The healthier lifestyle magazine for Africans
Issue 3 – Winter 2009
FREE
Breaking the taboo Interview with Sheikh Bashir
Staying healthy Positive
Living
ALSO
The best of African cuisine
WIN
this digital camera!
Mambo Winter 2009
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Dear Reader,
Recently as I was flicking through the television channels, I stumbled across a current affairs programme on OBE, a Sky channel popular with Africans in the UK. I caught only the tail end of the programme, but in it, a group of Africans in Ireland were hotly debating the issue of divorce among Africans in the Diaspora. Most speakers remarked that too many marriages were breaking up, and that living in the West had something to do with it. Britain has one of the highest divorce rates in the world, but for a long time, the common view among us Africans has been that this is a problem for ‘white Britain’. Not any more, it would seem. Breaking up has become an African problem, too. For every marriage that breaks up, there is pain, disappointment, hurt feelings, a sense of loss, and anger, too. In this issue, ‘Senga’ (Auntie) Daisy Byaruhanga shares her views about divorce and the causes of divorce. She wants readers to understand that, apart from the pain and changed circumstances, splitting up can have serious sexual health implications for the partners involved. Also in this issue, Pamela Kaseke-Mushore writes about her role in setting up Fountain of Life, a support group for African people affected by HIV; Gus Cairns says lack of knowledge about how HIV is passed on can lead to unnecessary fear and stigma. And, as usual, we have a brand new digital camera to give away to one lucky reader (see page 9).
The healthier lifestyle magazine for Africans Issue 3 - Winter 2009 Mambo editorial team Daisy Byaruhanga Charles Kyazze Mary Lima Toju Cline-Cole Fola Rogers-Saliu John Owuor Marc Thompson Joseph Ochieng African communities mass media programme advisory group Dr Charles Mazhude Dr Edwin Mapara Maurice Cunningham Daisy Byaruhanga Anna Aguma Charles Kyazze Marie Tameze Asher Emetananjo MAMBO magazine is funded by, and published as part of, the Pan-London mass media programme aimed at promoting awareness of sexual health among Africans. The programme is being delivered by Terrence Higgins Trust in partnership with the following African organisations: Neovenator Community Organisation
Enjoy your copy!
The African Eye Trust Addington Afro Ethnic Health Promotion Group (AAEGRO)
Joseph Ochieng Editor
From 27 January, THT will be running a new three month City & Guilds course in understanding HIV and AIDS. The distance learning course is structured into three units, with two face-to-face study days held in central Manchester and 20 hours of study time for each unit. To sign up for the course or to get further information visit www.cityandguilds.com/ healthandsocialcare or contact Justin Barrett on 020 7812 1727.
Bantu Welfare Trust Future Builders
Free health promotion skills training
This is a course for people who want a career in the sexual health sector or are looking to update their health promotion skills. For more information please email ikenna.obianwa@tht.org.uk, or visit www.mambo.org.uk
Organisational development training
A free service that helps African organisations to build their capacity and management skills. For more information, please email samuel.cunningham@tht.org.uk or visit www.mambo.org.uk
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 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 Distribution of Mambo outside London has been supported by an unrestricted grant from Bristol-Myers Squibb. © Terrence Higgins Trust, November 2009. Code: 00975.00 Registered office: 314-320 Gray’s Inn 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.
For a long time, the common view among health promoters has been that African Muslims are a ‘hard to reach’ community - so hard-to-reach that not much sexual health work has been done with them. In this article, Sheikh Mohamed Bashir explains the reasons why very little has happened with the African Muslim communities in the UK, and offers tips on addressing the situation.
Is this the dawn of sexual health education in the Muslim community?
Breaking the taboo A combination of strong attachment to culture, long-held attitudes and lack of knowledge has meant Muslims have been less willing to engage in the discussion of sexual health and HIV. However, we should recognise that resistance to sexual health messages is not limited to Muslims; other faiths and cultures have, at one time or another, also resisted open discussion of sex and sex education. Certainly, many in our community still put up barriers against sex education. There are strongly-held views about, for example, family planning and the use of contraceptives; but such views are equally an issue for many other cultural or religious groups. The Muslim community in the UK is very diverse, so how each of the different sub-groups responds to particular sexual health initiative differs. My personal view is that the perception of ‘hard to reach’ is being fuelled by a combination of several factors. Key among these factors are: •A suspicion by community leaders that sexual health education will promote promiscuity amongst believers; • T he consequence of projects being planned and delivered without input from community leaders or Muslim religious leaders; • l ack of consultation and involvement of community members, including women and young people; • P eople in the community having the feeling that they are always being ‘talked down to, or looked down upon’; •A failure by stakeholders to deal with sensitive cultural, religious or social issues with due care and understanding.
