REVIEW JOURNAL

Family Impact Analysis of Section 6 (Sexual Transmission) of the Kenya HIV and AIDS Prevention and Control Act No. 14 of 2006

(Dorothy Rombo • Jane Rose M. Njue, 2012)

1.      Aims:

To analyze the impact of Section 6 of The Kenya HIV and AIDS Prevention Act on Kenyan families and especially within marriage.

2.      Method:

a.    Examined the context of the development The Kenya HIV and AIDS Prevention and Control Act no. 14 of  2006

b.    Evaluated the potential impact of Section 6 of The Act on families using the six principles of  Family Impact Analysis (FIA) proposed by Bogenschneider (2006):

(1)   supports and encourages being responsible in marriage

(2)   strengthens marital commitment and stability

(3)   acknowledges interdependence of family members,

(4)   empowers and respects family autonomy in collaborating with service providers,

(5)   acknowledges and values diversity,

(6)   supports vulnerable families.

3.      Previous Studies:

1)      Any policy might have intended and unintended consequences as well as direct and indirect impact on families (Bogenschneider 2006; Zimmerman 1992) if subjected to appropriate evaluations to determine such potential or actual outcomes.

2)      during the Kikuyu ethnic community circumcision, the young initiates were secluded from the community by gender to receive instructions on adulthood expectations (Mbito and Malia 2009).

3)      Girls who got pregnant out of wedlock were relegated to marrying old men as a second, third or subsequent wife, a position that was not as prestigious as being a first wife (Ogola 1994).

4)      Their children were not socially accepted and were not accorded the full care and protection as were other children born within a marriage (Evans-Pritchard 1950; Nyambedha and Aagaard-Hansen 2003; Ocholla-Ayayo 1976).

5)      not many Kenyan parents talk with their children about sexuality (Mbugua 2007).

6)      The limited involvement of parents in sexuality education leaves an important gap. Research has shown that similar gaps characterized by lack of communication on sex matters exist within marriages (Miller et al. 2009).

7)      Many social problems, including the HIV epidemic, out of wedlock births, sexual exploitation and abuse of women and children as well as domestic violence have increased (Cohen and Atieno-Odhiambo 1989; Ngige et al. 2008).

8)      These changes have been associated with the changing dynamics of family functions which are often accounted for by other forces such as urbanization,

9)      migration, rapid population increase and lack of political goodwill to support policies that address social problem (Wilson and Hennon 2008).

10)  The governments of Kenya and other African countries have been faulted for failing to include HIV in its political agenda. Lorch (1993) cited several reasons for this failure by the Kenya government from the 1980s through the 1990s. First, the government was preoccupied with ensuring that it stayed in power at the expense of implementing social and economic developmental policies which would have addressed the increase in HIV. Second, the government feared that focusing on the rising prevalence of HIV in the country would interfere with tourism which is a great source of foreign exchange. Third, there was lack of knowledge regarding the identification of the HIV virus and lastly the government lacked financial resources to engage in research and intervention strategies to combat the spread and invest in HIV/AIDS education.

11)  The impacts of HIV infection are economic, social and psychological and have been reported in both quantitative and qualitative research. Barnett and Whiteside (2003) have detailed the timing and degree of impact caused by HIV infection from individuals, families, communities and the nation. Barnett and Whiteside (2003) have argued that HIV/AIDS infection has far reaching effects that even the most intensive and extensive evaluation designs cannot capture its totality. The authors observed that although the impact of HIV is felt at every level of the nation, the greatest impact is felt by the family unit.

12)  Research shows that women who delay marriage while engaging in unprotected

premarital sex significantly increase their risk of HIV infection (Bongaarts 2006; Rombo 2009). This could explain why Freeman and Glynn (2004) found that among discordant couples in Kenya, women are more likely to be the infected partner.

13)  AIDS patients do not get fair treatment especially in public health care system (Raviola et al. 2002).

14)  Partner disclosure by women with HIV has been associated with a fourfold increase in reported condom use to nearly 70% (Farquhar et al. 2004). A comprehensive review of studies on disclosure in sub Sahara Africa concluded that only the women whose relationships are strong were willing to risk disclosure (WHO 2004).

15)  The ratio of men to women who are infected is 1: 2. This ratio shows that more women are infected than men. The policy therefore has the potential to hurt the

vulnerable in the population, namely the women. Several authors have argued that married women find themselves in situations where they have little if any control (Esu-Williams 2000; Nyindo 2005; Patterson and London 2002).

4.      Differences With Another Studies:

Perbedaan dengan studi lainnya yaitu studi ini mencoba mengisi studi pengujian atas undang-undang atau peraturan pemerintah dan dampaknya. Penelitian ini menganalisa dampak dengan menggunkaan pendekatan FIA (Family Impact Analysis). Penelitian ini ingin menguji secara langsung dampak UU tersebut  bagi keluarga, karena tujuan undang-undang ini jelas, yaitu diperuntukan untuk masyarakat yang memiliki anggota keluarga terkena HIV, dan juga membahas mengenai tindakan preventif dan represifnya.

  

6.      Conclussion:

a.     HIV is highly stigmatized and therefore the HIV free partner might not stay committed to the relationship. The Act would serve discordant couples where one is positive and the other is negative if it were not for stigmatization and cultural gender expectations including economic gender divide that lead to negative outcomes for women living with HIV. On the other hand disclosure of HIV status to a partner and subsequently to other family members helps the individual achieve better quality of life through support. When family members are supportive the individual living with HIV might take precautions to avoid infecting others especially their partners.

b.      The Kenyan constitution recognizes customary, Islamic, Hindu and civil marriages. However, risks of HIV infection exist within these marriages as well as within remarriage and cohabitation. All these unions are sanctioned by the society and yet they are risky. When the norm is also the risk, the law has the challenge of isolating risky behavior from non risky behavior within such socio-cultural contexts. For example,

currently the law offers protection to women who are being forced to marry their late husband’s kin (also referred to as wife inheritance).

c.       The effectiveness of Section 6 partly depends on HIV testing. The Kenya National HIV/AIDS Strategic Plan is to test 2 million people annually. Although the number of  people testing for HIV have risen from 15% of  the adult  population in 2003 to 40.4% in

2008/09, among the infected many remain unaware. For example, in 2007 KAIS reported that 83% of  HIV positive adults ages 15 through 64 was unaware because they never tested, tested and did not receive results or once tested negative and assumed to have remained negative (Kenya Government 2009).

7.      Critical Review:

Kelemahan tulisan ini:

1)   Masih ada kata-kata “The question of who can access justice under this law still remains to be determined. It is likely that individuals of higher socio-economic status might be able to use the law” –menunjukan bahwa si penulis belum dapat menemukan jawaban atas permasalahan ini selain itu walaupun di jawab tetapi penulis kurang yakin atas jawaban dari pertanyaan tersebut dengan ada kata “likely” dan “might”.