In Swaziland, 'Secret Lovers' Confronted in Fight Against AIDS
Sunday, October 29, 2006
MBABANE, Swaziland -- This tiny kingdom's new anti-AIDS campaign arrived without warning one day in July, featuring a slogan both unusually explicit and dripping with implied accusations: Makhwapheni Uyabulala.
Your secret lover can kill you.
Despite living in a country that has the world's highest rate of HIV, Swazis had grown accustomed to bland billboards suggesting that more condoms or a positive attitude toward the disease would curb its spread. These new ads were different.
By the time they disappeared two weeks later in a frenzy of controversy, they had sparked a passionate national debate about how best to combat a disease that, Swazis say, has pushed their country to the brink of collapse. And the ads forced many here to confront how freewheeling sex was fueling an epidemic of early death.
In Swaziland's bustling capital, callers were jamming the lines of radio shows. Men at pubs began looking askance as their friends maneuvered their way into casual hookups. And Musa Ndlangamandla, the stocky 35-year-old editor of the Swazi Observer newspaper, began rethinking his attitude toward casual relationships.
"Sometimes you need shock therapy," said Ndlangamandla, a short man with a neatly trimmed goatee, broad shoulders and a bit of a beer belly. He was so impressed by the campaign that he began printing "Say No to Multiple Sex Partners!" in capital red letters on the front page, just below the newspaper's nameplate.
Swaziland, a southern African country about half the size of Maryland, at first glance appears deeply traditional, with cattle roaming freely among clusters of mud-and-thatch huts nestled in the green folds of steep mountainsides. But Swazis say it is modernizing at warp speed, with new highways, shopping malls and easy access to American soap operas and gossip about the exploits of Hollywood celebrities.
Although polygamy is common -- the king has 13 wives -- even more common, Swazis say, are relationships in which men have only one wife but girlfriends also. Women often maintain several partners as well. A study by a Christian aid group, World Vision, reported in May that in several southern villages, roughly three out of five residents, both men and women, reported having two or more sexual partners in the past three months.
The word makhwapheni (pronounced "ma-kwa-penny"), which means "your secret lover," became the centerpiece of radio and newspaper ads on the order of Derek von Wissell, 62, a courtly, gray-haired former cabinet minister who founded the national AIDS commission in 2002. He grew frustrated with his agency's inability to curb a virus that had infected an estimated 200,000 of Swaziland's 1 million residents. Among adults 15 to 49, the rate was even higher, with one out of three infected.
Von Wissell concluded that the vague, unfocused public education campaigns common here and throughout Africa had failed. In this, he was persuaded in part by the research of Daniel T. Halperin, an AIDS expert for the U.S. Agency for International Development based in Swaziland, who in speeches and private presentations pointed to dozens of studies showing that condom promotion campaigns were having little impact and that it would be more effective to target the multiple, concurrent sexual relationships that fuel high rates of HIV.
"We have been pussyfooting around sex," von Wissell said in an interview in his office in a small concrete building dominated by a convenience store and gas station. "The first thing you must recognize is that sex spreads HIV."
The issue of multiple sexual partners has rarely been the focus of anti-AIDS campaigns in Africa, both because of taboos against publicly discussing sex and because of a long-standing consensus among anti-AIDS groups that educational messages should inspire hope rather than fear, researchers say. Campaigns have been especially careful to avoid suggesting that people with the disease -- including millions of women who had sex only with their unfaithful husbands -- bear any blame for contracting it.