Many Muslim scholars, including myself, have for some time been engaged in the process of creating a pathway for sexual health work with the Muslim community. A key initiative in which I have recently been involved is the Muslim Faith Tool Kit. The first of its kind, the Muslim Tool Kit is designed to equip Imams and Muslim community leaders with the knowledge and skills they need to engage in advocacy, raising awareness of HIV & AIDS and reducing HIV-related stigma and discrimination within their community or congregation. Consisting of a resource manual, activities booklet, leaflet, model poster, a USB storage device, model certificates and other goodies, the toolkit is a useful resource for not only faith leaders but also health promotion professionals and other people who work with Muslim faith communities. The Tool Kit was developed in collaboration with the African HIV Policy Network as part of the National HIV Prevention Programme (NAHIP) for African communities. Distribution will target Muslim religious leaders throughout London and the rest of England. For more information about the Muslim Faith Tool Kit, please contact African HIV Policy Network (AHPN) on 020 7017 8910.
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Jack Lakana-Loum, Tooting Bec
THE
VOX-POP
Increasingly, faith groups are becoming key partners in the efforts to raise awareness of sexual health and HIV amongst African communities in the UK. However, whilst considerable progress has been made with the Christians, not enough work has been done with Muslim communities, and this has resulted in missed opportunities and continued exposure to avoidable risks. Mambo asked readers to say what they think can be done to take the sexual health message to Muslims. Here are a selection of views:
I think people in the Muslim communities should join hands with the other communities who are already deeply involved in sexual health work. More specifically, Muslim religious leaders can benefit from joint work with other faith leaders, for example through inter-faith forums. Secondly, it would be useful to have ‘champions’ who are trained to deliver sexual health work in the community. Young people can be very effective in this respect.
The first thing needed is an understanding of the community’s views about sex education; it is also important to know what the barriers to sexual health services are. Once these issues are fully understood, it should be a matter of going down to the community and making people more aware of the sexual health risks they face, and of the advantages of regular sexual health screening.
Mary Olubumni, Camberwell
As a faith-based health promoter, I’d say we need to give our Muslim brothers and sisters the message that sexual health is everybody’s priority, and that being a Muslim does not offer protection against a sexually transmitted infection. Once they understand the risks, people in the community will want to know more about sexual health.
I think health workers from the Muslim community need to start going into the mosques to talk to Imams and other Muslim leaders. Once they have understood the importance of sexual health, they will take the message to the congregation. Perhaps we should start by working with Muslim youths. We know that young people are more open to new ideas; they could then go and talk to the elders, Imams and sheikhs.
Dear Auntie Fola,
Ingredients
I attended a workshop where somebody said it is possible for someone to have unprotected sex with a positive person – and not get infected. How’s this possible? I always thought you get the virus the moment you don’t use a condom when having sex with a positive person. Mghanga, Dalston
What kind of sex The kind of unprotected sex you have can make a big difference. For example, oral sex is less risky than vaginal sex, which is less risky than anal sex. Man or a woman. It’s easier for women to get infected (although millions of African men have also been infected). If a man has HIV his semen (with the virus in it) is left inside the woman’s vagina for a long time, giving HIV more chance to enter her bloodstream. If a woman has HIV it’s harder for her body fluids (e.g., vaginal fluid or blood) to get into the man’s body through his penis. Damage during sex Friction during sex can cause small cuts inside the vagina or on the skin of the penis. The damage can be too small for you to see it but it allows HIV to pass from one body to another. The amount of HIV inside the body. People recently infected have a very high level of HIV in their body, making it easier for them to pass on HIV. If a positive person is taking HIV medicines, that usually means less HIV in their body, so they are less likely to infect others.
Harvey Leacock, Hackney The way sexual health work is delivered to the Muslim communities matters. It’s crucial that any work targeting the community is sensitive to established custom and beliefs. People in the community respect their religious l eaders, so working with these leaders is a good way to begin. The important thing is for the community to understand the disadvantage of not getting tested. Also, like for the other religious groups, stigma and discrimination are barriers to HIV services, so messages targeting the community should also aim at addressing these two issues.
Steak
Dear Mghanga,
John Owuor, Huddersfield
Sandra Mtudza, Stratford
The best of African cuisine
Auntie Fola
HIV isn’t passed on EVERY time unprotected sex happens but it could be passed on ANY time it happens. The risk depends on the following:
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Ejaculation The risk of a man infecting someone is greater if he ejaculates inside them. If he pulls out before he ejaculates, the risk is lower (although infection could still happen). Other illnesses If an HIV negative person has an illness (e.g. a sexually transmitted infection, TB or malaria) then their immune system is under attack already, so is less able to protect them from getting HIV. If an HIV positive person has another illness, this weakens their immune system even more, leading to higher levels of HIV in their body. This makes it easier for them to pass on HIV. Circumcision Studies have shown that circumcised men are less likely to get HIV. Removing the foreskin – which can be easily damaged during sex – makes the tip of the penis tougher and harder for HIV to get through. But if a circumcised man has HIV this does NOT make him less likely to infect a woman. All of the things I’ve mentioned above may reduce the risk of HIV infection but none are guaranteed to protect you or your partner. Condoms are the best protection against HIV (and other sexually transmitted infections). If you’d like to talk in confidence to someone about how HIV is passed on you can call the African AIDS Helpline on 0800 0967500 or THT Direct on 0845 1221 200.
