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The healthier lifestyle magazine for Africans

Soap Sensations Hot African soaps that are turning heads and sending a message

Issue 9 - Winter 2012/13

18

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things to do before your African holiday

Risky Business

Are you taking chances in the bedroom?

Life After Love

How to move on when your relationship ends

NEW Men’s Health Pages Ask The Experts

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to 04Going Africa?

18 things to do when visiting the home continent

an 05Win iPad mini

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06Stephen Sodje

Dear Reader,

Ex-professional player seeks to turn young people’s lives around through football

As you’ve probably noticed, this edition of Mambo is slightly different from the last. We’ve taken note of all your feedback and come up with a magazine that offers a lot more. The smaller format means you can now carry your copy of Mambo everywhere you go, and you get a lot more from the increased number of pages.

08Teenage Mum

Getting pregnant at 17 didn’t end Juvin Djoukouo’s career ambitions

10Soap Sensations

HIV and relationship dramas take African TV by storm

In this issue, we introduce you to a phenomenon that has taken African television by storm: HIV soaps. In Kenya, South Africa, Tanzania and a few other African countries, TV stations are airing local content about HIV, sexual and gender rights and related social issues. Boring stuff, right? No, actually. The soaps give real meaning to the concept of ‘edutainment’: there’s plenty of excitement, humour, passion and relationship crises. Everywhere they are broadcast, these soaps have won millions of viewers, and several awards.

16Risky Business If you’re having sex, what’s your risk of getting HIV?

20Men’s health

If you’re black and aged over 50, you could be at risk from prostate cancer

Also in this issue: A young woman’s ambition to tackle gender violence within her community; award-winning poet Nissi Mutale offers tips on how get over a relationship break-up, and in our Agony Aunt column Quinet Akanoh responds to a reader whose husband has walked out on her.

22Ask the Experts Quinet Akanoh and Charles Kyazze respond to reader’s problems

the end 27Isof this HIV? Experts say treatment can help protect future generations from HIV

Enjoy your copy! joseph.ochieng@tht.org.uk

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We would like to know what you think of magazine. Any comments about the look, feel and content of the magazine would be most welcome. Please email feedback@tht.org.uk or leave a comment on www.mambo.org.uk Alternatively, you could write to: The Editor, magazine, Terrence Higgins Trust, 314-320 Gray’s Inn Road, london WC1X 8DP. Winter

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© Terrence Higgins Trust, December 2012. Code: 1694200. Registered office: 314-320 Gray’s In Road, London WC1X 8DP. Terrence Higgins Trust is a registered charity in England and Wales (reg. no. 288527) and in Scotland (SC039986). Company reg. no. 1778149. A company limited by guarantee.

2012/13

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Going to

Africa?

If you’re planning to visit Africa, here are 18 things to be aware of:

Malaria

Tuberculosis

As we’re from Africa, we may assume that we have immunity against malaria - however once we move abroad, this immunity diminishes. Before travelling, ask your GP for a course of anti-malaria prophylaxis (a preventative treatment). This is started before travelling and continued for several weeks after you return.

Tuberculosis (TB) is a contagious bacterial infection. It is a good idea to take these basic precautions:

Malaria is spread by mosquitoes, so try the following tips: Use a mosquito net. Spray your room with insect repellent. Wear long trousers and long-sleeved tops. Use anti-mosquito ointment or spray on exposed skin.

The Bacillus Calmette-Guérin (BCG) vaccination is 70-80 per cent effective. Speak to your GP to find out whether the BCG would be appropriate for you or your family members. Avoid sleeping in an overcrowded or poorly-ventilated room. If someone you visit in Africa has symptoms associated with TB (such as a productive cough, high temperature or weight loss) advise them to seek medical help and spend less time around them. If you think you may have been exposed to TB, it is worth having a test when you return.

Hepatitis A

Hepatitis A is a virus affecting the

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Winter 2012/13

liver which is passed on through food or water contaminated by human faeces. Your GP can vaccinate you against hepatitis A four to six weeks before you travel, and give you a booster jab six to12 months later. You can minimise the risk by washing your hands with soap after using the toilet and before eating.

Hepatitis B

Hepatitis B is a virus affecting the liver. It is transmitted through blood and sexual fluids. There is a vaccination against hepatitis B which you can get from your GP – it involves three injections over four to six months.

HIV

Among Africans, HIV is most commonly spread through unprotected sex. Using condoms or Femidoms when you have sex is the best way to protect yourself and your partners.


If you are HIV positive and taking antiretroviral medication, remember to pack enough to last your entire trip - with some extras in case you stay longer.

Typhoid

Typhoid occurs when food or drink is contaminated by a bacterium called Salmonella typhi. This usually happens when someone preparing food has infected faeces on their hands, or when a fly lands on food. To protect yourself against typhoid: See your GP at least two weeks before you travel to find out whether you need a vaccine. Once in Africa, only eat freshly prepared cooked food, served piping hot, or fruit that you have peeled yourself. Only drink bottled or cooled boiled water, or pasteurised milk. Wash your hands with soap and water before preparing food, eating or drinking, and after using the toilet. Use bottled or cool boiled water to brush your teeth. Avoid using tap water. For more information about health and safety when abroad visit : www.nhs.uk/livewell/travelhealth www.fco.gov.uk/en/travel-andliving-abroad www.travelhealth.co.uk

Personal safety: Give some thought to personal safety: Avoid travelling alone or at night. Avoid carrying large sums of money. Speaking with a British accent may mark you out as a visitor, and could make you a target for muggers. Try to dress the same as the locals – blend in with the crowd. Minimise the use of chauffer-driven hire vehicles. If you have British citizenship, register with the British High Commission and if you have any problems, notify them.

