Malian Women Push Condom Use to Reduce Spread of AIDS

Women in Mali are encouraging more men to use condoms to slow the spread of the virus that causes AIDS.

The prevalence of HIV/AIDS in Mali is low for West Africa, effecting less than two percent of the adult population.

Since 2003, the U.S. Agency for International Development has been working with the Malian League of Imams and Scholars on an Imam Outreach program to include prevention messages in Friday sermons.

Diarra Munjara heads a group for Malian women and children effected by AIDS. Some are HIV positive. Others have lost husbands or fathers to the disease.

Munjara says her group needed the support of religious leaders to help lower the stigma surrounding HIV-positive women. With the help of other civil society groups and President Amadou Toumani Toure, Munjara says that education program has made real progress.

The problem now is what happens to women when their husbands die from AIDS. Munjara says a woman's in-laws expect her to marry her late husband's brother to keep the inheritance in the family. If a woman says no, the in-laws can take her children and prevent her from inheriting anything, even if the only reason she does not want to marry her brother-in-law is to keep from infecting him with HIV.

Munjara says the problem is that many in-laws do not believe the disease exists. They say a wife who refuses to marry her brother-in-law is trying to sabotage tradition.

Even if a woman agrees to remarry and they go for their blood tests, when the health worker encourages the man to use a condom, Munjara says many men refuse. She says women do not traditionally have the standing to talk about condoms with their husbands. Husbands make all the decisions. So if the disease is spreading, Munjara says it is the fault of the men.

Munjara says her group does sometimes succeed in educating men about condom use and some do use them. But others, even when they know the risks, do not want to use condoms. And when their wives insist, she says that can lead to divorce.

Health officials in Mali estimate that about one-third of men between the ages of 15 and 24 use condoms. The figure is even lower for higher-risk members of the sexually-active population including soldiers and truck drivers.

One of the groups trying to increase condom use is Mali's Association of Young People Against AIDS and Sexually-Transmitted Disease. Moussa Sango is the group's president.

Sango says his group's sensitization and prevention programs focus on bars and restaurants where they counsel both men and prostitutes about the need to practice safe sex.

Market women in Mali are also organized against AIDS. Samoura Dembele heads their group.

Dembele says women in Bamako's two largest markets talk to their customers about preventing AIDS and train other market women to spread the message outside the capital. She says the group encourages women to get tested for HIV. And if they are positive, the market women help them find proper treatment.

Sheikh Omar Toure runs the AIDS awareness group Wanaso which focuses on prevention campaigns and information sharing among AIDS groups in the 15 countries of the Economic Community of West African states as well as Mauritania.

Toure says civil society groups face many challenges to changing the way the epidemic is spread including finding sustainable financing, integrating the work of anti-tuberculosis campaigns, reducing the stigmatization and discrimination surrounding the disease, improving access for treatment, and boosting efforts to prevent mother-to-child transmission.