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Most Angolan women unaware of AIDS risk

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Afrol News, 28 April  - A majority of Angolan women interviewed by relief workers are still in the dark about HIV and AIDS. Those knowing about the disease are unable to describe how it is transmitted. AIDS prevalence is still relatively low in Angola, which however borders to some of the world's most HIV-affected areas.

- I have never heard of HIV/AIDS, "Gabriela" told researchers from the group Refugees International (RI) at the maternity ward in Luau town in Moxico province. Only half of the six women that RI spoke to had heard of HIV/AIDS and none of them could describe how HIV/AIDS was transmitted.

All of these women were refugee returnees. They mostly are returning from countries with a significantly higher HIV prevalence than Angola. The lack of knowledge of these women documented by RI confirms an earlier survey conducted by UNICEF countrywide.

According to the UNICEF survey, 32 percent of Angolans had never heard of HIV/AIDS. Only 8 percent knew how the virus is transmitted and how to protect themselves. People in Angola's provinces barely know of HIV's existence, the two studies conclude.

- People think HIV is something that comes from the outside, a doctor working in Moxico for over a year told RI. "AIDS is not a reality here." The UNICEF survey however found that the provinces with the least knowledge of HIV/AIDS were the provinces bordering countries with high prevalence rates. To the east, Zambia's prevalence rates are over 30 percent; to the south in Namibia the rates are over 22 percent.

- Ironically, peace in Angola, by allowing the movement of people and facilitating international commercial traffic into the country, encourages the very factors that may contribute to an HIV/AIDS explosion, the RI report notes. Risk factors included high displacement rates, coupled with massive population movements of internally displaced people, returning refugees, ex-UNITA and Angolan army members; low education levels (more than 1 million children are out of school); a destroyed health infrastructure; and the disintegration of social structures, which results in women being forced to exchange sex for survival.

For the time being, it is difficult to know what the HIV prevalence rates of Angola are. No national HIV sero-prevalence surveys have yet been conducted. What is known is that prevalence rates among women in antenatal clinics in Luanda are 8.6 percent, in Benguela 2.6 percent and in Huila 4.4 percent.

- Although this is low compared to other African countries, the warning signs for an HIV/AIDS epidemic are clearly present, RI notes. "One such warning is the prevalence rates of 33 percent for HIV/AIDS among commercial sex workers."

Further, the syphilis rate is often considered a proxy indicator for HIV/AIDS. A UNICEF survey found syphilis rates in Luanda to be 19 percent, in Benguela to be 18.5 percent and in Huila to be 13.9 percent. More disturbing still is that these syphilis statistics represent a 250 percent increase in rates of infection in the last two years throughout the provinces surveyed.

Approximately 350,000 returnees, mostly refugees from Zambia and Congo Kinshasa (DRC), are expected to move through Moxico province in the coming year. The presence of the military in some returnee areas has already had noticeable consequences in the transmission of sexually transmitted infections.

In Cazombo town, a heavy military presence has resulted in young women and military personnel engaged in short-term relationships, which provide women with security and food, RI reports. "With military personnel changing every three months, it is no wonder that 80 percent of those coming to the local hospital for screenings were found positive for sexually transmitted infections."

Response to the looming HIV/AIDS problem is still reported to be minimal. There are only five voluntary testing and counselling facilities in the entire country, and they are all located in Luanda. Less than two percent of the population has been tested for HIV and less than one percent has received the results. The vast majority of the provinces lack testing materials, making the blood supply vulnerable to infection. Condoms, whether for free or for purchase, are rarely available.

RI says the government of Angola "needs to do more." In his end-of-year speech in 2002, President dos Santos however acknowledged the potential for an HIV/AIDS problem and declared his intention to address this issue.

- President Dos Santos appointed himself head of the HIV/AIDS Commission, but neither he nor other government officials has provided leadership towards organising a response to this impending catastrophe, RI criticises. "No national AIDS policy has been put in place, nor has the government made funding the commission a priority. Moreover, in the 5 months of the commission's existence, not one meeting has been held."

- The future of Angola is at stake, the group says. "The country's future leaders and workforce, those under age 24, who make up 70 percent of the population, are at highest risk of being hardest hit by HIV/AIDS. Without fast action to translate the government's verbal commitments into actions, the people of Angola will face yet another challenge to their survival. This one, however, may be too difficult to overcome."







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