Travel insurance: When travelling abroad, remember to take out travel insurance. This will cover you if any of your possessions are stolen or lost or if you need medical care. You can find a list of companies who provide travel insurance to people who are living with HIV on www.myhiv.org.uk

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I know more about sexual health than I did before I can protect my sexual health better I understand the benefits of discussing sexual health with my partner I know where to go for sexual health services I am more likely to try to find out my HIV status I know I should use a condom with someone whose HIV status I don’t know I realise how stigma affects people who have HIV

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GOOD LUCK! Now put your form in an envelope and mail to: The Editor, magazine, Terrence Higgins Trust, 314-320 Gray’s Inn Road, London WC1X 8DP. Alternatively, you can fax your form to 020 7812 1799. The deadline for returning your questionnaire is 20 February 2013.

Winter 2012/13

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Home&Away Stephen Sodje was born into a sporting family: four of his brothers are current or retired professional football or rugby players in England. A former Millwall player, Stephen is founder and Chief Executive of The Stephen Sodje Sports Foundation, a charity promoting grassroots football in the UK and Africa. He was interviewed by editor Joseph Ochieng.

: You were a professional football player who became an investment banker. Many people would have started their own businesses and earned lots of money. Instead, you chose to start a football charity. Why? STEPHEN: Because of the passion and the joy I get from sports. Being a City banker was stressful - the money was good but I really wasn’t myself - starting a sports foundation offered me the chance to rediscover myself. I wanted freedom, plus I wanted to make a difference to the lives of the children from deprived backgrounds who don’t often get the chance to develop their sporting potential. Luckily, I come from a sporting family, I’ve played professional football in England, and four of my other brothers play or played professional football and rugby. We thought that by starting a sports

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foundation to promote grassroots football here in the UK and in Africa, we would become role models who inspire young people. : What has your experience of working with young people in this country been, compared to working with young people in Africa? STEPHEN: Nowadays in the UK it’s very easy for young people to go

astray, they are usually bored because they don’t have anything to do and are exposed to many negative influences. However, young people do tend to listen to advice from people they regard as role models. Generally, all the young people I have engaged with have responded well. In Africa, kids look at us as people who have made a success out of life. They’re hungry for similar success and will do whatever they’re told because they think it might help them achieve their dreams. Given the chance, all young people will aspire to a successful life regardless of where they live. : What are the Foundation’s key achievements? STEPHEN: We have donated kits and coaching equipment to football clubs in Nigeria, Tanzania, Zambia, Zimbabwe and Ghana.


In May 2011 we took an English Football Association coach, Paul Fairclough, to Lagos, Nigeria where he coached players from the Lagos State Football Association. In the UK, we’ve started delivering Coaching and Mentoring Level 1 and Level 2, and are teaming up with Focus Learning UK to deliver education-focused skills to young people from deprived backgrounds. In the longer-term, we plan to set up a sporting academy in Nigeria to offer training in football skills as well as formal education. A lot of our work has been possible because

of the support of well-wishers, such as Arik Air, The Football Association, Boots4Africa and Focus Learning UK. : Do you think football has a role in promoting awareness of health issues among young people? STEPHEN: Definitely. We know that young people face specific health

‘Football is a great way of bringing young people together in one setting so they can access information and advice around topics such as sexual health...’

issues, but not many know enough about them. Football is a great way of bringing young people together in one setting so they can access information and advice around topics such as sexual health, weight problems, drug habits and so on. Through our initiative with Focus Learning, we hope to develop the health promotion aspect of our work with young people. For more information about the Sodje Sports Foundation, please email: stephen.sodje@aodjesf.org

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What’s it like being a

Teenage Mum? 08

Winter 2012/13


Juvin Djoukouo is founder of the young mums’ website www.youngmamas.co.uk She was 17 when she became pregnant and had to take a year off school. contributor Rianna Raymond-Williams In this interview she tells about the challenges of being a young mum, and how she managed to put her life back on track. RIANNA: What was it like when you found out that you were pregnant? JUVIN: It wasn’t the best of feelings. The pregnancy wasn’t planned, so it was all a bit of a shock to me. I wasn’t for the idea of aborting, so I decided I’d keep the baby. RIANNA: What was the reaction from your friends? JUVIN: A soon as they heard I was pregnant, their attitude towards me changed. I think some of them didn’t want to associate with me because of the stereotype attached to young motherhood. Others felt they no longer had anything in common with me as I was constantly talking about baby stuff, while all they wanted to talk about was parties and all the other things that girls do. Soon there developed a distance between me and my friends. I decided that my baby was my number one priority. RIANNA: What impact did the pregnancy have on your education?