Auntie Fola can help you to find a solution to your problem. Have you got a health or lifestyle issue that you feel strongly about? Why not share your views with other Mambo readers? Email your name and contact details to joseph.ochieng@tht.org.uk
Please write to her at: MAMBO magazine, Terrence Higgins Trust 314-320 Gray’s Inn Road, London WC1X 8DP.
Sentiments expressed in ‘Your Shout’ columns do not necessarily reflect the views and/or policies of Terrence Higgins Trust or its partners.
Your letter should state the nature of the problem, your name and the area you live in.
Method:
10ml olive oil
1. Lightly brown the chopped onion in heated oil in a pot;
300g cubed steak
2. Add the steak, stiring gently around the bottom of the pot;
1 medium onion, coarsely chopped S alt and freshly ground pepper (if preferred)
3. Sprinkle the salt, curry powder and (if preferred) pepper; 4. Transfer to a casserole dish;
Half a teaspoon of thyme
5. Pour on the hot stock, cover and place in the oven for 40 minutes;
125ml spiced beef stock
6. Add the thyme;
1tbsp beef stock mix
7. Leave to cook on medium heat for another 10 minutes;
1 tbsp of mild (or hot, if prefered) curry powder If you prefer your meats with wine, we suggest: Shiraz, Cabernet or your favourite red.
8. Serve. Suggested accompaniment: Parsley, lemon and baby onion couscous. Optional extra: Green vegetable such as broccoli or green beans.
Potatoes Ingredients 4 medium sized potatoes cut into 1inch chunks 2 tbsp olive oil 2 tbsp chopped fresh rosemary 1/2 tsp garlic, minced Salt and pepper to taste
Method 1. Cook the potatoes in slightly salted boiling water for about 10 minutes, or until tender. Remove and leave to cool for a few minutes; 2. Next mix, in a small bowl, the remaining ingredients – olive oil, rosemary, garlic, salt and pepper. Brush the potatoes with the mixture; 3. Place the potatoes on a tray and put in the oven, gently turning occasionally to ensure an even bake. Cook until the potatoes are browned; 4. Serve with the steak.
Recipe courtesy of Exceline Catering Services 175 Mare Street, London E8 3RH. Tel: 020 8525 9222.
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Notes on well-being
In Manchester...
How to stay healthy Like a lot of risks in life, if you don’t know the facts about HIV transmission, it’s easy to panic about unlikely risks and yet ignore real ones. There are so many people whose lack of knowledge about how HIV is passed on makes them worry unnecessarily about getting infected. Take the following example of this lady, who says:
HIV transmission is mainly about what you do rather than who you do it with. The reason some acts are safe and others are not depends on how much HIV is in people’s body fluids (quantity); whether it’s infectious (quality); and whether it has a way in to your body (route).
Quantity
There has to be enough of the virus to establish an infection. This means very small amounts of the infectious body fluids (blood, sperm, vaginal and rectal secretions, breast milk) won’t be enough.
“ I kissed this guy I met at a club By Durani Rapozo Services Adviser, George House Trust
I know just how hard it is for African men to talk openly about issues such as living with HIV – I am myself an African man. However, our way of thinking is changing all the time and, increasingly, African men are realising that there are benefits in talking about issues that af fect their sexual health. In the UK cities with big African communities, such as London, Birmingham and Manchester, men are forming self-help groups which provide a useful platform for sharing information and experience. The atmosphere helps members to gain the motivation and self-confidence to discuss issues concerning their sexual health.
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Why it’s good to talk: That African men are now more willing to talk about HIV is due to several factors. These include: • A gradual reduction in the fear and stigma linked to HIV; • Greater awareness of the benefits of modern HIV treatment; • Better understanding and knowledge of HIV, including how it is transmitted; • Lessons learnt from African women, who have been more involved in HIV work; • Encouragement from a growing number of male role models; • Results of the work of African and other voluntary organisations. In Manchester, we at George House Trust have recently launched a support group for African men who are living with HIV, and contrary to earlier fears, participation has been great: at the most recent support meeting which took place on 8th September, 12 men turned up. The men evaluated the outcomes of the ‘Getting to know each other’ event that was held earlier in the year at the African Space.
They also talked about issues that affect them in their day-to-day life, such as: • HIV and Sex • Sexual dysfunction • HIV and Sexual Health • Sperm washing • Dealing with relationship problems. Members of the self-help group say the ‘Getting to know each other’ series of meetings give them the opportunity and space to raise and discuss issues that affect them, and that they also learn from each other’s experiences. They also say the meetings are helping to break the taboo subject of HIV, which is key to tackling the problem of stigma. Other benefits reported by group members include increased confidence to talk about HIV and sex issues with their HIV doctor, GPs and support organisations. We have developed an information pack, based on topics raised at the ‘Getting to know each other’ meetings, which should be most helpful to African men. The information packs can be obtained by calling the telephone number given below.
