The Relation between HIV Prevalence and Virgin Rape

In this commentary, Ms Smith treats a theme that cannot but conjure utter abhorrence in any of us: the rape of young children, so-called virgin rape, which, sadly, appears to be increasing in countries with high HIV/AIDS prevalence.

By: Charlene Smith, journalist, documentary film maker and author, South Africa.

Rape is the most silent of four letter words. Few use it easily. The notion of the sexual violation of an indidivual is repulsive. Human rights organizations say that rape is akin to torture. And yet, there is a curious inertia around combating the scourge of ‘virgin’ rape that accompanies high HIV prevalence, and lack of access to treatment, in some countries with high HIV infection.
Many countries in Africa, India and the Caribbean are reporting the phenomenon of the rape of babies—some only a few days old—and the rape of very small children and very elderly women, in the belief, by those that rape, that sex with such females, or small boys, will rid them of HIV. Superstition in many cultures, and religions, including Westernised religions, has it that vaginal lubrications are ‘dirty’ and probably disease carrying.

UNAIDS reported in December 2002 that the highest incidence of HIV worldwide was in women—55 percent, with 58 percent of those infected in Africa being female. The USA Centers for Disease Control has noted that the highest incidence of HIV infection in the USA—68 percent of those infected— is among African-American women.

HIV is the flagbearer, the early warning system of human rights abuses in any culture. Whether it is alerting the world to homophobia or sexual violence, it goes the most vulnerable, the most vilified and the most silent in any culture and washes across them—until action is taken. But even though the World Health Organisation and UNAIDS, jointly reiterated in March 2003 that sexual violence is a primary causative agent in HIV transmission (a woman or child whose right to say “no” to forced sex or rape is ignored), pathetically little is being done to combat virgin rape. Shame and horror at what is happening to very small children seem to immobilize action to stop it. Too many say, “how can such terrible things happen”, too few are examining how to stop it from happening and implementing solutions.

Between October and December last year, Gauteng, the smallest and most populous province of South Africa, reported a 30 percent increase in rape, most of it child rape. South Africa, according to Interpol, has the highest incidence of rape in the world—with a rape every 26 seconds—and the most violent rape. Testimony to South African parliamentary hearings into baby rape in March 2002 presented estimates that half a million children are sexually abused each year. Childline, a counselling and welfare service for children, estimates that one in four girl children, and one in five boys have been sexually molested by the age of 16.

The virgin cleansing myth
There are many reasons for the rape of small children, and it is important to bear in mind that it is not a new phenomenon. One reason is linked to a myth in Africa, parts of India and the Caribbean that if an HIV-infected person rapes a virgin, he can rid himself of the virus. The myth is similar to one that prevailed in 19th century England where some believed that sex with a virgin could cure a man of venereal disease. Leclerc Madlala notes that, “according to the virgin cleansing myth (in southern Africa), a man can ‘cleanse’ his blood of HIV/AIDS through intercourse with a virgin, sexual intercourse with a virgin is thought to provide inoculation against future HIV infection.” The vaginal passage is seen as being ‘sealed off’ by the intact hymen (which) is viewed as a barrier that prevents HIV from getting into the girl’s womb and thus her ‘blood’. But too, “the vagina of a pre-pubescent girl is not associated with the vaginal lubrications of the adult woman (which are considered dirty) and is conceptualised as ‘clean’, ‘dry’, ‘uncontaminated’. Being a dry surface, it is believed that ‘dirt’ (HIV) cannot easily attach itself.”

She says, “myths exist to explain the unexplainable. They give meaning to realities that are beyond control. They provide an alternative way of knowing. In times of desperation myths (and the behaviours they inform) are more likely to come to the fore as people frantically search for answers, meanings, and solutions. When faced with a protracted and painful death through AIDS (and no accessible modern treatment as an alternative) is it surprising what some people would be willing to try as a possible cure? Childline reports a 400 percent increase in child rape in the past decade and a half. In KwaZulu Natal there is hardly a community that is not discussing child rape and the idea that one can secure an AIDS cure through virgin sex.”

A failure by the South African government to extend universal access to basic HIV treatment—simple medications to counteract opportunistic infections—coupled with the world’s highest HIV infection rates and a culture of violence has not helped.

The case of Baby Tshepang
The South African Law Commission estimates that 1.6 million women and children, in this nation of 43 million, are raped each year. In 1998, the Department of Justice said 54,000 rapes were reported, perpetrators were arrested in seven percent of the cases, but less than one percent went to jail. Along the way case files get ‘lost’, sold, or rape survivors withdraw charges.
Anele Mda (24 years old) of an HIV activist group called Creative Young Women in the Indian Ocean resort town of Port St Johns says, “men are sleeping with babies aged from two to five. They say they will be cured of HIV/AIDS. They rape grannies too because they say an old woman who has not had sex for ten or 20 years is like a virgin.” Sylvia Mdluli of the National Peace Accord, a group that tries to end the reasons for conflict in southern KwaZulu Natal, an Indian Ocean province of South Africa, says boys and girls are sodomised “because men say the children will remain virgins longer and can be used again”.