Business Management at Middlesex University. RIANNA: What inspired you to start the Young Mamas website? JUVIN: During my pregnancy I became conscious of the very negative and stereotyped attitudes people around me had towards me. I realised that the attitudes reflected the typical media portrayal of young mums as being uneducated and lazy benefits scroungers who had very little to contribute to society. I decided that I’d do something to challenge the negativity. I also wanted to help young mothers get back into education so they can secure a future for themselves and for their children. I never intended the website to be a business, but going about it in a business way helped me to get the £300 seed money from O2 that I used to design and launch it. RIANNA: How is the website doing?

the majority of them young mums who want to know about things such as breastfeeding, gifts and toys, voucher codes for baby products, and generally how to join networks of young mums. It is a great place for young parents to engage with each other because we are all young and are happy to have a new baby. We have the same ambition to make our children proud of us. We want teenage mums whose education was interrupted by pregnancy to get back to school, training or apprenticeship. RIANA: What is your advice to teenage mums? JUVIN: I’d encourage young mums to go out and talk to other mums. I got involved with groups and met other mums and it felt so much better to know that I wasn’t the only one going through the challenging times. It helped me to feel normal again and to think clearly about what I wanted in life. Ask for help when you need it, and do not give up your career ambitions.

JUVIN: Today youngmamas.co.uk has 2,000 visitors and 1,000 users,

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Photographs by Annabel Vere

For more information and advice about teenage pregnancy and JUVIN: I fell pregnant in 2009 and motherhood, please contact: had to take a year out of school to Shine ALOUD Sex. Worth Talking About on look after my baby. However, magazine contains information 0800 282 930 I was serious about education so about sexual and reproductive health Brook on 0808 802 1234 in 2011 I went back to finish for young people, at www.shinealoud.co.uk Care To Learn on 0800 Year 13. I passed my exams 121 8989 and am currently studying Terrence Higgins Trust’s freephone helpline FPA on 0845 122 8690 THT Direct offers sexual health information and advice, seven days a week, on 0808 802 1221.


Africa’s Next Top TV Soap

From Lagos and Nairobi right down to the Cape in South Africa, TV soaps with a focus on HIV, sexuality and reproductive rights are proving to be a massive hit with viewers. This signals not just a shift in audience perceptions about a subject traditionally regarded as ‘taboo’, but also a transformation of Africa’s media landscape.

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Winter 2012/13

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hether it’s Shuga and Makutano Junction in Kenya, Intersexions, Scandal and 4Play: Sex Tips for Girls in South Africa or Tinsel in Nigeria, the soaps appear to confirm one theory: that a conflation of HIV information and artistic talent can beat down barriers thrown up by stigma, fear and ignorance – for too long the bane of HIV prevention efforts in the continent. editor Joseph Ochieng picks out the top shows.

Intersexions Visitors to the show’s website are greeted by the question: ‘Do you know your lover’s lovers?’ That, in a nutshell, is what Intersexions is about. This multi-award winning show puts ‘sex’ and ‘connections’ together to illustrate the kind of social networks within which HIV occurs. The message is simple and stark: the person you’re currently having a sexual relationship with has probably had sex with lots of other people already. A single infection anywhere within this ‘network’ has the potential to circulate all around. The 26-episode drama is supported by heavyweight sponsors

Johns Hopkins University’s Health and Education in South Africa (JHESA), USAID and PEPFAR (the US President’s Emergency Plan for AIDS Relief). This shows in the quality of the production: at the March 2012 South African Film and TV Awards (SAFTA), Intersexions won in 11 of the 13 TV drama categories in which it had been nominated - more than any other TV show. Weeks later, it also won the George Foster Peabody Award, one of the most prestigious accolades for excellence in broadcasting. The episodes, though linked, are independent of each other and produced with the aim of educating the audience about specific aspects of HIV transmission and the social dynamics within which it occurs. HIV itself is personified, providing a voiceover narration to the entire series, showing how the virus spreads regardless of class, race or education.

Intersexions ??????? as ??????? & ??????? as ??????? in Intersexions

Winter 2012/13

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4Play: Sex Tips for Girls

Written and directed by an all-woman team, 4Play: Sex Tips for Girls seeks to change audience perceptions of African woman in relation to sex and sexuality, empowerment and relationships. The lead characters are educated and highly sophisticated. They all think they know what they want – love. Unfortunately, they don’t always get what they want. The episodes in this drama treat the audience to a mix of emotional ups and downs, relationship crises and humour – all played by a cast that seems capable of giving even the top Hollywood actors a run for their money. 4Play: Sex Tips for Girls succeeds in projecting sexual health messages alongside brilliant and humorous, if sometimes sad, storylines.

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4Play: Sex Tips for Girls

Soul City

Soul City

This South African drama blazed the trail that other HIV soaps were to follow: the first series aired in 1994, a time when stigma, lack of knowledge and fear made HIV a no-go area for TV audiences across the continent. The latest series, which debuted last year, attracted millions of viewers and established Soul City as one of the most successful TV soaps to emerge out of Africa.