For more information about our African Men’s Group, please call me on 0161 2744499 or email durani@ght.org.uk or Daniel at daniel@ght.org.uk. The following agencies provide useful sexual health services for Africans living in the Midwest of England: Black Health Agency 0161 2325386 CAFPH 0158 2726061 Terrence Higgins Trust Sandwell 0121 5800645 Birmingham 0121 6946440 Wolverhampton 0190 2711818 Shropshire 0195 2221414 Other useful services for African men: Organisation of Positive African Men (OPAM) 020 7923 4744 HIV Health Support contact NAM on 020 7840 0050 Fountain of Life Support Group contact CAN 0750 145 9543 Ealing, Hammersmith and Fulham HIV Service Users Forum 020 8749 9814
– I mean, like, for an hour, we were really into each other – and then I found he had HIV! I’m sure I have got the virus, now.”
Not if all you did was kiss. You simply can’t catch HIV that way. Lack of knowledge about transmission can also make some people do things that put them at risk. Another example: “I had sex without a condom with this girl but she’s really fit and only 18. I knew just by looking at her she was clean?” - Most people with HIV are healthy, and they look healthy, too: You can’t rely on appearances only.
It also means that people who have recently been infected with HIV themselves and have a lot of virus in their fluids are very infectious, and people who have been on successful HIV treatment for over six months may hardly be infectious at all.
Quality
In general, HIV is a fragile virus that can’t survive for long outside the body. That’s why you can’t get it from, for example, breathing it in like flu. HIV can be found in saliva, but there are substances in saliva that weaken it and stop infection, which is why you can’t get HIV through kissing and only very rarefy through oral sex.
Route
The usual advice is that you can’t get HIV through broken skin, but in my experience people then start worrying about invisible cuts. In fact HIV can only get into the body at certain points: • t he lining of the vagina; • t he lining of the rectum; • t he lining or the urethra (tube you pee through) and in uncircumcised men the inside of the foreskin; • f or a baby, via breast milk – babies have not yet developed the defences against infection by mouth that adults have. This is why in a country like the UK which has clean water, women with HIV should bottle-feed their baby. The reason HIV can only enter at these points is because HIV is a very lazy virus and these are the only parts of the body where special cells exist which actively carry it into the body. The only other way is via a direct injection such as a blood transfusion (in countries where blood is not screened), or by sharing needles.
Comparing the risks
It’s very difficult to estimate exactly how risky particular sex acts are because so many factors come into play. Some types of sex are more risky than others.
By Gus Cairns, Editor, HIV Treatment Update, NAM
For example, most studies have shown that: • f emale-to-male transmission happens about half as often as male-to-female transmission; •U sed correctly, the condom can reduce the risk of HIV infection by 90%; •O ral sex is a lot safer than vaginal sex without the use of condoms. However we also know that: • I f either partner has a sexually transmitted infection, the risk of HIV infection can be much higher; • S omeone who has just been infected (in the previous six weeks or so) is much more likely to pass HIV on to their partner than someone infected a long time ago; •A partner with a HIV-related illness is also more infectious, if they’re not on effective HIV treatment, than someone who does not have an STI or is receiving antiretroviral treatment; Useful services for people living with or affected by HIV: HIV Health Support contact NAM on 020 7840 0050 Fountain of Life Support Group contact CAN on 0750 1459543 Ealing, Hammersmith and Fulham HIV Service Users Forum contact 020 8749 9814 Organisation of Positive African Men (OPAM) 020 7923 4744
Rules of thumb
So if you want to reduce the risk of getting HIV:
1 Use a condom
4 The more different partners you (or your 3 If you’re HIV negative, partner) have, the higher get tested regularly and your risk of getting HIV avoid taking risks or another sexually 3 Get regular sexual health transmitted infection. checkups and get any infections treated
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What exactly is happening to us? Could the days when marriage was ‘for better or for worse’ – be drawing to an end? What has happened to the “We don’t do divorce. We are Africans!” slogan? What is it that puts African couples’ relationships under strain from the time they arrive in the UK? A number of reasons are probablyto blame.
New culture, new lifestyle:
It used to be that when African couples married, they stayed married ‘for life’. But that is no longer true of Africans in the UK. Nowadays, we are seeing more and more marriages and relationships break up. In this article, ‘Senga’ (Auntie) Daisy Byaruhanga asks what it is that is causing tension between African couples in the UK.
As an opinion leader and a health promoter of several years experience, I have noted with some concern the rising rate of divorce and relationship crisis among African couples in the UK in recent years. At the risk of setting off a controversial debate, I have decided to share my thoughts more widely with fellow Africans because I believe the consequences of divorce go much deeper than the emotional upset and changes in living arrangements. Nowadays, breaking up has serious social, economic as well as health consequences for the parties concerned. If children are involved, they are affected as well. I say this from personal experience, having myself gone through divorce (and I never thought I would!).
