For women, power is an absolute dimension of physical health, says Dr. Nancy Padian, Director of Research at the AIDS Research Institute at the University of California at San Francisco (UCSF). Padian, an expert on the heterosexual transmission of AIDS, has been conducting research in Harare, Zimbabwe for the past seven years in an attempt to help Zimbabwean health workers find new solutions to the massive AIDS epidemic in southern Africa. The United Nations High Commission for Human Rights estimates that, by 2005, more people in sub-Saharan Africa will have died from AIDS than all the people killed in both World Wars combined. Through UCSF and the University of Zimbabwe, Padian conducts research on the effects of contraception in preventing HIV in Zimbabwean women, and has worked to build women’s negotiating skills to overcome cultural barriers to condom use.
Condoms have been the primary methods of AIDS prevention in Africa, and the Alan Guttmacher Institute (AGI) reports that consistent condom use is as much as 87% effective in preventing the heterosexual transmission of HIV. Access to condoms and other methods of STD prevention is poor in Africa, although numerous studies and programs have been conducted in an effort to improve both access to and use of condoms in the region. Padian’s studies focused on a group of women who regularly visited two family planning clinics in Harare, 30-40% of whom are infected with HIV. In one study, Padian and her group of researchers worked with uninfected women to convince their male partners to use condoms by teaching the women negotiating strategies and finding culturally appropriate ways to overcome cultural obstacles to condom use. Over half of these women were able to convince their partners to use condoms. A 1998 study published in AGI’s Family Planning Perspectives argued that gender inequity in sub-Saharan Africa was too acute to make programs like Padian’s effective, and showed that condom use among men was higher among those who were better educated and who had improved access to condoms.