- jncfhnb 2y agoWhy would someone secretly be on prep
- ttul 2y agoSo that their partner doesn’t think they are cheating.
- jncfhnb 2y agoWhy would it imply they are cheating and not simply protecting themselves from their partner’s HIV?
- ttul 2y agoWe are used to a western perspective on marriage, where the playing field is generally level between partners. In Africa, there is often a huge power imbalance between men and women in marriage. A woman particularly might want to keep her prescription status a secret because it suggests that she might be cheating on her husband. Even though it may seem obvious to us in the west that taking medication to avoid contracting HIV from our spouse is an obvious and reasonable thing to do, in Africa, it would be more culturally acceptable for the wife to remain vulnerable to contracting HIV from her husband because that would also infer that she is not sneaking around having sex with other men. Source: Was born in South Africa.
- jncfhnb 2y agoWhy would the woman getting HIV imply she cannot be cheating on her husband?
- opprobium 2y ago[flagged]
- cubefox 2y ago> From the perspective of the husband, the woman taking prep implies she is cheating. But that only makes sense if the husband thinks his wife doesn't believe he has HIV.
- vlovich123 2y ago>> You're digging for a logical explanation for a fundamentally illogical cultural problem and you aren't going to get it. > But that only makes sense if Reread and if you’re still not getting it, keep rereading your parent’s line that I highlighted for you.
- jncfhnb 2y agoQuoting this line is not a blanket pass to say whatever you want about a culture credibly.
- vlovich123 2y agoWell, you have an anecdote from someone claiming to be from SA saying that’s culturally the perception. Here’s a summary of research [1] on the topic concluding similar reasons (among others): > Several participants felt that they could stop taking PrEP when the need, as they saw it, had passed. Often this was to do with the nature of their current relationship, for example with a person regarded as unfaithful: “If I find someone that I will be in a relationship with and if he is not faithful, or I have started being unfaithful, then I will come back and get them.” And > On the basis of these findings, the authors suggest that take-up and continued use of PrEP is likely to remain subject to established social norms. These norms often relate to gender and they determine, for example, who decides what HIV prevention methods to use, and the extent to which a woman in a relationship might – or might not – be able to make and implement such choices. Just because something seems logical to you, doesn’t mean that social norms and pressures don’t superseded it. In fact, we even see it in our own cultural with people believing vaccines cause autism, the whole belief that ivermectin cures COVID-19, or flat earthers. What’s really impressive though is you having such a problem with this idea despite overwhelming objective evidence to the contrary being available online and people telling you their lived experience on this very website and you significantly discount the very real possibility that people can be illogical in their strongly held beliefs even if it seems nonsensical to you. If you know nothing about a subject, you’re likely to believe what all your peers tell you which is how misinformation gets a foothold. This misinformation can even come from nowhere. The point is that if enough people believe it, they can get others to believe it to. That’s literally how human belief systems work where beliefs spring out of nothing. [1] https://www.aidsmap.com/news/sep-2020/why-do-people-southern-africa-stop-taking-prep https://www.aidsmap.com/news/sep-2020/why-do-people-southern...
- wityl 2y agoBecause the partner doesn't test for HIV and/or is in denial that they have it or that it will affect them. These are cultural contexts where the woman has no right to question any of this.
- jncfhnb 2y agoWell that’s a stupid answer but it seems consistent and feasible I guess.
- esond 2y agoBecause their husband secretly has HIV? Secret outside of the relationship, that is.
- jncfhnb 2y agoYou’re implying that the prep and HIV are known internally to the marriage but secret externally? That seems unlikely. Taking medication in private does not seem to qualify as a “secret” to me
- opprobium 2y agoBecause they can get HIV from their husband, but also cannot discuss HIV, refuse sex, or take prevention steps for themselves without reprisal.
- astockwell 2y ago[flagged]
- jncfhnb 2y agoCould you fucking not? I’m asking a question because I don’t understand it. You don’t need to try to shame for not knowing something and trying to learn.
- b800h 2y agoDo any of these drugs cross the placenta?
- cassepipe 2y agoI don't understand your point, can you elaborate on the dynamics at play ?
- whimsicalism 2y agothere are a lot of conspiracy theories around hiv treatment in Africa, particularly SA
- Slava_Propanei 2y ago[dead]