There are lots of things to admire when one first lands in the UK, but also lots of things to shock – such as a woman driving a bus; men doing the cooking; men doing the ironing or washing up! However, before long, Africans become absorbed into the system. Gradually, the woman starts to do things she never dreamt of doing back in Africa. She realises she has got rights, and if employed or on welfare benefits, she starts having control over her money. The man realises that he can no longer dictate how things are run in the home. Unless employed, he also realises he has little, if any, financial power. From being the breadwinner, when in Africa, he now has to depend on the wife. And, to add insult to injury, he is expected to do household chores such as cooking, ironing, washing up or walking kids to school – all taboo, as far as he is concerned! All these factors are putting a lot of our men under pressure. They feel it is a challenge to their pre-dominant position in the household. Some seek comfort in alcohol, others try to reassert authority by threatening violence. Often, this doesn’t work, and the atmosphere at home soon becomes very unpleasant. The UK welfare state system has been blamed – unfairly, in my view - for contributing to the rise in divorce rates. Admittedly, the system does appear to do more for women than for men. Often, it is the woman who receives the housing support, child tax credit and other child care allowances. The weekly cash can add up to a fair amount. Unless he is working, the man usually has to make do with the £40 or so in job seekers’ allowance. The problem is, few of them do.
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Even when in a paid job, the man finds himself under pressure. The hours are long and hard, the wages low. By the time he returns home, he is probably too tired, in a bad mood, and not ready for any quality time with wife or children.
Sexual health checklist:
Other factors that commonly cause a breakdown of a marriage include:
• Finding out about your new partner’s HIV and sexual health status; • Checking with the new partner about using the condom during sex until a HIV test has been taken; • Finding a good and convincing response in the event your partner demands sex without a condom (i.e. unprotected sex); • Getting some condoms yourselves, just in case your partner doesn’t keep any.
Relate www.relate.org.uk
There are real benefits in knowing your partner’s HIV status well before any unprotected sexual contact. The benefits include:
www.fmassoc.co.uk 0117 946 7062
• Pressure or interference from friends or family members; • Long periods of separation due to immigration restrictions; • A woman’s inability to give birth to children; • Cheating (unfaithfulness) • Domestic violence; • Negligence; • An HIV positive diagnosis of one or both partners. Based on what I have seen from my work as a health promoter, when a couple split up, the following things usually happen: • There is a feeling of guilt for breaking the cultural taboo around divorce; • Some ex-partners are immediately made homeless, destitute and without essentials such as cooking utensils, clothing etc…; • They go through emotionally and psychologically difficult times; • Some ex-partners are left with complex Immigration issues to deal with. Many people who are just coming out of a divorce tend to jump into a new relationship. This could be for a number of reasons, such as: • Revenge for getting divorced, or ‘rejected’, by the ex-partner; • To escape the loneliness, insecurity and the financial difficulties caused by the split; • To find comfort and a shoulder to cry on; • To get a place to stay in.
Sexual health issues The period following a break-up is, for many people, not the best time for worrying about sexual health. Yet, it is often a time when the risk of acquiring an STI from a new partner is greatest. The need to have a new relationship can be so strong that an ex-divorcee will not pay enough attention to the question of whether their new partner might be carrying an STI.
If you have recently split from your partner and are into a new relationship, these are some of things you need to think about in order to protect your sexual health.
• You will cut the risk of getting HIV or another serious STI; • You will show to the partner that you care about your (and their) sexual health; • You will have the peace of mind of knowing your partner’s HIV and sexual health status; • Both of you will be in a better position to discuss about trying for a baby.
HIV disclosure issues As mentioned above, an HIV positive diagnosis is often the cause of a marriage breakdown. This is more likely if the diagnosis was in only one partner. Not surprisingly, many people choose not to inform their partner about a positive test result. There are real advantages in letting your partner know about your HIV test result, whether it was positive or negative. These advantages include: • You may get understanding and support from the partner; • The partner can also get tested so they know their HIV status; • Both of you will be more understanding about the need to practise safer sex until the other partner is also tested; • Both of you will be able to make informed decisions about the future, such as whether to have children or not.
Help is available There are many organisations in London and the rest of the UK that offer good advice, help and support to couples who are having problems maintaining their relationship. They include: 0300 100 1234
Parentline Plus
www.parentlineplus.org.uk 0808 800 2222
British Association for Sexual and Relationship Therapy www.basrt.org.uk 020 85432707
Marriage Care
www.marriagecare.org.uk 0845 660 6000
Family Mediators Association
Innovative Visions Organisation (IVO) 020 8365 0349 South London African Women’s Association (SLAWO) 020 8648 1808
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THE
HIV prevention methods
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SURVEY
Fill in this short questionnaire and you could be the proud owner of
On 1st December, the world will be united in marking World AIDS Day in memory of the millions of people who have died of AIDS. With its theme of ‘Universal Access and Human Rights’, World AIDS Day 2009 also reminds us of the need to stop the epidemic from spreading further. In this article, Toju Cline-Cole writes about the search for microbicides, products which, along with vaccines, could one day hold the key to preventing HIV in high risk populations.
Of the 33 million people living with HIV in 2007, women accounted for half. Given such high levels of infections, the search for effective ways to prevent HIV, such as vaccines and microbicides, must be a priority alongside efforts to make HIV treatment available to everyone affected. Currently, the condom is the only product widely used to prevent HIV being passed on during sex. However, many people in poor regions of the world cannot afford to buy them. Also, the use of a condom is dependent on the sex partner. Some men may object to it for a number of reasons. The main advantage of a microbicide is that it can be inserted by the female partner without the male partner knowing about it.
