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In fact, casual sex of every kind is commonplace here. Prostitutes are just the ones who admit they do it for cash. Everywhere there's premarital sex, sex as recreation. Obligatory sex and its abusive counterpart, coercive sex. Transactional sex: sex as a gift, sugar-daddy sex. Extramarital sex, second families, multiple partners. The nature of AIDS is to feast on promiscuity.
Rare is the man who even knows his HIV status: males widely refuse testing even when they fall ill. And many men who suspect they are HIV positive embrace a flawed logic: if I'm already infected, I can sleep around because I can't get it again. But women are the ones who progress to full-blown AIDS first and die fastest, and the underlying cause is not just sex but power. Wives and girlfriends and even prostitutes in this part of the world can't easily say no to sex on a man's terms. It matters little what comes into play, whether it is culture or tradition or the pathology of violence or issues of male identity or the subservient status of women.
Beneath a translucent scalp, the plates of Gertrude Dhlamini's cranium etch a geography of pain. Her illness is obvious in the thin, stretched skin under which veins throb with the shingles that have blinded her left eye and scarred that side of her face. At 39, she looks 70. The agonizing thrush, a kind of fungus, that paralyzed her throat has ebbed enough to enable her to swallow a spoon or two of warm gruel, but most of the nourishment flows away in constant diarrhea. She struggles to keep her hand from scratching restlessly at the scaly rash flushing her other cheek. She is not ashamed to proclaim her illness to the world. "It must be told," she says.
Gertrude is thrice rejected. At 19 she bore a son to a boyfriend who soon left her, taking away the child. A second boyfriend got her pregnant in 1994 but disappeared in anger when their daughter was born sickly with HIV. A doctor told Gertrude it was her fault, so she blamed herself that little Noluthando was never well in the two years she survived. Gertrude never told the doctor the baby's father had slept with other women. "I was afraid to," she says, "though I sincerely believe he gave the sickness to me." Now, she says, "I have rent him from my heart. And I will never have another man in my life."
Gertrude begged her relatives to take her in, but when she revealed the name of her illness, they berated her. They made her the household drudge, telling her never to touch their food or their cooking pots. They gave her a bowl and a spoon strictly for her own use. After a few months, they threw her out.
Gertrude sits upright on a donated bed in a cardboard shack in a rough Durban township that is now the compass of her world. Perhaps 10 ft. square, the little windowless room contains a bed, one sheet and blanket, a change of clothes and a tiny cooking ring, but she has no money for paraffin to heat the food that a home-care worker brings. She must fetch water and use a toilet down the hill. "Everything I have," she says, "is a gift." Now the school that owns the land under her hut wants to turn it into a playground and she worries about where she will go. Gertrude rubs and rubs at her raw cheek. "I pray and pray to God," she says, "not to take my soul while I am alone in this room."