At the Red Cross Children’s hospital in Cape Town, nine years of research presented in December 2001 showed that three-year-olds are more likely to be raped than any other age group. And yet, there is a curious inertia about effectively grappling with virgin rape.

It was the rape of a nine-month-old baby, known as Baby Tshepang, in November 2001 that awoke South Africans to the problem. In March 2002 police arrested 23-year-old David Potse, a former boyfriend of Tshepang’s mother. On the day he was arrested Tshepang was undergoing her seventh reconstructive procedure at the Red Cross Children’s Hospital in Cape Town. During court testimony it was revealed that his commonlaw wife, Lya Booysen, watched while he raped the infant. He received a life sentence.

Lack of forensic knowledge
A twenty-minute drive from the Red Cross Children’s hospital are the South African police forensic laboratories. In an office filled with ferns and certificates, senior superintendent Petra Hennop, head of the biology section that tests for DNA leans over new crime kits. Although the new crime kits into which medical officers put forensic material from rape survivors are among the best in the world, the Forensics Department has no budget to train people so very few have been trained since they were issued in October 2001.

And in 1999, Minister of Health, Manto Tshabalala Msimang began closing down district surgeon’s offices, where forensic tests after rape are carried out, as a cost cutting exercise. Now most forensic examinations—in this crime ridden nation—are carried out by doctors who may, or may not, have undergone an optional 50 minute forensics training during their seven years of medical studies in a South African university. A lack of forensic knowledge leads to violent crime often going unpunished.
Last year the Delft laboratories received 12,000 blood and semen samples for DNA testing, more than half were for rape. The Pretoria police forensic laboratories received three times this figure. Petra Hennop observes that, “with babies and little children, or women brutally raped, there is so much blood that it can overwhelm the DNA”.

Physical consequences of child rape
At the Red Cross Children’s Hospital in Cape Town, Dr Sebastian van As who heads the trauma unit, says that long term physical consequences of sexual assaults in small children include dysuria (pain when urine is passed which leads to them becoming frightened to urinate), temporary urinary incontinence (urine leaks out), perineal infection (an abscess or wound of the perineum that resists healing) and ecopresis (when they are unable to keep the stool in). In the rape of infants the perineum gets ripped and the vagina and anus become a single wound. “If the rupture extends into the abdomen the children develop peritonitis and die within a day. These children have scar tissue that will ensure they will never have a completely normal sex life.”

The South African government promised in April 2002 to “immediately” provide post-exposure prophylaxis after rape to prevent HIV, this has failed to materialize in all but a dozen hospitals. Dr Ames Dhai of the Nelson Mandela School of Medicine says those raped in South Africa have a 40 percent risk of being infected with HIV.

South Africa’s Medical Research Council reported in August 2000 that, “the belief that having sex with a virgin can cleanse a man of HIV has wide currency in sub-Saharan Africa. In sexual health promotion workshops in South Africa a third of participants indicated that they believed this.” A survey early in 2002 among Daimler Benz automobile workers in Pretoria by the University of South Africa, found that 18 percent believed the virgin myth.
Six times more girl children are HIV-infected in Africa than boys according to UNICEF.

Koketso Rantona, who heads Botswana’s department of Women Affairs, notes that “when a child is raised she is told it is OK for a girl to have sex with her uncle; girl children are not raised to know ‘bad touches’. Traditionally sex with young girls was sanctioned through arranged marriages of young women. This tradition has changed but the perception that it is nice for an older man to have sex with a young girl hasn' t.”

Selected topical literature
An Evil so Vile. Documentary for the BBC, screened June 2002 and before South African parliamentary committee September, 2002. Produced by Clifford Bestall and Pearly Joubert.

van As A.B. et al, ‘Child rape-patterns of injury, management and outcome’. In South African Medical Journal, December 2001.

Jewkes R. et al, Stepping Stones: feedback from the field.

Leclerc Madlala, Suzanne, ‘The Mythogeny of Virgin Rape’. In African Journal on HIV/AIDS, September 2002.

McGreal, Chris, ‘Aids myth drives South African baby rape crisis’. In The Guardian, Nov 3, 2001.

Pitcher, Graeme and Bowley, Douglas, ‘Infant rape in SA’. In The Lancet, vol. 359, 26 January 2002.

Smith, Charlene, Proud of Me: Speaking Out Against Sexual Violence and HIV. Penguin, 2001.

South African Law Commission. Fourth interim report: aspects of the law relating to AIDS. Compulsory HIV testing of persons arrested in sexual offence cases.

South African Police Services

Wolff, Owen, ‘Here be Monsters‘. In The Big Issue, February 2002, issue 55, vol. 6. South African-based website on sexual violence and HIV.