One afternoon in late July, I sat in a field at the base of Mt. Kilimanjaro. In that field near the Tanzanian town of Moshi, I had the chance to speak with a group of women who wanted change in their community. This group of women called themselves ‘Upendo’, or ‘love’ in Swahili. It was perhaps an expression of a feeling they wished to use to transcend the estrangement many women such as themselves felt in communities around Africa. They were women who lived with the consequences of their husbands who traveled to the town of Moshi for work. All of these women face hardships, but many of these women’s lives were impacted due to HIV/AIDS.

Moshi is an area most known for its tourism, yet is also affected by a high HIV/AIDS rate relative to the rest of Tanzania as a result of an engrained culture of migration. Migration increases the likelihood of concurrent partnerships, which are when a person has sexual relations with more than one sexual partner during a given, overlapping interval of time. Concurrent partnerships increase the rapidity with which HIV/AIDS spreads and have been the reason for high HIV/AIDS prevalence rates across Sub-Saharan Africa. These other sexual partners are either additional girlfriends or prostitutes. When these migrant men return home to see their wives in the rural areas surrounding the town of Moshi, many of these wives will be infected as a result of the men’s risky decision to engage in concurrent partnerships. This challenge, “the feminization of the HIV/AIDS epidemic”, has become a very common one throughout Sub-Saharan Africa.

Focusing on the feminization of HIV/AIDS in Kenya and Tanzania, HIV/AIDS prevalence rates show a bias towards women. HIV/AIDS rates in Kenya and Tanzania are 6.1 and 6.5% respectively, which is a significant portion of the population. Of Kenya’s 1,300,000 living with HIV/AIDS, 740,000 or 57% are women. The epidemic in Tanzania is more balanced, as 51% of the 1,400,000 living with HIV/AIDS are women . The HIV/AIDS epidemic has increasingly affected women due to African society’s subordinate views of women coupled with early marriage. Situations of rife poverty and unemployment typically force men to migrate for work, which increases the chances their wives will become infected with HIV/AIDS through men’s engagement in these concurrent partnerships. A variety of women’s empowerment civil society organizations, through programs to combat stigma, are critical components to counteract this increasing trend.

One method of empowering women is through teaching them how to provide financial opportunities for themselves through a micro enterprise group. An example of this type of women’s empowerment organization is WORTH , where I had the privilege of working this past summer in Nairobi, Kenya. In my experience, I have found that a supportive group setting composed of HIV positive and negative women will help to curb societal pressure that women living with HIV/AIDS face in the short term, in order to change the overall perception of HIV/AIDS in the long term. A micro enterprise organization like WORTH gives women tangible skills to allow all women to make an income and to create a cohesive group to fight challenges the community faces. Increased income could have a significant impact on the family by enabling men to stay at home, reducing susceptibility to risk factors that increase the rates of HIV/AIDS transmission.

Through integration of women living with HIV/AIDS into community-based programs, women are likely to reach across boundaries in order to achieve a common goal and to work for the betterment of the community. The first step is dialogue, followed by the second step of female empowerment. Since women are disproportionately affected by the epidemic, their empowerment is crucial to reverse the cycle. Giving women the facts about HIV/AIDS through existing community organizations and other trusted sources is fundamental in the progression to accomplish the goals of dialogue and empowerment. Finally, the women need to be a meaningful voice within their community in order to promote change.

Real life conditions on the ground in Sub-Saharan Africa make prevention and awareness of HIV/AIDS difficult without the assistance of civil society organizations. Moshi is a fairly urban environment with access to health facilities, whereas it can be a 3-day long walk to get to a clinic in other parts of Africa. Even where such facilities are available in Moshi, an information gap still exists. During my interviews with women in Moshi area, most were hesitant to talk about their status. Many people fear others that are suffering from the disease, but do not know how to differentiate the myths from the facts. HIV/AIDS status remains ambiguous for men and women due to the stigma of getting an HIV/AIDS test, and the fear of finding out that they are HIV positive. Stigma also prevents people from discussing HIV/AIDS, which results in the perpetuation of myths and people not learning about ways to prevent the transmission of the virus. Lastly, stigma can isolate people living with HIV/AIDS from other community members due to the fear surrounding the disease.

Stigmatization and isolation of people living with HIV/AIDS is prevalent in communities throughout Sub-Saharan Africa, particularly since people do not widely discuss the issue of HIV/AIDS. Women living with HIV/AIDS become physical weak over time, which complicates the conduct of house hold tasks such as caring for their fields, fetching water, and feeding their family. The family faces economic strain, forcing many children to drop out of school and many families to go hungry. Incorporating women living with HIV/AIDS into a micro enterprise, village banking group would be crucial; the micro enterprise model is seen as the antidote to remedy the condition of poverty. Involvement in an organization such as WORTH helps to mitigate social pressures that surround living with HIV/AIDS, for it collectivizes women to work together to support the betterment of everyone’s life. Women often seek support from other women to simultaneously provide a support network and to find innovative ways to supply an income for their families and to dispel the stigma associated with HIV/AIDS throughout communities. Many of the WORTH groups have also taken the initiative to care for Orphans and Vulnerable Children (OVCs), indicating an increase of community support for those victimized by the virus.

Mariam, a WORTH woman living with AIDS, exemplifies the hardships that an empowered woman can overcome to become an influential voice within the community. Originally, she did not feel comfortable in her village. Her husband died from AIDS; not only was she stigmatized by his family, but also she was blamed for his death. Mariam’s WORTH group became her empowerment and support network; the group environment taught her new ways to provide for her family, provided a new space for dialogue and helped her to break down barriers of discrimination within her community. Furthermore, Mariam has become a role model in her HIV/AIDS self-help group, due to her ability to bring hope to others living with HIV/AIDS for the strength to fight the stigma and the disease as she has. Mariam’s story highlights the realities of life for a woman living with HIV/AIDS and shows how empowerment can help one individual to become an inspirational member of a larger community.

Mariam’s experience exemplifies the dramatic changes that can occur at the community level from including vulnerable women in micro enterprise organizations. Including a variety of women’s empowerment projects to combat stigma from various angles is important in the effort to reduce HIV/AIDS prevalence rates worldwide. Influential organizations and voices have the ability to change the mindset of people across the world, such as the work WORTH has done throughout Africa and Asia. The most successful prevalence rate reductions occur in countries where people talk about HIV/AIDS and are willing to change their own behavior in order to avoid getting infected. Only when people realize that modifying their actions can save their own life will the global incidence rates decline.

For more information about WORTH, please visit their website at: www.pactworld.org/cs/the_story_behind_worth