Bikila Balis

Department of Midwifery, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Western Oromia, Ethiopia

Correspondence: Bikila Balis
School of Nursing, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
Tel +251 921788619
Email bik.balis2008@gmail.com

Background: Human immunodeficiency virus infection has been one of the top health-related challenges for the past four decades. Ethiopia is extremely infected by HIV pandemic every year, whereby 22,300 people were newly infected and 690,000 were living with HIV at the end of 2018. Sexual behavior of HIV positive individuals visiting treatment clinics is a neglected issue. Nonetheless, it has been a significant way of HIV transmission to serodiscordant partners.
Methods: A facility-based cross-sectional study design was used on a sample of 432 women attending treatment clinics in west Oromia from February 26 to March 26, 2019. Systematic sampling was used to select the study participants. A pretested and structured interviewer-administered questionnaires were used to collect the data. The data were coded, entered, cleaned and exported to SPSS version 20.0 for analysis. Descriptive statistics were used to present frequency distributions. Variables with P-value < 0.25 during bivariate analysis were entered into multiple logistic regression models to control for all possible confounders. Odds ratio along with 95% CI were estimated to measure the strength of the association. Level of statistical significance was declared at a p-value less than 0.05.
Results: Out of total respondents, 240 (56.9%), 95% CI: (52.1– 61.6%) were involved in risky sexual practices in the prior 12 months. Urban residence [AOR: 3.24, (95% CI: (1.52, 6.89)], those with no formal education [AOR: 2.77, (95% CI: (1.18, 6.54)], being on ART for > 2years [AOR: 2.74, (95% CI: (1.13, 6.65)] and CD4 count ≥ 200 cells/mm³ [AOR: 3.20, (95% CI: (1.50, 6.82)] were factors significantly associated with risky sexual practice.
Conclusion: A considerable number of respondents were involved in risky sexual practices 240 (56.9%) due to being rural residence, not attending formal education, being on ART for > 2 years and CD4 count ≥ 200 cells/mm³.

Keywords: women, HIV/AIDS, risky sexual practices, Oromia, Ethiopia

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On Feb. 7, the Black Resource Center at San Diego State commemorated National Black HIV/AIDS Awareness Day by hosting a lecture with activist and best selling author Marvelyn Brown.

Diagnosed with HIV at 19 years old, Brown spoke to SDSU students to promote her new book, “The Naked Truth: Young, Beautiful, and (HIV) Positive,” as well as to raise awareness on the importance of sexual awareness.

Brown said her experiences speaking at numerous events in the past have culminated into three main messages she spreads to her audiences regarding HIV.

“One would be to get tested,” Brown said. “I also tell people to be educated because (at that time), I still haven’t seen anyone who looked like me that had the virus … My last one is to be responsible.”

Africana Studies lecturer Dr. Bonnie Reddick helped coordinate the event with the Black Resource Center and said a prior speaking opportunity for one of her classes led to a chance to speak to a bigger audience outside the classroom.

“I was teaching a black women’s studies class and I saw her on MSNBC, so I emailed her,” Reddick said. “She hit me back up, emailed me and gave a talk to my students which was great. So I hit her back up and said, ‘I’ll pay the director of Black Resource Center, I’d really like to bring you back again,’ and she’s here.”

Brown said winning an award at the Ryan White National Youth Conference in the past, a national event on HIV care and treatment, helped give her nationwide exposure in spreading HIV awareness.

“Here at this conference there were over 1,000 youth from all over America who had HIV at this conference,” Brown said. “I was given an award at the conference for my courage. I had no idea that by putting the story in the paper I was doing what so many people are scared to do.”

Brown also said the experience gave her connections that allowed her to elevate her platform and activism to the next level.

“I remember there were people in the audience that completely changed my entire HIV activism career,” Brown said. “Before you know it I was traveling, doing TV shows and it was a whirlwind of experience.”

Students who attended the lecture said the informative lecture opened their eyes on the risks of contracting the disease, especially in a college campus.

Finance freshman Natalie O’Neal said the event enforced a difficult point to come across for younger generations.

