July 28, 2008


After a while in Itipini, some things just come to seem so commonplace and everyday I forgot that perhaps I should write about them and share them with a broader audience.

One such example is the deep-seated reluctance many young people have to getting tested for HIV, even though there are numerous advertisements and campaigns to make sure every South African knows his or her status. Objectively, there’s a number of benefits to knowing if you’re positive, the prime one being that you can get regular CD4 tests and eventually go on anti-retroviral treatment when you qualify. Hopefully, it will also change your sexual behaviour to prevent further transmission. And if you’re negative, hopefully you’ll breath a sigh of relief and be more cautious in the future.

As I’ve been in Itipini longer and gotten to know many people quite well, I’ve become more comfortable in conversations about these sorts of issues. The idea of talking with someone about sex makes my safe-church-trained self recoil, particularly if those people are high-school students who are coming to me expecting an English class and not sex ed. But I also want to be able to talk about what is the most pressing issue facing their generation. Gradually, and with no overriding plan or strategy, I’ve managed to have several very good conversations about HIV and the importance of being tested. I haven’t yet addressed the topic corporately with my English class but in some ways the individual approach might be more effective and certainly makes me feel more comfortable.

I have yet to succeed in getting anyone to have a test and each time the prime objection is the same - “ndinoyika” - I am afraid. Despite all the efforts at education, they would still rather not know than know. I patiently try to explain the benefits of knowing your status but so far it has not changed anyone’s mind, though there are signs that some people’s resistance is breaking down (after months and months!). It’s frustrating to me that the high school students are regular about coming to the clinic for their every 12-week birth control injections - obviously, they’re putting themselves at risk - but won’t take a few extra minutes to get tested. The three students who were mothers were likely tested when they give birth and so are negative but that was 18-months ago in the most recent case. A couple of them still breast feed, which means if they’ve been infected since giving birth they could be transmitting the virus to their healthy children.

After the “I am afraid” answer, a common second reason given by young women I’ve spoken with for not getting tested is that they only have one partner. This is heartening that they understand that being faithful to a partner is important to prevent HIV transmission but it doesn’t guarantee anything if their partner is unfaithful to them.

I’m not suggesting that I talk about this all the time or even that I seek out conversations about this. But when it comes up, I don’t always let it pass by anymore and do my best within the limits of our common vocabulary to stress the importance of testing. It is a long and uphill slog.

And to think that a primary message of the Gospel is “be not afraid.”