Women, HIV & violence – Egypt
In the Middle East and North Africa (MENA) region, new HIV infections are on the rise.
This is in stark contrast to the global trend, which has seen an overall year-on-year reduction.
Although on paper Egypt still has one of the lowest prevalence rates in the world, HIV activists in the country, many whom are practically working undercover due to high levels of stigma, will tell you that the stats are “wildly underestimated” and how HIV in Egypt is “a disaster”.
Additionally, due to gender inequality and norms, women and girls are disproportionately affected.
Photography and stories for Frontline AIDS.
The ‘LEARN MENA’ project supported women living with HIV and experiencing violence, as evidence shows that one increases the risk of the other.
Except for staff, all names have been changed, and photos taken anonymously.
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High levels of HIV stigma means most people will conceal their HIV status, often even from close family.
The LEARN MENA project supported women living with HIV and experiencing violence, as evidence shows that the two issues interplay, and the women affected are very isolated.
The LEARN MENA project supported women living with HIV and experiencing violence, as evidence shows that the two issues interplay, and the women affected are very isolated.
Alexandria, Egypt. Close to the neighbourhood where MENA-Rosa's all-female leaders meet up. A partner in the LEARN MENA project.
A woman's role?
"I think squashing female thought and independence has become normal. If you raise a daughter saying she should not go out or have money, and that her brother has a say in anything she does, then she is not taught how to express herself, or defend herself," - Reda Shukry, founder of Al Shehab Foundation, partner in the LEARN MENA project.
"I think squashing female thought and independence has become normal. If you raise a daughter saying she should not go out or have money, and that her brother has a say in anything she does, then she is not taught how to express herself, or defend herself," - Reda Shukry, founder of Al Shehab Foundation, partner in the LEARN MENA project.
Cairo is a mega-city (a city with a population of 10 million or more).
The amount of people living with HIV is "wildly underestimated" according to activists, and many people die because they don't have access to ARVs - but the deaths aren't recorded as being HIV-related.
The amount of people living with HIV is "wildly underestimated" according to activists, and many people die because they don't have access to ARVs - but the deaths aren't recorded as being HIV-related.
“I walked the ring road at 2am to get to my baby,” says Amirah, 27.
"No-one would come with me. It was very dangerous at night, but there was no other way."
"No-one would come with me. It was very dangerous at night, but there was no other way."
Amirah had received a call from a doctor at the hospital who told her to "come now". She held her daughter for the last time.
Communication.
"The difference LEARN MENA has made is as simple as talking. When you have to keep everything in, not even tell your own mother, just meeting others in the same position is a huge relief. When I speak, I feel better - the silence has been broken.”
"The difference LEARN MENA has made is as simple as talking. When you have to keep everything in, not even tell your own mother, just meeting others in the same position is a huge relief. When I speak, I feel better - the silence has been broken.”
All the women interviewed had to ask permission to leave the house, either from their husband or their mother-in-law.
"I'm here, but you can't see me."
Shaimaa, 28, is an outreach researcher at the Al Shehab Foundation in Cairo.
"I work here because there is a lack of HIV awareness. If people know the facts they can protect themselves."
One woman asked if the cockroaches in her apartment could pass on the virus, indicating how hard it is to get hold of accurate information.
"I work here because there is a lack of HIV awareness. If people know the facts they can protect themselves."
One woman asked if the cockroaches in her apartment could pass on the virus, indicating how hard it is to get hold of accurate information.
Women's needs are supported as holistically as possible.
Choices around sexual and reproductive health and rights are often hindered when a woman is in a controlling relationship.
Choices around sexual and reproductive health and rights are often hindered when a woman is in a controlling relationship.
One of the neighbourhoods where the women meet in secret.
They don't know where each others homes are so everyone feels protected.
They don't know where each others homes are so everyone feels protected.
Nutrition becomes additionally important when taking HIV medication.
Many women tell how they have resorted to sex work to buy food for themselves and their children. Either because their husband had left them, or died, and they were not financially independent, or because after paying bills and buying drugs, food was at the bottom of the list.
Many women tell how they have resorted to sex work to buy food for themselves and their children. Either because their husband had left them, or died, and they were not financially independent, or because after paying bills and buying drugs, food was at the bottom of the list.
Accurate knowledge about HIV is hard to get hold of - as a result many people have treatment gaps or don't take treatment at all.
"I did my own research. It was small to start with, just 13 women who were selling sex, plus people who had connections with them, such as late night mini-markets, taxi drivers, and concierges. People were hard to find as not many people wanted to admit to selling sex. Now, the supermarket sends me sex workers!" - Reda Shukry, founder of the Al Shehab Foundation.
Reda saw a need in her neighbourhood and started to address it - the organisation grew from there.
While far from ideal, Reda shares how she is proud that her staff continue to work even when there is no funding.
The underestimated HIV data - and government denial - means Egypt has suffered from not having the real amount of investment needed.
While far from ideal, Reda shares how she is proud that her staff continue to work even when there is no funding.
The underestimated HIV data - and government denial - means Egypt has suffered from not having the real amount of investment needed.