Scandal

Scandal

This series takes viewers into the world of NZH,

a Johannesburg-based media house that produces the glossy celeb magazine Scandal; but it’s the people in the newsroom who generate most of the scandal. The episodes in the show reek of passion, jealousy, ambition, personal conflicts and positive living. The fast and furious pace of the action pretty much sums up what goes on among Africa’s upwardly mobile professional class. The storylines around extra-marital affairs, living with HIV, jealousy and betrayal are not only entertaining to the audience, they also educate and help dispel common myths and misconceptions about African men and women in an era of AIDS.

Shuga

This is the series that has taken Kenyan TV by storm. Also supported by UNICEF and PEPFAR, as well as music channel MTV through its Staying Alive initiative,

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Photograph by Kim Wild

Shuga’s Sharon

Shuga is about a group of university students who want emotional and material contentment - fast, and without thinking too much about the potential consequences. The drama is meant to highlight HIV issues for today’s young people, so it’s not surprising that there are many titillating scenes of the bedroom nature. Storylines highlight the issue of multiple concurrent relationships and inter-generational sex that is driving the AIDS epidemic in Africa. The show also sends out powerful messages about the other vulnerabilities common among young people today: booze, drugs and money. The cast includes two of Nigeria’s most popular stars, singer Wizkid and R&B star Banky W, whose presence has helped make Shuga an instant hit in Nigeria, where it premiered last March.

For UK-based readers who haven’t seen the HIV soaps, most are available on Sky channels 209 (The Africa Channel), and 218 (Vox Africa).

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Can soaps make a difference?

W

atching a TV series is one thing, changing behaviour on the basis of what was seen is another. However, if viewing figures are anything to go by, there can be no doubt that the HIV soaps are breaking new boundaries. To illustrate: an independent survey found that 60 per cent of Kenya’s young population had watched Shuga and could identify the main messages as well as the lessons to be learned. In Zambia, where the series has been aired, 50 to 60 per cent of youths questioned said they believed the show had an impact on their thinking. Shuga is currently the most popular soap in Kenya. Makutano Junction, another Kenyan soap focusing on sexual and reproductive health and gender rights, currently attracts 7.5 million viewers in Kenya, an estimated 3 million in neighbouring Uganda and

2 million in Tanzania. For the same amount of money, few other HIV intervention methods can beat this sort of reach. Episodes of Makutano Junction enable viewers to text in with requests for services based upon what they have seen. When an episode about abortion was aired, 1,476 texts were sent by viewers asking for more information. Likewise, each Soul City episode is supported by leaflets giving more detailed information about a particular subject, including where and how to access intervention services. HIV soaps are turning the very character of African TV programming on its head. Up until now, imported Western (and especially American) content has been regarded as the Holy Grail - whether sports, news, sitcoms or documentaries. Not any more! Home-grown content is now the ‘in-thing’. With sky-high ratings, the soaps might be just what’s needed to make Africa attain an AIDS-free generation.


“We’ll play safe until we’ve both been tested” n Anyone can get HIV. n Avoid taking risks. n Use condoms. For more information about how and where to get free condoms, contact: or visit

Terrence Higgins Trust is a registered charity in England and Wales (reg no. 288527) and in Scotland (SC039986). Funded by the Pan-London HIV Prevention Programme.


HIV: What’s your risk? HIV is a serious sexually transmitted infection (STI), but it’s also relatively easy to guard against. Knowing how HIV is passed on during sex may help protect you or your partner from the virus. In this column, we explain the level of risk associated with different types of sex.

Sex without a condom:

HIV can be passed on through blood, semen, vaginal fluids, anal mucus and breast milk. Having sex without a condom (known as ‘unprotected sex’) is a high risk activity - it’s how most Africans with HIV are infected. Using a condom each time you have sex is one of the most effective ways to avoid the risk. You can buy condoms from supermarkets, chemists or late-night garages and get them free from community-based African charities, sexual health clinics or your GP. If you’ve had sex without a condom or a condom has slipped off or broken, PEP (post-exposure prophylaxis) may stop you becoming HIV positive if you have been exposed to the virus. It is a month-long course of HIV drugs which only works if taken soon after sex - within 24 hours is best but no later than 72 hours. PEP is available free of charge to everyone (regardless of their immigration status) from sexual health clinics and Accident and Emergency (A&E) departments in hospitals. To find out where to get free condoms or PEP, contact THT Direct on 0808 802 1221 or visit www.tht.org.uk/sexual-health

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Condom slipped off or broke:

Sometimes, condoms slip off or break during sex and semen can leak out, or there may be direct contact between your genitals and your partner’s. If this happens there is a high risk of infection if one of you is HIV positive. To avoid a condom breaking or slipping off, follow the instructions in the packet. Using a water-based lubricant during sex will reduce the risk of a condom coming off or tearing. Never use a condom more than once and if you are still having sex after about 30 minutes check it’s still intact or use a fresh one. Sharp fingernails can pierce a condom. If a condom slips off or breaks when you have sex you can seek PEP.

Oral sex:

There is a small risk HIV being passed on through oral sex but it’s less risky than unprotected vaginal or anal sex. The risk from oral sex, according to NAM (the National AIDS Manual, an HIV information provider) can be higher: If the person receiving oral sex has HIV and has high levels of the virus in their body (a high viral load) or if they have an untreated STI.