“I feel like it was really informative and also needed because a lot of people in our generation don’t understand the risk (of contracting HIV),” O’Neal said. “I feel like having Marvelyn come talk to us showed us just how real it could be for us as it was for her.”

Biology freshman Amber Davis said the lecture gave her a new sense of awareness about contracting the disease.

“This is something that’s not really talked about and is taboo,” Davis said. “So having her debunk it for us is just really good to hear and to take that step to be educated.”

O’Neal said the most important lesson she gathered from the lecture is that communication is key, especially when it comes to sexual health.

She also said she is now more aware of who she trusts.

“A lot of us don’t really think that it could be people that you trust and love and care about so I feel like that was really important that she said that,” she said. “She brought up a very important question for us to ask in the future.”

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If you remember the 1980s, you will likely summon up the image of the Grim Reaper or a black tombstone when asked to think about AIDS. Those images, embedded in our collective memory by two iconic Australian and British public health campaigns of that decade, reveal how AIDS has been both a medical and a cultural epidemic since it was first clinically observed in the US in 1981. In the words of American scholar Paula Treichler, AIDS has always partly been an “epidemic of meanings”.

As we commemorate another World AIDS Day and remember all those who have died, we must remind ourselves of all that is still left to do to eradicate HIV. We must also remember the role culture plays in shaping our understanding of the virus and those living with it.

If we take into account the highly homophobic social context in which news of the condition first started circulating, then its cultural dimensions become all the more important. We must consider what AIDS meant to people in the 1980s and 1990s, and what HIV still means today, at a time when antiretroviral therapies are being used successfully to manage existing infections and prevent new ones.

Take, for instance, these 1987 public service announcements, produced in the US for the State Health Division of Oregon:

These videos highlight some of the key features of the publically-funded AIDS awareness campaigns of the 1980s and early 1990s. Even if we ignore the fact that governments only publicly acknowledged AIDS years after the first known patients (homosexual men) started dying, these and other films of the time are evidence of the impact a homophobic mainstream culture had on the ways AIDS was dealt with in public.

Despite the fact that homosexual men had been one of the demographics most affected by the condition, these campaigns still refused to address homosexuals directly and communicate clearly to them ways in which homosexual sex could be made safer. Instead, they preferred to deal in visual metaphors and allusions aimed at an abstract general public.

Marked by a fear, on the part of the Thatcher and Reagan governments, that speaking directly to homosexuals could be seen as endorsing “deviant” homosexual behaviour, the often moralistic – and publicly-funded – health campaigns released during the peak of the Western AIDS crisis ignored the specific realities of those most affected by the epidemic.

Not only that, but health campaigns and news stories often played with metaphors that were not only deeply sexist and homophobic, but also inspired by the language of warfare. They also mostly chose to endorse celibacy or monogamy rather than educate people about risk-management and safer sex.

A fatal price

In Oregon’s “Revolver” video, for example, promiscuity is posited as the ultimate cause of AIDS. Further, the penis is represented by a gun and the (infected) semen by killer bullets, associating HIV transmission, in most cases unintentional, with murder.

Or consider the image below. Published in the popular science magazine Discover, in December 1985, medical illustrations and considerations about human anatomy are used to portray the rectum as “vulnerable” and the vagina as “rugged … designated to withstand the trauma of intercourse”. As a result, the article concluded “AIDS … is now – and is likely to remain – largely the fatal price one can pay for anal intercourse.”

Even in the realm of art, the earliest representations of HIV and AIDS weren’t any less problematic. When, in 1988, American photographer Nicholas Nixon included portraits of men living with AIDS in his show Photographs of People at the Museum of Modern Art (MoMA) in New York, activists were quick to respond with anger.

In the photos, which led activist group ACT UP New York to protest against the show, emaciated bodies of sick men are portrayed in a way that could be seen as objectifying them. In one image included in the show, the subject – Donald Perham – is depicted as an “AIDS body”, deprived of individuality or agency, his whole existence violently reduced by the camera to the syndrome that would eventually kill him. The photograph tells us nothing about him apart from his name and the health condition that will eventually destroy him. He is portrayed as a living corpse.