What is a microbicide?
A microbicide is any substance that can substantially reduce the risk of acquiring or transmitting sexually transmitted infections, including HIV, when it is applied in the vagina or rectum. No proven microbicide exists on the market yet, but scientists are hard at work to develop one. A microbicide would most likely be formulated as a vaginal gel, cream, foam, or ring. Candidate microbicides have so far failed to be effective in preventing HIV infection. The largest clinical trial to date was the Carraguard Phase 3 trial conducted between 2004 and 2007. As many as 6,202 women in South Africa participated in the trial, which concluded that the product was safe and acceptable to women, but did not reduce the risk of acquiring HIV. Despite this setback, researchers remain optimistic that an effective microbicide will be found. They are now looking into ways of including antiretroviral drugs in the making of microbicides, to see if that can make the final product strong enough to kill off the virus during sex.
Why microbicides would be useful to African women:
* Once properly developed and marketed, it could be cheaper than the condom;
* The woman can use it without the prior knowledge or consent of the male partner;
* Some types of microbicides might be effective against HIV and yet allow a woman to become pregnant. The above factors are among the reasons why a group of UK-based Africans have joined the global campaign for microbicides. Part of the UK Campaign for Microbicides, the group recently presented a poster to the 5th International AIDS Society (IAS) conference in Durban, South Africa which took place last July. The poster was judged to be of such high quality that it was given an award for distinction based on merit and innovation. Titled ‘Experiences of the Buzz Cafés in Microbicides Advocacy’, the poster describes the functions of ‘Buzz Cafes’, as spaces where members of the UK Campaign for Microbicides meet to discuss and develop their scientific and social research knowledge and skills in an informal and relaxed atmosphere.
At the Buzz Cafes, invited speakers inform and help to build the capacity of Group’s members to talk about HIV prevention-related issues and the implications for microbicides advocacy. In order to ensure that they share what they learn with other advocates in both the developed and developing regions of the world, the discussions are posted on the website of the Global Campaign for Microbicides www.global-campaign.org/ UKAfricanWG.htm. If you want to learn more about microbicides, please visit: www.global-campaign.org www.ahpn.org
this digital camera! All returned questionnaires will be entered into a draw, and one lucky reader will win the prize. The deadline for returning your questionnaire is 15th February 2010.
As a result of reading Mambo magazine:
Strongly Agree Agree
Yes Strongly & No Disagree Disagree
I now know more about sexual health than I did before I can now protect my sexual health better I am now more aware of the advantages of regular HIV testing I now know where to go for a sexual health service I am now more likely to seek to know my HIV status I feel strongly about the need to use a condom if and when I have sex with someone whose HIV status I don’t know I now realise how much stigma affects people who have HIV Thank you. Now please write your contact details here: Name: Address:
Suleyman ader Suzi re o b m a M ly one proud of Maryleb e il b her mo shows off ey er her surv phone aft ed k ire was pic questionna rabs e. Up for g ffl ra a m o fr
e: a 10MP in this issu era. digital cam
Email: Age:
Male
Female
I got my copy of Mambo from: GOOD LUCK! Now put your form in an envelope and mail to: The Editor, Mambo magazine; Terrence Higgins Trust, 314-320 Gray’s Inn Road, London WC1X 8DP. Alternatively, you can fax your form to 020 7812 1799
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What you need to know Swine flu (H1N1) can affect anyone. It may lead to medical complications, or sometimes death, even in people with no underlying health problems. There is no evidence that people with HIV are more likely to catch swine flu. However, it may be more likely to result in medical complications for people with weakened immune systems.
PositiveLiving
Mambo Winter 2009
If you have not been diagnosed HIV positive:
If you have been diagnosed HIV positive:
Some people have HIV without knowing it. People who have been infected with HIV but have not been diagnosed may have a weakened immune system.
People with diagnosed HIV will be eligible to receive vaccinations against swine flu from their GP. The vaccination programme is expected to start in October and will be available from GP clinics.
If you have never been tested for HIV, or if you have taken any sexual risks since your last HIV negative test result, now is a good time to test. To find your nearest clinic, please phone the African AIDS Helpline (freephone) on 0800 0967 500, THT Direct on 0845 12 21 200, or visit www.tht.org.uk/GUM If you are diagnosed HIV positive, HIV treatment can boost your immune system so that you will be less vulnerable to complications arising from swine flu. Also, you will be eligible for early vaccination against swine flu.
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The days following a positive HIV test can be one of the most difficult periods in a person’s life. All the stress, fears and worries over personal health can really destroy the spirit. But one person who refused to give up hope is Pamela Kaseke-Mushore, founder of the Compassion Acceptance Need which runs Fountain of Life, a support group for people living with or affected by HIV. In this article, she talks about life after her positive diagnosis, as well as her ambition to find help to balance faith and HIV, not just for herself but also for others in a similar situation.
Primary Care Trusts (PCTs) will be organising the delivery of local swine flu vaccination programmes. You may wish to contact your local PCT to check if there are alternative NHS sites that can provide vaccinations for those with HIV, if you do not wish to disclose your HIV positive status to your GP. If you have not already done so, it is recommended that you register with a GP.