If an HIV positive man ejaculates in the mouth of the person giving oral sex. If an HIV positive man has cuts, sores or rashes on his penis. If the person giving oral sex has bleeding gums, sores or wounds in their mouth. If the person giving oral sex has a sore throat, inflammation or untreated infection in the mouth. If the person giving oral sex has recently had dental work. NAM also explains that an HIV positive woman is unlikely to pass on HIV to her partner via oral sex; however, the levels of HIV in her vaginal fluid do vary. During her period, the amount of the virus in the vaginal fluid and the blood goes up so there’s more risk of HIV transmission. This risk goes up if the person giving oral sex has bleeding gums, sores or wounds, a sore throat, inflammation or an untreated infection in the mouth. Using a dental dam or a piece of latex cut from a condom to cover her genital area can help reduce the risk. To find out more visit www.aidsmap.com


Masturbation:

Photograph by Annabel Vere

Masturbation, where the sexual organs are stimulated for sexual pleasure, is a no-risk activity if you masturbate alone. The only risk of getting HIV or another STI would be if you transferred your sexual fluids to your partner’s genitals or onto broken skin (and vice versa) and one of you was HIV positive or had an STI.

Multiple relationships:

Being in relationships with several partners at once increases the risk of everyone getting an STI or HIV. To minimise the risk, use a condom each time you have sex.

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Photograph by Annabel Vere

Withdrawal:

‘Withdrawal’ is when the penis is pulled out of the vagina just before ejaculation. Some men do this to reduce the risk of passing HIV to their partner or to reduce the risk of pregnancy. Withdrawal is less risky than sex where the man ejaculates inside their partner, but there is still a risk. Men are not very good at controlling when they ejaculate. Also, HIV is present in pre-cum, the clear liquid that comes out of the tip of the penis when a man is aroused. So it’s possible that an HIV-positive man can pass the virus to his partner even if he withdraws before ejaculation.

Unprotected sex with someone who has HIV:

Having unprotected sex with

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someone who is HIV positive is a high risk activity. Condoms, when used properly, provide an effective barrier against HIV and STIs. If you have had sex without a condom and are worried about getting HIV, you can seek PEP within no more than three days. For more information about PEP please visit www.tht.org.uk/sexual-health.

Sex with someone who has an undetectable viral load:

You may have heard about the role of HIV treatment in reducing transmission. A team of HIV experts concluded that someone with HIV is not infectious if they meet certain conditions: they are in a monogamous heterosexual relationship they have had an undetectable

viral load for at least six months they take their HIV treatment consistently, and they have no other sexually transmitted infections. Having an undetectable viral load means there is less chance of the virus being passed on through unprotected sex; however, there’s still a small risk that this can happen. You can read more on this in our article on Treatment as Prevention on Page 27.

To read more about sex and HIV risk visit www.myhiv.org.uk or visit www.mambo.org.uk or call THT Direct on 0808 802 1221.


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PROSTATE CANCER Men over 50 are more vulnerable to prostate cancer, particularly if they are African or African-Caribbean. Doctors are not sure why black men are more likely to get the disease than white men, but think it may be due to genetics. Despite the risk to them, however, many African men do not know enough about the disease. Here are some facts: The prostate is a small gland underneath the bladder which helps produce semen. In the UK, the disease kills approximately 10,000 men each year. It’s the most common form of cancer in men. Black men have two to three times more risk than white men of the same age. Men whose fathers or brothers had prostate cancer are two-and-a-half times more likely to develop the disease. Older men (aged over 50) are at more risk.

Signs of prostate cancer:

Prostate cancer often has few symptoms and it progresses slowly, so many men don’t realise anything is wrong. In some cases it can spread to other parts of the body, usually the bones. The following can be symptoms of prostate cancer: A weak urine flow. Needing to urinate more

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frequently, especially at night. Feeling that the bladder has not emptied properly. Difficulty passing urine or dribbling urine. Difficulty achieving or maintaining an erection. Many men have enlarged prostates which can cause similar urinary symptoms to those listed above. This is know as benign prostatic hyperplasia (BHP) and is different to cancer. If you have any of the symptoms listed see your GP for advice or contact NHS Direct on 0845 4647. More information about prostate cancer visit: Cancer Research UK 020 7242 0200 www.cancerresearchuk.org Macmillan Cancer Support 0808 808 0000 www.macmillan.org.uk Prostate Cancer Charity 0800 074 8383 www.prostate-cancer.org.uk Prostate Cancer Federation 0845 601 0766 www.prostatecancerfederation.org.uk


Can prostate cancer be prevented?

There’s no evidence that prostate cancer is preventable. However, you may be able to lower the risk of developing the disease by avoiding high-fat foods and by eating five or more portions of fruit and vegetables each day. Studies of men taking the drug finasteride (currently used in the treatment of BPH and male pattern baldness) found they were 30 per cent less likely to develop prostate cancer than those taking a placebo.

How is prostate cancer treated?

Various treatment options can be used including removal of the prostate, radiation therapy, hormone therapy and chemotherapy. Prostate cancer treatment can lead to side effects such as loss of libido, inability to achieve or maintain an erection and urinary incontinence. Treatment is usually only recommended when the disease is serious and progressing.