A new visual vocabulary

Despite the many counter-narratives of HIV and AIDS that artists and activists have been producing since the 1980s, this mainstream visual imaginary still informs how we picture HIV today and sustains the stigma that remains associated with the virus. While many recent films and TV productions such as How To Survive a Plague (2012), Dallas Buyers Club (2013), The Normal Heart (2014), or 120 BPM (2017), have been revisiting the early years of the AIDS crisis and looking at it from afar, we need a new visual vocabulary to make sense of the virus today, at a time when treatment has made HIV a manageable and untransmittable condition.

Further, if AIDS became such a defining spectre haunting gay men during the 1980s and the early 1990s, we need to think about the ways in which gay masculinities and sexual practices are today being shaped and represented in the age of antiretroviral therapies.

That is, in part, the aim of my new research project, funded by a fellowship of the Arts and Humanities Research Council, which will look at contemporary representations of masculinity in “post-AIDS” gay pornography. The hope is that it will help us to understand the ways in which the AIDS crisis and its aftermath have impacted the lives, identities, and sexual practices of gay men, rather than just see it in terms of tombstones and grim reapers.

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Sexual harassment at workplace is a universal problem in the world whether it be a developed nation or a developing nation or an underdeveloped nation, atrocities and cruelties against women is common everywhere.

Protection of Women From Sexual Harassment At Workplace

Introduction-
Today’s world is accustomed to the term Sexual harassment. Sexual Harassment can be identified as a behavior. It can in general terms be defined as an unwelcome behavior of sexual nature. Sexual harassment at workplace is a universal problem in the world whether it be a developed nation or a developing nation or an underdeveloped nation, atrocities and cruelties against women is common everywhere. It is a problem giving negative effect on both men and women. It is seen to be happening more with women gender as they are considered to be the most vulnerable section of the society these days. Sexual harassment therefore is a serious problem in the workplace and it has become one of those issues that receive a lot of negative attention. 

What Is Sexual Harassment?

Sexual harassment has been identified as a term which is difficult to define as it involves a range of behaviors. Efforts have been made at both national and international levels to define this term effectively. often, the term is subjected to different interpretations. Some believe that it is better not to mingle with female colleagues so that one does not get embroiled in a sexual harassment complaint. The reality of sexual harassment incidents at the workplace is that there is more to worry about under-reporting, than people misusing the law.

In 1997, in the landmark judgment of Vishaka and others v. State of Rajasthan[1], the Supreme Court of India defined sexual harassment at the workplace, pronounced preventive, prohibitory and redress measures, and gave directives towards a legislative mandate to the guidelines proposed.

Sexual Harassment includes many things:
1. Actual or attempted rape or sexual assault.
2. Unwanted deliberate touching, leaning over, cornering or pinching.
3. Unwanted sexual teasing, jokes, remarks or questions.
4. Whistling at someone.
5. Kissing sounds, howling and smacking lips.
6. Touching an employee’s clothing, hair or body.
7. Touching or rubbing oneself sexually around another person.

Indian Constitution On Sexual Harassment-
Sexual harassment clearly violates the fundamental rights of a women to Equality under Article 14[2] and Article 15[3], her right to life under Article 21[4], and her right to practice any profession and carry on any occupation, trade or business[5], which includes a Right to safe environment free from sexual harassment.

In 2013, substantial changes were made in the way sexual harassment was viewed within the criminal justice system in India. The Criminal Law Amendment Act of 2013, which commenced on April 3, 2013, included Section 354A of the Indian Penal Code, 1860 that defined sexual harassment. The India Penal Code, 1860 has also defined the term sexual harassment and related offences and put forth punishments for the same:
· Section 354A- Sexual harassment is: unwelcome physical contact and advances, including unwanted and explicit sexual overtures, a demand or request for sexual favors, showing someone sexual images (pornography) without their consent, and making unwelcome sexual remarks
Punishment: Up to three years in prison, and a fine.

· Section 354B- Forcing a woman to undress.

Punishment: From three to seven years in prison, and a fine.

· Section 354C- Watching or capturing images of a woman without her consent (voyeurism). 
Punishment: First conviction – one to three years in prison and a fine. More than conviction–three to seven years in prison and a fine.

