Ending HIV stigma in Ghana and beyond
Ghanaian activist Akosua Agyepong. (Courtesy of XX)
Activist Akosua Agyepong explains how she is working to change the social norms that prevent girls from exercising their sexual and reproductive health and rights.
Being informed about sex, consent and sexual health should be an essential part of growing up. But around the world, conversations about these topics still take place in hushed tones. “Where I come from, you don’t talk about sexual and reproductive health,” says 25-year-old sexual health activist Akosua Agyepong, who grew up in Ghana. “You only know about what your biology teacher tells you, which is that your sexual organs are supposed to be ‘useful’ and that anybody who goes to have sex is a ‘bad girl.’”
Misinformation about sexual and reproductive health and rights can seriously impede girls’ ability to protect themselves against disease and abuse. In sub-Saharan Africa alone, approximately 4,500 girls and young women contract HIV every week and girls are twice as likely to contract HIV as boys. “The sheer lack of knowledge around sexual and reproductive health is devastating for girls,” explains Akosua. “You have people who don’t get to make choices. They just fall into circumstances and don’t know what they are going into.”
After her close friend tested positive for HIV, she became passionate about raising awareness about sexual and reproductive health and rights in her country and beyond. As a volunteer with the Youth Action Movement, Akosua led door-to-door campaigns on her college campus and in communities across Ghana aimed at changing social norms that prevent girls from accessing sexual and reproductive health care and education. At 19 years old, she co-founded The Pearl Safe Haven, a nonprofit which offers temporary housing and support services to female survivors of gender-based violence in Ghana. The organization is now in the process of building a fully operational women’s shelter in the outskirts of Accra, Ghana’s capital city.
I had the pleasure of speaking to Akosua about advocating for girls and young women in Ghana, dismantling HIV stigma and what it was like to lead a nonprofit at the age of 19.
Amara Ochefu (AO): When did you first become aware of the issue of sexual and reproductive rights in Ghana?
Akosua Agyepong (AA): Where I come from, you don’t talk about sexual and reproductive health. So we don’t know what it is. You only know about what your biology teacher tells you, which is that your sexual organs are supposed to be “useful” and that anybody who goes to have sex is a “bad girl.” But then in my first year at university I had two roommates who were volunteers with the Youth Action Movement, which is like the youth volunteer wing of the Planned Parenthood Association of Ghana. So they would forcibly take me to meetings of the Youth Action Movement, and when I got there and heard what they were saying on reproductive health and rights I was like, “This is interesting and I’d like to be a part of it.”
Around that same time, a friend of mine that I knew from senior high school called me on the phone and told me that she was HIV positive. And at that time I was like, “How? How are you HIV positive?” My reaction to her was that I wanted to keep it at arm’s length. Because even though we had learned about HIV, it was really in school in a classroom, and there’s really not a lot of awareness and sensitization on stigma and how to accommodate, love and address a person with an HIV diagnosis. So my initial reaction wasn’t that good. But then I began to do some self-reflection and I was like, “What kind of behavior is this?” And I realized that kind of reaction was something she was dealing with from a lot of people — her family, her school, health service providers. So then I was like, well, I need to improve myself and better myself so I'm able to approach the situation. So I really took a liking to the Youth Action Movement because we learned so much about those things and we tried to teach others about them also.
AO: How do sexual and reproductive health and rights and HIV affect girls in Ghana?
AA: Firstly, the sheer lack of knowledge around sexual and reproductive health is devastating for girls. Sometimes, they simply do not know. Like a girl can be menstruating and she doesn’t know that she’s menstruating. Or a man touches her and she doesn’t know that she’s being taken advantage of. Or a girl finds out she's HIV positive and doesn’t know what she was supposed to have done to protect herself. That is where you have people who don’t get to make choices. They just fall into circumstances and don’t know what they are going into.
“Firstly, the sheer lack of knowledge around sexual and reproductive health is devastating for girls. Sometimes, they simply do not know. Like a girl can be menstruating and she doesn’t know that she’s menstruating.”
