On Tuesday, the 28th of November 2023, The Star newspaper ran a front-page story with a headline that read: “Black women don’t want condoms”.
The headline was accompanied by an attempt at analysing the recently published 6th South African National HIV Prevalence, Incidence and Behaviour Survey (SABSSM IV) report compiled by the Human Sciences Research Council (HSRC) and its partners.
The report assesses the progress that has been made in eradicating HIV in South Africa, which has the world’s biggest HIV/AIDS epidemic. According to the study, while there have been some progressive developments in the country’s fight against the disease, which a few decades ago was decimating communities at an alarming rate, there are some areas of concern, specifically in relation to the gendered nature of the prevalence of infections.
The SABSSM IV, which was conducted between 2022 and 2023, found that there is a higher prevalence of HIV infection among Black women than men. Furthermore, the prevalence is two-fold among women aged 15-19 and 20-24.
Among women aged 25-29, the prevalence is three-fold higher.
Researchers involved in the study have stated that one of the key factors informing the higher prevalence of infection among women in these age groups is a lack of condom use during intercourse – a statement devoid of nuance which, unfortunately, the newspaper opted to sensationalise.
Three important points need to be made.
Firstly, the prevalence of HIV among Black women is historical. It is reflective of the racialised and gendered nature of the epidemic. Historically, the HIV epidemic has disproportionately affected specific geographical regions and demographic groups.
Rural areas, townships, and tenements have historically had the highest prevalence – and these are areas in which Black people are predominantly located. South Africa’s apartheid history, which laid the foundation for ongoing separate development and spatial inequities that mainly affect Black people, has meant that particular geographies where Black people reside still lack access to basic healthcare amenities such as clinics and pharmacies, as well as access to water and sanitation.
Secondly, there are crucial factors that inform low condom use among young Black women (and Black women in general) that have nothing to do with the conscious decision not to condomise.
The first factor, linked to the previous point, is that Black women, particularly those in rural areas and tenements, are less likely to have access to condoms due to factors including but not limited to not having clinics and pharmacies in close proximity. This results in Black women facing social and structural hurdles to health and reproductive care.
The second factor is that Black women often have limited agency to negotiate condom use in marriages and relationships. This is the result of several factors that are rooted in power relations, especially in marriages, and in relationships with older men.
In a South Africa, where capital is both racialised and gendered, women are particularly vulnerable to unemployment and underemployment, resulting in the prevalence of male partners providing material support.
This disadvantages women in negotiating condom use, because in such unequal relationships, power lies with men. The same applies to married women.
The cultural frameworks within which sex occurs in African marriages expose women to the risk of contracting HIV. This is why in sub-Saharan Africa, married and widowed women have a higher prevalence of HIV than women who were never married.
A study by Eric Y. Tenkorang titled “Marriage, widowhood, divorce and HIV risks among women in sub-Saharan Africa” found that compared to women who had never been married, widowed women were significantly more likely to be HIV positive.
Similarly, married women were more likely to be infected with HIV, compared to women who were not married, in Lesotho and Zimbabwe. In Tanzania and Zimbabwe, divorced women had higher risks of HIV infection, compared to women who were never married.
Lastly, a point must be made about the prevalence of infection among young girls.
Professor Khangelani Zuma, the principal investigator of the SABSSM IV, who also serves as the HSRC divisional executive of the Public Health, Societies, and Belonging division is quoted as saying that HIV prevalence among 15 to 19-year-olds is the result of young women having intercourse with older men.
This is a very dangerous statement that trivialises the real issue at play: the rape of young girls. Under South African law, any person under the age of 16 may not consent to any sexual activity, as they are legally minors. Even if the minor has voluntarily agreed to take part in a sexual activity, it is still regarded as unlawful, and the adult is committing statutory rape.
Thus, the fact that 15-year-olds are being infected with HIV does not indicate that women are “not using condoms”, but that children are being raped.
The issue of violence is also applicable to older women as they too are often on the receiving end of gender-based violence, which enables their domination in relationships.
The Star newspaper, through its irresponsible journalism, is perpetuating racist and sexist ideas about Black women. The lack of nuance in how studies such as the SABSSM IV are reported does a lot of damage.
It is important that when reporting on such studies, journalists employ analysis that appreciates the complex ways in which dominant patriarchal culture and society in South Africa exacerbates women’s inferiority, and their disparate health status.
Failure to employ such analysis results in ahistoric, sensationalist, and harmful reporting.
Malaika is a geographer and researcher at the Institute for Pan African Thought and Conversation. She is a PhD candidate at the University of Bayreuth, Germany.