Photograph by Sam Scott Hunter

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ASK THE EXPERTS

Do you have a health or lifestyle-related problem that’s troubling you? advice experts, Quinet Akanoh and Charles Kyazze can help you find answers. Please write or email your problem to the editor: joseph.ochieng@tht.org.uk Dear Quinet,

My husband and I got married in 2010, after six years of living together. We are both HIV positive and receiving medication, although from different hospitals. Everything was alright between us until we visited my husband’s sister in Portugal. My husband came back a changed man I suspect this was because his sister didn’t like the fact that he was married to a black woman.

Quinet Akanoh photograph by Paul Bowen

In September 2011, my husband disappeared from home altogether. Now I don’t know where he lives. Only on very rare occasions does he answer my phone calls. I’ve tried several times to get him to come back so we can work things out, but he’s refused. He accuses me of not being nice to his 19-year-old daughter from a previous marriage and of ‘sucking his blood’ - claiming that I don’t like paying for things. So one day I paid for a holiday to South Africa, where I come from, in the hope that we’d get the opportunity to talk things over. He did join me for the holiday,

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but then on the very day we flew back, he disappeared again. Dear Quinet, I don’t know what to do. I need my man back. What if something happened to him – what would I do? Please help.

Sandra Nomsa, Brixton

Quinet Akanoh

Quinet says:

Dear Sandra, Obviously you love your husband, which is why you want him to come back home. From what you’ve described, it appears as if he has many things on his mind besides concerns about his daughter and money matters. Some people who test HIV positive do find it hard to come to terms with their diagnosis; often, this affects the way they behave towards family members or friends. Perhaps it’s best if you gave your husband more time and space to

think things through. He might be more prepared to listen to you after a while. His leaving home could also be due to outside pressure. As much as inter-racial couples are commonplace nowadays, people outside the relationship (eg, friends and relatives on both sides) may have negative views about the relationship. Lastly, even though you did not raise the possibility that your husband could be having an extra-marital affair, perhaps this is something you need to consider. Whatever the reason for his leaving home, you need to let your husband know that you love him and that you care. However, also let him understand that if he’s no longer interested in the marriage, he should be honest and kind enough to tell you, so that you both know what steps to take next. In the meantime, I’d encourage you to get in touch with a support group for people living with HIV. Members of a support group share their experiences and learn a lot from each other. Often, the groups


meet in a good social atmosphere, which can help put your mind at rest. You might also want to contact Terrence Higgins Trust’s African Emotional Support Service they can help you to explore your feelings and emotional needs. For more information contact THT Direct on 0808 802 1221. For relationship and marriage counselling and mediation, plus face-to-face consultations and support, please contact Relate on 0300 100 1234 or COSRT (the College of Sexual and Relationship Therapists, formerly called the British Association of Sexual and Relationship Therapists or BASRT) on 020 8543 2707.

she has tested HIV negative but she doesn’t yet know that I am positive because I haven’t told her. I’d be most grateful if you could tell me how I can break the news to her. I’d also be grateful for any information about what other NHS services are available to me, and what I can do should my asylum application get turned down by the Home Office. Please help!

James, HMP Bullwood Hall.

Dear Uncle Charles,

I am an asylum seeker currently imprisoned at Her Majesty’s Prison at Bullwood Hall, Hockley in Essex. I was diagnosed HIV positive while at the prison, and currently receive HIV treatment. Lately I’ve been very ill. I believe my condition is made worse by the fact that, despite serving the 12 month sentence that was given to me, I’m still in prison, awaiting a decision on my asylum application. I’m worried that, if I’m deported back to Nigeria, I will not be able to continue with HIV treatment. Sometimes, I feel like committing suicide. I need to be released, or at least be sent to an immigration detention centre, where I might get better care. My partner lives here in the UK;

Uncle Charles

Uncle Charles says:

Dear James Prison is not a very good place for anyone to be in, HIV aside. The good news is that you are on medication; I am confident you’ll soon begin to see the benefits of the treatment. The asylum application process can take several months, even years. However, you should be patient and wait for the Home Office’s decision. Having HIV won’t necessarily affect the outcome of your asylum application one way or the other. In the past, immigration officials have argued in court that HIV antiretroviral drugs are now available in African countries, so an asylum seeker who is deported back to their home country should still be able to get them. Also in the

past, some asylum seekers destined for deportation were allowed, on appeal, to remain in the UK on compassionate grounds. However, all asylum cases are treated on a case by case basis. It’s important that you continue taking your medication exactly as instructed by the doctor, as you wait to hear from the Home Office. If you have served your prison term, you should be released, unless the prison authorities have a reason for not doing so. You can get your case worker to ask for an explanation. The suicidal feelings suggest you could benefit from professional counselling, which the Prison Service should be able to arrange for you. Counselling will help you to deal better with health and psychological issues, as well as the other challenges that arise from being in prison with a serious medical condition. Understandably, you’re worried about how you’ll tell your partner about your HIV status. I suggest you choose a good time and occasion. You can let her know that you’re disclosing your HIV status because you really do care and don’t want to put her at risk. Also, let her know that you’re there for her should she wish to continue the relationship, and that you two can use condoms for sex in order to avoid the risk of passing the virus on. For immigration advice, please contact the Refugee Council on 0808 808 2255 or Refugee Action on 020 7952 1511.

