Zuma Should Pledge New Sexual Habits. 30/4/10

Disclosure is more “powerful” when done by a prominent individual who is HIV-positive and who also talks about dealing with the stigma associated with the virus.

Business Day

President Jacob Zuma ’s disclosure of his HIV status on Sunday was meant to encourage others to be tested for the virus, but may

actually serve to muddy the waters in the fight against HIV/AIDS, which remains a complex disease with no simple answers.

AIDS activists point out that it is easy to disclose one’s status when one is negative, as Zuma is. Disclosure is more “powerful” when done by a prominent individual who is HIV-positive and who also talks about dealing with the stigma associated with the virus.

Zuma could be trying to make amends for his previous actions and take the lead in the behavioural change implied by disclosure. His multi-partner lifestyle had been blamed for the government’s failure to take up civil society’s campaign to discourage citizens from having multiple and concurrent sexual partnerships.

Zuma’s disclosure creates an opportunity for discussion about testing. But it also subjects his personal life to greater scrutiny, says Pierre Brouard of the University of Pretoria’s Centre for the Study of AIDS.

“The fact that he has multiple partners, is not using condoms — or at least is not using them all the time — and has conceded to having sex with a person living with HIV/AIDS, will raise questions about risk,” Brouard says.

In 2006 Zuma was accused of raping an HIV-positive woman known for being open about her status. Zuma conceded that he had had sex with her, but denied rape and was found not guilty.

Earlier this year it emerged he had fathered a child with the daughter of a close friend.

He now suggests that he is hoping that a disclosure of his status will encourage others and help to reduce the effect of the epidemic, which in SA is the worst in the world.

“My April results, like the three previous ones, registered a negative outcome for the HI virus,” Zuma told thousands of people who attended the launch of a scaled-up testing and counselling campaign at Katlehong hospital east of Johannesburg.

His spokesman, Zizi Kodwa, says the gesture by the president “brought to the fore the depth of ignorance, prejudice, cynicism and the stigma associated with the pandemic”.

However, Sue Goldstein, a senior executive at health communications institute Soul City, says testing is not enough, since research has shown that people who test negative do not necessarily change their risky behaviour. “Testing is good but we have to focus massively on prevention,” she says.

Dean Peacock of the Sonke Gender Justice Network applauds Zuma for testing and encouraging others to do the same. But he says the president should have gone further and said something like, “I know I’ve taken risks which put me and my partners at risk so I feel lucky to have tested negative. For my own health and the health of my wives and girlfriends, I’m hereby committing to practise safe sex every time I have sex.”

Some believe the effect of leadership is exaggerated in an epidemic driven by personal choices. Zuma is often compared with Yoweri Museveni. The Ugandan president is credited not so much with providing moral leadership, but with working towards a collective response to HIV/AIDS by mobilising all sectors of society.

Museveni won international recognition for galvanising the anti-HIV/AIDS campaign in Uganda, resulting in a dramatic fall in the rate of HIV infection in that country.

In the same way, Brouard says Zuma’s leadership should go beyond disclosure. “We have for too long focused on individual change rather than building social movements, addressing shared and co- created norms and values, and addressing structural factors in behaviour change,” he says.

Zuma will be hoping his administration will do better in dealing with HIV/AIDS than his predecessors. The governmental response has been far from impressive since the early 1980s, when AIDS was first diagnosed.

During Nelson Mandela’s presidency, the fight against HIV/AIDS was superseded by more visible priorities, such as housing. Zuma came into office amid frustration with the Mbeki administration’s questioning of the science of HIV/AIDS.

It would be tragic if the president’s best intentions are undermined by his lifestyle.

But Peacock says the new administration has so far introduced significant changes in the way the government deals with HIV/AIDS, as shown by its support for the Brothers for Life Campaign that puts men at the centre of prevention, along with efforts to create more effective public health systems.

“HIV is complex and there are no simple answers; trying to reduce this complexity to PR or campaign sound bites has always been problematic,” Brouard says.