A country where women are forced to have unprotected sex with husbands—even if the men have AIDS

Maseru, Lesotho—“That’s how African men are,” the woman said. She and two others laughed aloud at the infidelity of their husbands. Their hearty, free-spirited laughter resonated in the hotel lobby, attracting disapproving stares from the men in business suits who occupied most of the other coffee tables.

They were quite a trio, these bold, beautiful women from Lesotho. Malefu, 32, left her abusive partner 12 years ago, but contracted AIDS from him. Matseisei, a 42-year-old weather forecaster, is HIV positive, but continues to live with her husband. Mamakhete, 45, a survivor of domestic and sexual violence for 20 years, is now separated from hers.  

As the world celebrated World Aids Day earlier this month, with greater stated commitments to end the AIDS epidemic by 2030 as part of the Sustainable Development Goals put forward by the United Nations, it becomes all the more imperative to focus on this issue and women, especially in sub-Saharan Africa, which has the highest rate in the world. According to a UNAIDS 2015 fact sheet, around 25.8 million people—more than half of them women—were living with HIV in sub-Saharan Africa in 2014. And Lesotho is one of the countries hardest hit by this epidemic. At 23 percent, the country has the second highest prevalence of HIV/AIDS in the world, UNAIDS reports.

From left, Mamakhete, Malefu, and Matseisei. (Priyali Sur)

Together, these three women are fighting two of the gravest problems that plague Lesotho and sub-Saharan Africa today—gender-based violence and HIV/AIDS—and they’re not entirely disparate plagues. “There is a strong connection between the two,” Mamakhete says. “Women have no agency and sexual rights. They are forced to have unprotected sex with their husbands even if the men have AIDS.”

A 2014 UNAIDS report found that women are 55 percent more likely to be HIV positive if they have experienced intimate partner violence. According to the report, in some contexts, partner violence directly contributes to the HIV epidemic. In Lesotho, the 2014 UNAIDS Gap Report found HIV/AIDS to be prevalent in around 4 percent among adolescent girls, which increased to 24 percent in young women aged 20-24 years.

“You can’t force a man to wear a condom if he doesn’t want to,” Malefu says in her mellow voice. Her high cheekbones frame her soft but resolute face. “We end up becoming submissive and hence we get AIDS. It happened to me. He got me pregnant and we eloped. I was 20 then. He started abusing me right from the start, but I thought a baby would change him. But it didn’t, and one day he locked me in a room and beat me with my 4-month-old baby in the bed. I couldn’t take it anymore and finally decided to leave.”

Malefu went back to her parents, but frequently fell ill. She tested for HIV and was found positive. “I found out in 2003,” she says, choking on tears. “I went three weeks after the test to get my report. I didn’t want it—I was scared. At the clinic, the doctor asked how I would feel if I was told I was HIV positive. It wasn’t easy. It wasn’t easy.”

It’s been 12 years since then. Malefu, who works as a project coordinator with European Union-funded projects in Lesotho, has found support in like-minded women survivors such as Mamakhete and Matseisei.

After escaping an abusive marriage of 20 years, Mamakhete decided to start She-Hive, a nonprofit organization that works with women who are survivors of violence and living with HIV. “People thought I was crazy when I started this, but I had made up my mind,” she says. “I finally felt happy about what I was doing with my life. Me and some other women started by telling stories of our survival on TV to inspire more and more women to come forward and not be scared.”

She-Hive helps other women survivors with legal advice and counseling. Other organizations, such as Help Lesotho, also work on the increased risk of HIV for victims of violence, but with the problem so widespread, a comprehensive, government-backed plan of action is also urgently needed.

“We need new laws and the proper implementation of the existing ones,” Mamakhete says in frustration. “We don’t even have a domestic violence law. We are advocating for the domestic violence law to be in place.” The Domestic Violence bill in Lesotho has been pending since 2000, even though Lesotho has committed to the Convention on the Elimination of All forms of Discrimination Against Women (CEDAW). “Fifteen years is too long to wait for a bill to be passed,” Mamakhete says. “The government has to understand that controlling violence against women will also check the spread of AIDS.”

But in a country like Lesotho, which is deeply rooted in patriarchy, even Matau Futho-Letsatsi, director of the ministry of gender, youth, and sports, feels helpless. Letsatsi told me that the biggest challenge she faces is inadequate funding. “The government doesn't give enough importance to gender-based violence issues for funding,” she says. “Most people in decision-making are male, and they feel threatened to transform the ideology and the system allowing gender equality.”

Yet while the government can seemingly ignore gender violence issues, it cannot turn a blind eye to AIDS. International attention to the high prevalence rate in Lesotho and sub-Saharan Africa has increased. Billboards, posters, and fliers on safe sex are almost everywhere, and free condom dispensers abound in public places and toilets.

“I think we need the international aid organizations to pressure our government to tackle the problem of AIDS by also investing in stopping gender-based violence,” says Matseisei.  She has three sons and has known about her positive status for almost 10 years now.

Lesotho, she explains, is so patriarchal that the starting point has to be educating men and boys. She uses her sons as an example. “My three boys understand everything,” she says. She talks about how they’ve seen their father abuse her and even fought back one night when her husband came home drunk and tried to beat her. After that day, her husband never raised his hands against her, she says. “I think he is scared of me now.”

With a smile that reflects a mix of pride and love, she speaks of the hope of a better future though the next generation: “My boys respect women and I know they will never repeat the mistakes of their father. I have done well, at least, there.”