My dream to start a faith-based support group for people living with HIV came to me shortly after my own diagnosis in the April of 2004. As a born-again Christian, I had desperately needed an organisation which could provide support to me in the sort of Christian way that I wanted. However, when I looked around, I could find none.
If you are on treatment for HIV, your clinic may advise you to stock up on medication in case their service is disrupted.
In those days, I had to deal with a lot of issues – my health, my career plans, my relationships, my immigration status, the fears and the concerns around my being HIV positive etc…. I was desperate for somebody to talk to, somebody who not only understood the predicament I was in, but could also lend me spiritual comfort.
Amid the emotions that followed the diagnosis, I wondered how I was going to tell my friends and relatives. Fortunately, through prayers, I found the courage to inform my loved ones about my status. My fellow church members were very understanding; it was partly through their support and encouragement that I was able to come to terms with living with HIV. With my confidence restored, I then asked myself, if faith helped me to accept and live with my diagnosis, surely it can do the same for my friends and other people with the infection? So it was that, with the help of a few friends, I started Compassionate Acceptance Need, or CAN. Right from the start, we intended CAN to be a faith-based group driven by the need to nourish and give health to people living with HIV.
God’s love knows no limits! Please keep this notice and share this information with your family and friends. For more information, call the swine flu information line on 0800 1 513 513, or visit www.mambo.org.uk or www.direct.gov.uk/swineflu
In 2008, ‘Fountain of life’ (FOL) was launched as a support arm of CAN. It was intended to work for the following: • The need for understanding of people who have HIV; • The need for HIV positive people to share and learn from each other’s experience of HIV; • An opportunity to find out about HIV and sexual health services; • An opportunity to access health promotion skills; • Having a break and a time for socialising. Key services provided by FOL include: • Monthly support group meetings; • Workshops on aspects of HIV treatment and care;
• Excursions to holiday destinations in the UK; • Picnics; • Referrals to specialist sexual health services. FOL’s main priority is to give members the opportunity to enjoy the same fun they used to have before they were diagnosed with HIV. We want them to know that having HIV does not necessarily signal the end of everything. They can, and should still enjoy life to the full. Apart from having a good time, members are also encouraged to make the best use of available HIV information, including news about HIV treatment and related care services.
Occasionally, we provide details about local services such as counselling, peer support and emotional support. Members who need deeper spiritual guidance can be quickly linked to faith groups such as London Ecumenical AIDS Trust (LEAT) and CARA Trust. One of the biggest challenges that HIV positive Africans face is stigma, whether from other people, or internalised stigma (the fear that other people will stigmatised you for having HIV). Coming together at the FOL support group has really helped us to deal with the fear of stigma. There is comfort in knowing that having HIV does not turn someone into different human species; that we are normal people.
People with HIV who would like to join Fountain of Life support group can contact Pamela on 07501459543. Other useful services for people living with HIV: He Intends Victory 07940 031439 London Ecumenical AIDS Trust 020 77012200 African Advocacy Foundation 020 7738 7238 Organisation of Positive African Men 020 7923 4744 THT African emotional support 020 7812 1777 THT refugee mentoring 020 7812 1715 CARA Trust 020 7243 6147
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Mambo Winter 2009
know4sure FOCUS ON COMMUNITY HIV TESTING
Whenever Paula Muzirikani was approached by an outreach worker and asked about taking an HIV test, she would say: “I’ll take it when I get the time” but she kept postponing the visit to the clinic - until one day she fell seriously ill and had to be admitted at Charing Cross Hospital. A serious fever and sore throat left her bed-ridden for four days. On the fifth day, she felt well enough to phone the outreach worker. “I wish I’d taken your advice and visited the clinic. I’m calling from the hospital; I have been badly off for a few days and, guess what, I’ve taken the test from here. I’m positive!” Paula’s experience is not uncommon among the African community. An estimated three out of every 10 Africans with HIV do not know they have the infection because they have not been tested. Also, four out of every ten Africans with HIV get tested late - often after they have fallen ill. Getting more Africans to test for HIV has become a priority for health planners. In west London, the African Communities Project (ACP) of NHS Hammersmith and Fulham has been running an HIV testing programme targeting African and African Caribbean communities. Called ‘Know 4 Sure’, the programme involves a team of outreach workers who go out into the community to engage individuals in discussions about sexual health and HIV. The discussions are structured in such a way as to encourage people to go for an HIV test at a local clinic. The outreach workers operate at various locations across the borough of Hammersmith and Fulham, as well as in neighbouring areas. Clients are given not just basic information about HIV and other common sexually transmitted infections, but they also get advice on where they can go for tests.