Winter 2012/13

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Love:

Life After

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Winter 2012/13


How to cope with separation By Nissi Mutale

R

ecently a colleague made the following observation: ‘Pressure from the inside of an egg causes an explosion of life, but pressure from the outside of an egg can cause it to break, resulting in death for whatever life is inside.’ Later as I thought about this statement, I realised that, often in life, we care too much about what other people think about us. We try to live up to unrealistic expectations and find ourselves joining the rat race. The example of the egg resembles the internal and external pressures that can crush our dreams and kill off our personalities. It reflects the heartbreak

Having been through a couple of heartbreaks myself (I am a hopeless romantic), I have come to view relationships in a different light. Like my colleague’s observation above, heartbreak is a force from the inside that can give birth to an explosion of new life - but only if we let it. Falling in love with someone is such an amazing experience; however, as human beings, we do have our flaws and things do not always go to plan. Whether it is loss of interest, growing out of love for each other or a lack of commitment and respect, relationships can and do fall apart. So how do you react when this happens? Do you let the pain grind you down or do you dig deep inside yourself and burst out with renewed passion and a strength that can help move you forward?

Of course, heartbreak is not easy to deal with - it takes time to heal, and you need to make a conscious decision to move on from the pain. Try to focus on the good things that you gained from the relationship, forgive the one who hurt you and look forward to another life. Do not blame yourself - to love is never ever a negative thing, so go easy on yourself. Leaving one phase of your love life will open doors to another. But the worst thing that you can do at this time is rush into another relationship. Take some time to get to know your new self - enjoy your freedom! The relationship would have changed you in many ways, so you need to get to know who you really are, what you want and just how much you can give before you commit to a new relationship. Remember, we all go through this phase of our individual journey. As long as you keep going, who knows what or who is waiting round the corner? For relationship advice or counselling, please visit: www.relate.org.uk www.cosrt.org.uk www.brook.org.uk www.ruthinking.co.uk

Winter 2012/13

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Main photograph by Annabel Vere

‘Don’t blame yourself - to love is never a negative thing, so go easy on yourself.’

that follows the collapse of a relationship. Often when we think about a relationship gone wrong, we think about how we gave a lot and made ourselves vulnerable to another, who then went on to betray our trust and crush our hopes. This can make us feel bitter and sorry for ourselves.

Each time something doesn’t go to plan, you need not be left at the mercy of the situation. You can take hold of yourself, pick yourself up and move forward. The only person who really has control over your life is you.


f o t u o e r o Get m is more than a magazine. It’s also an online community where you can join the conversation about the things that are important to you: life, love, health, relationships and much more. There is plenty of fun and entertainment thrown in to make an essential part of your day. on Connect with both Facebook and Twitter.

e yl st fe Li bo am /M m co k. oo eb ac .f w w w @MamboLifestyle

We’ll see you there!


Is this THE END OF HIV? A

t the International AIDS Conference in Washington DC in July, the US Secretary of State Hillary Clinton spoke about the goal of achieving an AIDS-free generation. She described this as a time when children wouldn’t be born with HIV and young adults, wherever they lived, would be at a low risk of becoming infected. Finally, she said: ‘If someone does acquire HIV, they will have access to treatment that helps prevent them from developing AIDS and passing the virus on to others.’ Hillary Clinton was referring to Treatment as Prevention (TasP), a new development in the fight against HIV. This is the idea that if everyone living with HIV had access to treatment, fewer people would be infectious and the rates of HIV infection would go down.

Viral load

To understand TasP, you first need to understand the relationship between someone’s viral load and how infectious they are.

HIV treatment helps to reduce someone’s viral load. This means if more people are on treatment, fewer people will be infected.

For TasP to work, as many people as possible living with HIV would need to go onto treatment soon after diagnosis. At the moment, we use TasP to help prevent mother-to-babytransmission of HIV. If a pregnant woman who is living with HIV takes treatment during the last third of her pregnancy, has a Caesarean birth (if her viral load is high) and doesn’t breastfeed, the risk of the baby having HIV is less than 1 per cent. Studies across Africa have shown that effective HIV treatment can reduce HIV transmission.

Can TasP reduce the African epidemic?

If treatment was available to every HIV positive African on the continent, it is likely new infections would decline. TasP is particularly relevant to the African epidemic because: there is a lack of access to and use of condoms many women are not able to negotiate safer sex many Africans have a strong desire to have children. TasP means couples in serodiscordant relationships who want to have children

can more safely have unprotected sex, which could lead to a pregnancy. To really work, TasP will need to be used with what Hillary Clinton calls ‘combination prevention’ including safer sex, increased testing, preventing mother-to-baby transmission, male circumcision and reducing partner numbers.

Implications for UK-based Africans

TasP has particular benefits for African couples in monogamous, heterosexual relationships who: have HIV but prefer not to use condoms are in a serodiscordant relationship and want to minimise the risk to the negative partner are in a serodiscordant relationship where either partner is HIV positive, but the couple want to have a baby. Photograph by Annabel Vere

Viral load is the amount of HIV found in an infected person’s blood. If the viral load is high it makes it easier to pass HIV on to someone else.

Does TasP work?

