World Aids Day is marked globally on December 1. This is a day that brings bad memories for many women living with HIV/Aids. For many it reminds them of the agony and pain they went through after contracting HIV at the hands of their unfaithful spouses or rape during the 1994 Genocide against the Tutsi. That is the story 36-year-old Daphrose Mushimiyimana relates to with deep pain.

She found out that despite being faithful to her husband, she was betrayed by him. In 2003, she tested HIV positive, eight years into her marriage. The news sounded like a death penalty. Her life was never to be the same. The only thing that crossed her mind was death. The mother of two and pregnant with her third child then, plunged into depression.

"I started living with my husband in 1995 but I got to know about my status after eight years of living with him. It was hard for me to believe and accept it, because I was confident about my fidelity to my husband. By that time, I had gone alone for testing so I had to break the shocking news to my husband. He was shocked and traumatised for some time but later, he also had to go for testing and the results came out positive too.

"I was still young and the thought of dying at such a tender age scared me. Worse, the thought of my husband’s betrayal on the other hand hurt me terribly. To make matters even worse, when I gave birth, my baby passed away and the only daughter I had tested HIV positive. All walls were closing in on me. My kids and husband were the only family I had since I lost everyone in the Genocide.I even wished I had also died in the Genocide because the pain was too much for me to bear,” Mushimiyimana sadly narrates.

Her story is not isolated. Many women living with HIV/Aids have gone through the same ordeal. But luckily for Mushimiyimana and many others, Imbuto Foundation came to their rescue. With the help of the foundation, Mushimiyimana, along with other women started an association for women living with HIV at the Kacyiru Police Hospital of which she is the president.

In 2001, Protection and Care of Families against HIV/AIDS (PACFA) was established – as a project under the Office of the First Lady - to mobilize resources desperately needed in the fight against HIV/AIDS. Through PACFA, Imbuto has given hope and renewed value to the lives of thousands of women traumatized by genocide and deliberately infected with HIV/Aids.

"With all the pain and confusion I faced, I had a deep feeling that other women with HIV were experiencing the same, and therefore something had to be done. Our association "Impore” has done a great job for us; we are given counseling and have got other skills like tailoring which help us to earn a decent living,” she continues.

Mushimiyimana encourages other women in a similar situation to seek early treatment so that even in the case of conception, innocent babies are spared the agony of contracting the deadly virus. Knowing that her daughter was HIV positive broke her heart and she wouldn’t wish any other woman to go through the same experience.

Her life has since turned for better. Mushimiyimana’s children are grown up and the unfortunate situation has amazingly brought her family much closer; including a blossoming relationship between her and her husband.

"I am thankful for all the opportunities I have had especially being a mother, and I’m particularly thankful to Imbuto Foundation and the antiretroviral therapy we are provided at the hospital.

With this, I believe we can end mother-to-child transmission of HIV and transform the lives of many Rwandans and the future of our country,” Mushimiyimana adds.

Sometimes mothers with HIV have to redefine the meaning of motherhood. They struggle to balance their health with the demands and needs of their families even while dealing with illness.

Statistics from the Ministry of Health show that on average, one person is infected with HIV every thirty minutes in the country and the current prevalence of HIV in the country among the adult population aged 15 to 19 remains at 3 percent.

Nathan Mugume, the head of division at Rwanda Health Communication Centre at Rwanda Biomedical Centre says that in order to curb the transmission of HIV, different strategies have been put in place such as the PMTCT (prevention of mother-to-child transmission), BCC- Education and Sensitization (behaviour change communication strategy) and also, there are campaigns encouraging abstinence, being faithful, condom use and male circumcision.

"We are trying to increase awareness on the burden of HIV pandemic and to sensitise people on the use of available HIV services and ensure that all HIV infected people are enrolled and linked to long term care and treatment services. The HIV prevalence rate is still 3 percent, the number of ARV sites is 490 and the PMTCT sites are 486. With this, we expect the risk of new infections and transmission of HIV to progressively reduce,” Mugume says.

In a recent interview with The New Times, the head of HIV division at Rwanda Biomedical Centre, Dr. Sabin Nsanzimana said: "The government intends to raise condom use by 13 per cent, decreasing the estimated new infections in children from 1,000 to less than 200 and increasing the fraction of male adult circumcision from 13 per cent to 66 per cent by 2018.”

Abstinence has always been one of the most effective ways to avoid HIV but as doctors and counselors advise, sticking to one sexual partner will also help a great deal in preventing and controlling the spread of HIV. In the unfortunate event that one contracts HIV, especially when it comes to pregnant women, early testing will save the baby’s life.

Women remain more vulnerable to HIV/Aids-research

A book edited by a Northwestern University School of Law professor draws upon research from a number of disciplines to offer a provocative look at why today poor black women are overrepresented globally in the HIV/AIDS epidemic.

"Sex Power & Taboo: Gender and HIV in the Caribbean and Beyond” pulls back the veil to show how gender and economic power imbalances play out in the bedroom and make women particularly vulnerable to the infection.

The problems of poor black women, like those of many women, often are compounded by the consequences of male dominance inside and outside the bedroom. "Even powerful women who wield a lot of influence in their professional lives report they sometimes have difficulty asking men to use a condom,” said Roberts.

And women’s experience of violence is a strong predictor of HIV infection. Research shows that fear of violence prevents women from refusing unwanted sex or discussing condom use with their partners, according to the book.

In the United States, nearly half of over one million Americans living with HIV are black. African- American women are 15 times more likely to be infected than white women.

The book critics most of the HIV researches which mostly aim at stopping risky behaviours, and studies dealing with gender tend to focus on how HIV/Aids is different for men and women, without exploring the underlying power imbalances and gender norms that perpetuate the epidemic, said Roberts, who also is a faculty fellow at Northwestern’s Institute for Policy Research (IPR).

"Gender inequities affect women in a number of ways, from engaging in sex for money to putting up with unfaithful husbands because they cannot afford to leave them,” she said.

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