The outreach workers offer to accompany a client to the clinic, should this be necessary. Often, having an outreach worker around helps give the client the confidence and motivation to go through with the test procedure. Feedback from the outreach workers suggests that people from the African community still have many issues with HIV testing. These include: Not knowing where they can go for tests; being afraid they might be seen going into the clinic; worries about confidentiality, and fears about not being able to cope should the result turn out to be positive. Although clients have the option of visiting a clinic of their choice, Know 4 Sure has specially designated testing centres at White City and at the Naz Project in Westminster. The service is run every Thursday and Friday of the week. According to Stella Oryang, a Health Improvement Manager at ACP, Know 4 Sure is helping to improve access to HIV testing by Africans in west London. In the 12 months to April 2009, a total of 192 clients were referred to the White City clinic; this is more than double the 72 people who visited between June 2007, when the project was launched, and March 2008. “We expect more people to seek testing now that we have increased the number of outreach workers,” she said.
Why you should test for HIV? There are real benefits in knowing your HIV status, whether you are infected or not. The benefits include:
If you are negative:
• You will have a stronger reason to remain free of the virus; • It might help you to decide whether to have a baby; • You will better plan for your future and that of any dependants; • If your partner is also negative, you may not need to use condoms every time you have sex.
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Mambo Winter 2009
Phone company enriching communities
One of Africa’s biggest phone companies, MTN is showing just how big international companies can become a development partner in areas where they operate. The company has funded several projects in health, education and income generation throughout Nigeria, one of their fast-growing markets. Their latest projects have benefited Rivers State; they include a 300KVA power transformer donated to the Orogbum community, a modern town hall building for Eligbolo community, water boreholes for Rumuolumeni and Borokiri communities, and a scholarship scheme that has benefited 69 students from the state. An official of MTN, Wale Goodluck, said: “These projects are our contribution to boosting grassroots development and another way of enriching the lives of our community dwellers.”
For more information about Know 4 Sure project, please call ACP on 020 8749 9814. For information about other HIV services in West London, please contact:
West London Centre for Sexual Health: text ‘WLC appt’ to 0778 6201816
African AIDS Helpline 0800 0967500
THT Lighthouse West London 020 7229 1258
THT Direct
0845 1221 200.
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AFRICAN
ROUND-UP
‘Pleasure hospital’ opens in Burkina Faso
Kenyan students get in gear for success
Victims of female genital mutilation (also known as ‘female circumcision’) are looking forward to the opening of ‘Pleasure Hospital’, West Africa’s first clinic for reconstructing clitorises damaged as a result of the ritual. Called ‘Pleasure Hospital’ the clinic is being built with a US$ 50,000 grant donated by US non-profit agency Clitoraid. It will offer free surgery to circumcised girls and women in West Africa, a region where FGM is widely practised. Demand for the service is so high that Clitoraid has placed a limit on the waiting list at 100.
Two university students have invented a new and cheaper means of charging mobile phones, in what could put an end to the need for electricity. Pascal Katana and Jeremiah Murimi collected old electronic equipment from a dump site – including radios, TV sets and computers – and then built them into a charger that is connected to a bicycle. Peddling the cycle charges the mobile phone. The final year electrical and IT students of the University of Nairobi said plans were underway to put their gadget on the mass market.
Ugandan boarding schools to protect daughters
If you are positive:
• Finding out that you have HIV will give you the opportunity to discuss about treatment and support services with your doctor; • With proper treatment, an adult aged 35 can now expect to live well into the 70s; • You will be able to make better plans for you and your family; • If you want to have a baby, you can discuss with your doctor what precautions to take in order to cut the risk of passing HIV on to the baby; • Information about your test result will not be given to your GP or any other person without your knowledge and permission (although a court may ask your doctor to reveal the information if required); • Nowadays, HIV tests take much less time than before; results can come out within an hour, meaning you won’t have to spend a long time at the clinic.
Mambo Winter 2009
A group of parliamentarians has come up with a solution to the problem of parents taking their daughters to secret locations so they can get circumcised. In a report submitted to the education minister, the MPs asked the government to build boarding schools within practising communities to accommodate girls who are at risk of female genital mutilation during the school vacation. The girls can stay at these safe havens until it is time to report to their respective schools. That way, they can stay out of the reach of the knife.
To Breastfeed, or not to Breastfeed? That has always been the dilemma for HIV-infected mothers. It is well known that HIV can be passed on to the baby during pregnancy, at birth or through breastfeeding. The typical advice given to HIV positive mothers has always been to not breastfeed their baby, in order to cut the risk of passing the virus on through breast milk. Now, researchers in Botswana say breastfeeding may not be as risky as widely thought – as long as it is done ‘exclusively’ (that is, breastfeeding only, without also using formula milk). Recently, the World Health Organisation (WHO) said the benefits of breastfeeding in developing countries have made them change their thinking about the breast milk of HIV positive mothers.
$210 million loan for farmers
Farmers have been told they can pledge their crops in exchange for loans from a government fund. The US$210 million had been set up for farmers who want to buy agricultural materials such as fertilisers, seeds and farming implements. However, not all farmers have benefited because they cannot provide the guarantee needed for the loan (such as a house, tractors or trucks). Now, the government has said farmers can deliver their crops to collecting depots, and then take receipts to the local commercial bank to get the loan. Zimbabwe has experienced severe food shortages in recent years; it is widely expected that greater access to the loan scheme will lead to increased production.
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Mambo Mambo Winter Autumn2009 2009
MamboAutumn Winter 2009 2009 Mambo
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