For additional about Treatment as Prevention, please contact THT Direct on 0808 802 1221 or visit www.aidsmap.com or www.myhiv.org.uk

Winter 2012/13

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HIV treatment is now free for all, so there’s no better time to test

A new law allowing free HIV treatment for everyone diagnosed with HIV, regardless of their immigration status came into effect on 1 October. This gives everyone a fresh incentive to have an HIV test, knowing that if they are HIV positive they will receive free treatment.

HIV tests are available free at most sexual health clinics in NHS hospitals. To find out about a clinic near where you live, please call THT Direct on 0808 802 1221 or visit www.tht.org.uk/clinics

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Winter 2012/13

If you are an asylum seeker with outstanding treatment bills that you cannot pay, get help from your local HIV support agency to get them cancelled, otherwise they will still be enforced.

Photographs by Sam Scott Hunter

Starting treatment at the right time, with good adherence means helping keep the immune system as strong as possible, reducing viral load and giving people a strong chance of living a near-normal life span.


Are you newly diagnosed?

If you’ve just found out you’re HIV positive, Terrence Higgins Trust’s African Groupwork service can help. Our facilitators run a range of groups in a safe, supportive and friendly environment. All sessions are free. Being newly diagnosed can be an anxious time, but meeting other African men and women who are going through the same as you can make all the difference. Understanding more about HIV can help you to carry on with your normal life without fearing the future. We cover a wide range of topics including looking after your health, sex and relationships and growing older with HIV.

To find out more, please contact African Groupwork London on 020 7812 1719 or email: african.groupwork@tht.org.uk Funded by the Pan-London HIV Prevention Programme

Terrence Higgins Trust is a registered charity in England and Wales (reg no. 288527) and in Scotland (SC039986)


AFRICAN

ROUND-UP

Malian woman rises from housewife to bank manager

Within five years, Mariam Jaras Dirassoubafrom the Malian capital, Bamako, rose from being a housewife to bank manager – after joining a microcredit scheme that gave small business loans to women. Their business did so well that the women set up a co-operative bank of their own. Mariam was appointed head of the bank. Today she authorises loans of up to £620 to people who want to start a business. The loan scheme is supported by aid agency Oxfam.

Nigerian football star sets up record label

Senegalese farmers use waste to produce electricity

Farmers in Kalom, a village in eastern Senegal, are using agricultural waste to produce electricity. With a $245,000 (£152,500) grant from German companies, they built a 32 kilowatt generator that runs on groundnut shells, dried millet stalks and other farm waste. This produces biomass, which generates enough electricity to light up the village, including the local hospital. Villagers earn 125 CFA (15p) for each kilo of waste material that they deliver to the plant.

The healthier lifestyle magazine for Africans

Issue 8 - Winter 2012 editorial team Charles Kyazze Mary Lima John Owuor Joseph Ochieng

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The programme is being delivered by Terrence Higgins Trust in partnership with the following African organisations: Neovenator Community Organisation

Winter 2012/13

Gold sales generated $2.6 billion (£1.6 billion) for Sudan over the past 16 months but this could be dwarfed following the opening of the country’s first gold refinery in September. Situated at Al-Hila Al-Jadida, an outpost just north of the capital Khartoum, the refinery will produce 900 kilogrammes of gold per day. Earnings from gold should make up for the three-quarters shortfall in revenue resulting from the loss of oil money following the separation of South Sudan, where most of the oil fields lie.

Chelsea midfielder and Nigerian international player John Obi Mikel has launched his own record label, Matured Money Minds (MMM). The footballer has already signed popular artistes such as Charass, Kido, Edgar and Splash. While he is away playing in the English Premiership, his younger brother Patrick Obi will be looking after the music business.

magazine is funded by, and published as part of, the Pan-London HIV Prevention Partnership mass media programme aimed at promoting awareness of sexual health among Africans.

Sudan’s first gold refinery opens

South African slum dwellers get iShack

Stellenbosch University academics Andreas Keller and Mark Swilling have developed an eco-friendly prototype housing unit that is warmer in the winter and cooler in the summer. Called the iShack, the unit was constructed using straw, clay and roofing materials. It comes complete with a solar panel for lighting and charging mobile phones, and an outdoor alarm. The total cost is: $870 (£540).

The African Eye Trust Addington Afro Ethnic Health Promotion Group (AAEGRO) Congolese Family Centre Information in this magazine is correct at the time of going to press. For the latest information or updated version of this publication, visit www.mambo.org.uk

The people featured in this publication are models; unless otherwise stated, no association with any particular lifestyle or HIV status is implied. If you have any questions or comments about this resource, or would like information on the evidence used to produce it, please email feedback@tht.org.uk

www.facebook.com/ MamboLifestyle @MamboLifestyle

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Join the UK’s largest online HIV community

secure forums, counselling, CD4 Tracker, HIV dating and much more at

Terrence Higgins Trust is a registered charity in England and Wales (reg. no. 288527) and in Scotland (SC039986).


Funded by the Pan-London HIV Prevention Programme. Terrence Higgins Trust is a registered charity in England and Wales (reg. no. 288527) and in Scotland (SC039986).

Know what else you’re getting into bed with. Did either of you take risks before you met? Until you’ve both had an HIV test, use condoms. For tips on using condoms and where to get free ones go to mambo.org.uk


Mambo 9