A crew of twentysomethings spend the afternoon on a bench outside the Lesotho Planned Parenthood Association. Two young women braid the hair of a third friend, and two guys sit alongside them, potentially flirting.
“It’s a good place to hang out because, surprisingly, we might have some session as the youth where we talk about HIV and AIDS, or teenage pregnancy. That’s a good thing, so it’s a good place to be,” says Seeiso, one of the young men.
He’s been coming here since June because of Planned Parenthood’s reputation in Lesotho for programming that engages young people in issues that affect their lives. That reputation has turned the organization’s head office into a socialization spot, a safe space to spend time. It’s uncertain whether he or any of the young people with him are HIV positive.
A room full of broken computers reflects through the window behind the group. It once was a recreation space for young people at Planned Parenthood, but now sits in disrepair because, for one, donor funds are fickle.
“I want to be honest with you,” pipes in Majery, whose head is tilted to the side to allow for her friends to finish their braiding. “We come here expecting some things to happen, invitations, workshops or something. We gain a lot from workshops.”
Lesotho, a tiny nation of steep, dusty mountains inside South Africa, has the second-highest prevalence of HIV/AIDS in the world, at 23 percent. The pandemic has left the average life expectancy rate at 48.8 years and contributes to the country’s dismal economy, which in turn intensifies the HIV crisis because, among many issues, young women turn to sex work for money. Even more alarming, the rate of new HIV infection is 10.5 percent for women ages 15-24, according to UNICEF, nearly twice the rate of men that age.
That’s where the Lesotho Planned Parenthood Association (LPPA) comes in, an organization that was cited to me over and over again as the best means of combating the HIV crisis and promoting women’s sexual health, two things that go hand in hand. In this case, that doesn’t mean abortion, which is illegal in Lesotho, an outwardly Christian nation. Instead, that means teaching women about the risks of unsafe sex and empowering them with more options and a sense of agency when it comes to basic family planning.
“The Planned Parenthood association of Lesotho is unique in the sense that it’s addressing certain critical issues,” says Alti Zwandor, the country director of UNAIDS in Lesotho. “They are the group using a targeted approach to look at populations that are most vulnerable and at higher risk of HIV infection”—like the LGBT community and sex workers. “They are open to providing services to young people. Their services are attractive.” In other words, LPPA’s services are considered top-notch, and still stay relatively cheap, maxing out at around $15 for the most expensive types of birth control, like the implant.
This is not unlike the role of Planned Parenthood throughout other poor nations. The organization often fills a gap left by inefficient governments, weak healthcare systems, and conservative, traditional norms that discourage a woman from saying she wants safe sex, and seeking help when she finds that she’s HIV positive. For a woman in Lesotho, being found HIV positive means that she may be considered loose, even if her cheating husband was the one who infected her. This negative stigma remains a huge barrier in combating the crisis because women often won’t get tested or feel the need to hide that they are on antiretroviral therapy after they find out their status. LPPA is trying to fight this.
“In Lesotho, I think the biggest challenge is that young women don’t have much self-confidence,” Teboho Mohloai, a soft-spoken yet passionate 25-year-old woman explains to me the first time we meet at Planned Parenthood in Maseru’s city center. We sit in a small office in LPPA’s pastel purple building. Its peeling walls display posters explaining what to do if you are living with HIV and would like to have a child. Teboho volunteers with Planned Parenthood and helps lead education workshops in Lesotho’s rural areas.
“One training that we conducted, we went there and we found that most of the young girls that attended the training already had children at the age of 16 downwards,” Teboho says of a week she recently spent in a rural village. “We found they they never knew about contraceptives.”
LPPA is part the International Planned Parenthood Federation, which works in 172 countries. Planned Parenthood in the United States is a member of the federation too. The American organization developed side-by-side with the international federation in the early 20th century when the birth control and family planning movement began to be institutionalized.
Teboho tells me she joined LPPA three years ago when she heard about Planned Parenthood via Facebook and decided it was her best option for helping young people. Still, she wishes they could do more.
“If we are able to do those trainings all year round, and we also engage our churches and church leaders in the community, we would have a better sense of things,” she says. “We would know that we are able to maybe…”—now Teboho lowers her voice and speaks wishfully—“have lower rates of HIV and AIDS.”
I ask Teboho, along with Tlali Matela, a program officer at LPPA, if either has heard about why Planned Parenthood has been in the news in the United States.
“The controversy that takes place in America?” Tlali responds. He shakes his head. “No, I haven’t been following that.”
“It’s not political here,” he adds.
Outside the LPPA building, a few days later, I asked the group hanging out on the bench how they thought HIV is affecting young people in their country. After all, they are choosing to spend time outside Planned Parenthood, and LPPA’s mandate focuses extensively on fighting the HIV pandemic among their peers.
I ask them: “Is it something you’re all worried about it?”
As it turns out, the issue is so big, so fraught, still laden with such negative stigma, it wasn’t easily put into words.
Everyone hesitates at the question.
“It is difficult,” Seeiso says, and they all agree. So we leave it at that.