Secondly is access. Even if the girl knows about her sexual and reproductive health and rights, how does she assert these rights of hers? How does she access care? This friend of mine I was talking about, she took me once to go and get her antiviral drugs and the nurses were like: “Why did you bring this person here?” and “We know it’s HIV stuff you are coming for,” and were just so mean. That behavior truncates girls’ ability to access these services in confidence. You have so many girls that are going through stuff in their bodies and don't have the confidence to approach a health service provider to say, “This is what's going on with me. I want to know what's wrong and what the problem is.”
So now the person has access, but the community or the people within the community does not allow for policies to be implemented. So child marriage, for example, in Ghana is illegal according to the laws. Female genital mutilation is illegal. All of these things are illegal, but they are still going on within communities that have decided to be gatekeepers to these practices.
AO: How did your activism first take form? What tools did you use early on?
AA: Let me say firstly that social media is a powerful tool. It’s a cheap, fast way of sending messages across. But I’ve come to learn that there’s also a lot of work that has to happen at the grassroots level, and usually the people we are trying to reach are not on social media. So most of the work that we used to do was door-to-door campaigning on campus, speaking from person to person about different issues to do with sexual and reproductive health. Sometimes we’d organize outreach trips where we’d leave school and go into a particular rural area or village and spend a week there with the people. And during the week we go to churches, we go to mosques, we go to classrooms, we go from hut to hut or from building to building speaking to people who are the traditional rulers of the area. So it's different types of work that we used to do, but mostly had to do with personal interactions.
AO: At the Education Plus event, you talked a bit about reproductive justice. What does reproductive justice mean to you and how do you think it can be achieved?
AA: I think the point where we have reproductive justice is where we are able to assert our reproductive rights, and the journey to getting there is what we are dealing with. It demands participation and collaboration from every side. Right now there are a lot of calls on governments to commit to things and on institutions and organizations that can provide funding — which is good, but we also need to take into consideration the context. For example in Ghana, the president is the president and whatever he says is supposed to go. But where his laws begin to be truncated or the implementation doesn’t take place is within the community. Why? Because of the gatekeepers, the traditional leaders whose decrees are held in high esteem, even more than what the president says. For example, the president can’t overturn what an Ashanti Chief has said to the people. They listen more to the chief than to the president, especially because the person that is your chief is speaking your language, knows your heritage, knows your history and has been ordained by the Gods. People respect that authority. So I feel there needs to be a lot of engagement with faith-based leaders and organizations on issues of gender equality.
AO: Tell me a bit more about the goal of your organisation, The Pearl Safe Haven, and what it's like leading a nonprofit at such a young age.
AA: When I was 19 I wrote in my diary that I wanted someone to build a place that could be a refuge for survivors or victims of sexual and gender-based violence. Two years later I met Isobel Acquah, one of my co-founders, and she shared the same idea. So I came up with a proposal with a plan, researched what others were doing and put together a bid for a grant, which we received from the Australian High Commission in November of 2020.
Akosua leads stakeholders to the Pearl Safe Haven construction site. (Courtesy of Akosua Agyepong)
The idea was to have a safe haven, a shelter for survivors and victims of sexual and gender-based violence. We want to make sure that if a woman wants to leave her abusive relationship, that she doesn't need to think twice, that she knows where to go. Again, it goes back to the kind of communities we have. Some women, if they run to go back to their families, their families will bring them back to the husbands because of the value placed on marriage. So some people need a neutral place to go. And in Ghana, we really didn't have that at the time.
Leading a nonprofit at this age was a lot. At 19 I was moving about, going from session to session to session to talk about the house idea and why we needed money. And it was difficult trying to convince people, but I had the time and energy for that. Even right now — I'm 25 and I work, I'm in school, I'm getting married this year and also I'm managing the NGO. It's a lot, so I appreciate the fact that people are beginning to recognize us. It’s difficult, but it can be done.
AO: How can Assembly readers support your work?
AA: Assembly readers can help us fundraise for our safehouse by sharing this link with the people in their networks. Additionally, I think anybody doing work around gender equality, reproductive health or gender-based violence is already supporting our work. Fighting for these rights is not just our job, it’s everybody’s. So bring these conversations to your church, mosque, parliament and home — if you do then you are, in your own small way, helping girls reach their full potential.
This interview has been edited and condensed for clarity.
Read more