· Section 354D- Following a woman and contacting her or trying to contact her despite her saying she does not want contact. Monitoring a woman using the internet or any other form of electronic communication (stalking).

Punishment: First conviction – up to three years in prison and a fine. More than one conviction–up to five years in prison and a fine.

The same definition is given in the law enacted specifically for Sexual Harassment of Women at Workplace (Prevention Prohibition and Redressal) Act 2013.

Pre- Vishaka Scenario-
Before the Vishaka guidelines came into picture, the women had to take matter of Sexual Harassment at Workplace through lodging a complaint under Sec 354 and 509 of IPC.

Sexual Harassment as we know has become a global problem which is a kind of violence against women. International community has recognized in their International treaties and documents, the protection from Sexual Harassment as a human rights of women. All the legal instruments dealing with this matter have been laid down to protect life and liberty and these instruments have been used as a means to curb and address this issue.

In India until the Vishaka’s judgment was given out, there was no law to govern this matter and the guidelines which came as an outcome of this case were derived from the Convention on the Elimination of all forms of Discrimination Against Women (CEDAW). TheIndian Constitution had grounded provisions in the form of fundamental rights. 

Vishaka And Others V. State of Rajasthan-
In the case of Vishaka and Ors v. State of Rajasthan and Ors[6], the Hon’ble Supreme Court has laid down guidelines and norms to be observed to prevent sexual harassment of working women.

Preventive Steps-
All employers or persons in charge of work place whether in public or private sector should take appropriate steps to prevent sexual harassment. Without chauvinism to the generality of this obligation they should take the following measures:

a. Express prohibition of sexual harassment at the work place should be notified, published and circulated in appropriate ways.

b. The rules of government and public sector bodies relating to conduct and discipline should include rules prohibiting sexual harassment and provide for adequate and appropriate penalties against the offender.

c. As regards private employers, steps should be taken to include the aforesaid prohibitions in the standing orders under the Industrial Employment (standing orders) Act, 1946.

d. Appropriate work conditions should be provided in respect of work, leisure, health and hygiene to further ensure that there is no hostile environment towards women at work places and no employee woman should have reasonable grounds to believe that she is disadvantaged in connection with her employment.

Criminal Proceedings-
Where such conduct amounts to an offence under the IPC or under any other law, the employer shall initiate appropriate action in accordance with law by making complaint with the appropriate authority. In particular, it should ensure that victims or witnesses are not victimized or discriminated against while dealing with complaints of sexual harassment.

Disciplinary Action-
Where such conduct amounts to misconduct in employment as defined by the relevant service rules, appropriate disciplinary action should be initiated by the employer in accordance with those rules.

Complain Mechanism-
Whether or not such conduct constitutes an offence under law or a breach of the service rules, and appropriate complaint mechanism should be created in the employer’s organization for redress of the complaint made by the victim.

Such complaint mechanism should ensure time bound treatment of complaints.

Internal Complaints Committee-
The complaint mechanism should be adequate to provide a complaints committee, a special counselor or other support service, including the maintenance of confidentiality.

The complaints committee should be headed by a woman and not less than half of its member should be women. Further, to prevent the possibility of any undue pressure or influence from senior levels, such complaints committee should involve a third party, either NGO or other body who is familiar with the issue of sexual harassment.

The complaint committee must make an annual report to the government department concerned of the complaints and action taken by them.
The employers and person in charge will also report on the compliance with the aforesaid guidelines including on the reports of the complaints committee to the government department.

Worker’s Initiative-
Employees should be allowed to raise issues of sexual harassment at a workers’ meeting and in other suitable forum and it should be affirmatively discussed in employer-employee meetings.

Awareness-
Awareness of the rights of female employees in this regard should be created in particular by prominently notifying the guidelines (and appropriate legislation when enacted on the subject) in a suitable manner.

Third Party Harassment-
Where sexual harassment occurs as a result of an act or omission by any third party or outsider, the employer and person in charge will take all steps necessary and reasonable to assist the affected person in terms of support and preventive action.
The central/state governments are requested to consider adopting suitable measures including legislation to ensure that the guidelines laid down by this order are also observed by the employers in private sector.
These guidelines will not prejudice any rights available under the protection of human rights act, 1993.

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