Gender, Family, and HIV/AIDS in Lesotho

This research document examines how patterns of marriage and family formation in contemporary Lesotho intersect with high levels of HIV infection in young women. It examines recent changes in marriage practices, family relations, and gender systems and their implications for women’s individual risk and social vulnerability within the context of HIV/AIDS. Specifically, it considers whether and how the organisation of gender and family life - with a focus on marriage, childbearing, and motherhood - can inform understandings of HIV risk and vulnerability more broadly in Lesotho where, in 2008, HIV prevalence was 23%.

The context for changes in marriage practices is the migration of young people for extended periods for the purpose of employment, resulting in later marriage and an extended period of premarital sexual activity, during which young people may engage in a greater number of sexual partnerships, with more frequent partner change.

The paper draws on qualitative data collected in 2004 from the Lesotho Children’s Project, which studied children who were less than 15 years old. This paper draws from 74 in-depth interviews with urban and rural children’s caregivers to yield insight into the normative context of marriage, as well as emerging changes and challenges to established beliefs and values regarding that institution, within family and gender systems.

The authors found that marriage is the institution most closely linked to perpetuation of the gendered social order - to reproducing the patrilineal family structure: "And most women - old and young - found the centrality of marriage to family organisation important." Migration of men remains common within families and, with a loosening of migration restrictions in South Africa and the possibility of more frequent visits home, expectations have changed. Some men abandon families; some women migrate for employment; men with partners outside of their families may bring infection exposure risks back as they return home. Unplanned pregnancies, particularly outside of marriage, frequently leave young women and their families with full responsibility for child-rearing in the absence of a father. If a woman marries subsequent to bearing a child outside of marriage, she is not expected to bring previous children to the new marriage; thus, her parents become their caregivers. "In this context, motherhood becomes a social rather than strictly biological role, with the social role of the mother related to marriage and status."

Marriage and motherhood are linked in that those women who are not married are expected to leave parenting to married female relatives. "Whether a woman becomes a mother to a specific child is related not only to the biological act of having a child, but also to the mother’s characteristics, including age, marital status, availability of material resources, and her overall suitability, including her own marital and household situation....While the biological mother remains single, she is often the one sent out to work - this is partly because she is younger and has more skills, but also because the responsibility of caring for ‘her’ child takes on a different meaning."

When the role of a non-married mother becomes one of financial support for those "mothering" her biological child, there can be an associated rise in the risk of HIV. "The rise of social motherhood has implications for young women’s HIV risks;... young women labor migrants may be especially vulnerable to risk of HIV infection." The study concludes that: "The qualitative data from this study provide a detailed illustration of the inner workings of marital and family formation processes, and of women’s daily lives within the family and household context. These patterns of continuity and change provide insight into the ways that demographic patterns particular to Lesotho serve to increase young women’s HIV risks. These marital, family and household dynamics suggest an integrated framework of social vulnerability and individual risk through which gender and HIV/AIDS intersect."

[Editor's note: According to one of the authors, this is an early, formative version of a longer paper under development. It also appeared as a poster presentation at the Population Association of America Annual Meeting in April 2010 in Dallas, Texas, United States.]