TITLE: Attitudes to sexual coercion and rape within the Anglican Church, Cape Town: A cross sectional survey Okwuosa .O.S MB; BS. Odili Sabastine. Division of Family Medicine and Primary Care, University of Stellenbosch. Submitted in partial fulfillment of the Masters in Family Medicine (MMed) degree Supervisors: Prof Bob Mash Rev Canon Rachel Mash 1 Stellenbosch University https://scholar.sun.ac.za “Declaration I, the undersigned, hereby declare that the work contained in this assignment is my original work and that I have not previously submitted it, in its entirety or in part, at any university for a degree. Signature: ............................……...................... Date: ..………………..............” 2 Stellenbosch University https://scholar.sun.ac.za Abstract. Introduction: In South Africa 5.6-5.9 million people are currently living with HIV/AIDS, making South Africa the country in the world with the largest number of people living with HIV/AIDS. Despite numerous government measures to curb the pandemic, the prevalence and deaths due to HIV/AIDS have continued to rise to unacceptable levels. South Africa is reported to have one of the highest rates of sexual violence in the world and has the worst known figures for gender–based violence for a country not at war. Violence and coercive practices have been found to dominate sexual relationships in South Africa. Male dominance in sexual relationships as well as the role of traditional masculinity has made women vulnerable and encouraged the spread of HIV/AIDS. Church attendance has been found to have an inverse relationship with domestic violence. This implies that the church through its community engagement could assist with reducing gender based violence and sexual coercion. Aims & Objectives: To determine to what extent the Anglican Church in the Cape Town Diocese is contributing to or challenging rape-supportive attitudes, sexual coercion and gender inequality. Specific objectives were: 1) To determine the beliefs, values and attitudes relevant to rape, sexual coercion and gender inequalities amongst people attending the Anglican Church in the Diocese of Cape Town: clergy, leaders and members of the church. 2) To make recommendations to the church regarding any specific issues that the church should address through its gender desk or other structures. Method: A cross sectional survey, which collected quantitative data. Study population was members of the Anglican Church from the 48 churches within the Diocese of Cape Town. 21churches were selected by simple random sampling that was stratified in terms of the membership numbers and predominant racial composition of the congregation. All people who attended the church on the study day were asked to complete a questionnaire. The data was analysed using Statistica version 8 with the help of the Centre for Statistical Consultation at Stellenbosch University. Results: There were 581 respondents from 21 churches of which 380 were females (65.4%), 184 were males (31.1%) and 17 (2.9%) did not indicate their gender. In general, the Anglican 3 Stellenbosch University https://scholar.sun.ac.za Church in the Diocese of Cape Town espoused progressive attitudes that did not create an environment conducive to sexual coercion, gender violence and rape. For instance, 98.8% of respondents disagreed that a man has good reason to hit his partner if she does not complete her housework to his satisfaction. 94.9% of respondents agreed that the church leadership considers rape and domestic violence to be important, while 98.3% of respondents disagreed that it is okay for a man to have multiple partners. However, the survey did show some potentially discriminatory attitudes amongst the church members towards those living with HIV and that different archdeaconries have different degree of openness in dealing with issues of rape, divorce, marriage and domestic violence. More than half of the respondents agreed that it is okay for a man to ask for a divorce or separation when he is afraid that the partner may infect him with HIV while two-third of respondents agreed that a woman could also do so for the same reason. Conclusion: In general the Anglican Church in the Diocese of Cape Town espoused progressive attitudes towards sexual coercion, rape and domestic violence that stand in contrast to more conservative and discriminatory attitudes reported in other denominations and African countries. Churches were willing to talk openly about the issues and to offer practical support and counselling. This implies that this faith based organization may be a useful ally in addressing these issues in South African society. Keywords: HIV & AIDS; Rape; Gender violence; Anglican Church; Religion; South Africa. Acknowledgement: I am heavily indebted to Prof. Bob Mash, my supervisor, without whose intellectual input and guidance this piece of work may not have been possible. Many thanks to Canon Rachel Mash for her intellectual input, hard work and encouragement in making sure that this piece of work was a success. My gratitude goes to Dr Zandy Rosochaki who took time to review this work and Rev. Cheryl Bird for her help in the phase of questionnaire adaptation. I am also grateful to the trainee lay counsellors of the Diocese of Cape Town (Richard and Myrna Engel; Elecia Daniels; Bernard Norman; Michelle Burrows and Sheila Hendricks) who assisted with questionnaire distribution and to Dr. Werner Viljeon for his help in translating the informed consent to Afrikaans. 4 Stellenbosch University https://scholar.sun.ac.za BACKGROUND AND INTRODUCTION South Africa has the largest number of people living with Human Immunodeficiency Virus (HIV) worldwide, despite efforts to curb the disease.1 About 5.7 million South Africans were estimated to be living with HIV in 2008 according to the United States Agency for International Development (USAID) global report 2008 and United Nation International Children Emergency Fund (UNICEF) reports highest estimate of 5.9 million for 2009.2 This figure was 5.3 million in the 2004 report .3 The prevalence of HIV has continued to rise in South Africa. The prevalence rate in the adult population (age 15 -49) has risen from 16.2 percent in 2005 to 16.9 percent in 2008 and 17.8 percent at the end of 2009 according to AIDS epidemic update report 2009 and UNAIDS report on the global AIDS epidemic 2010.4,5 The prevalence rate reported by Human Sciences Research Council in their survey in 2002, 2005 and 2008 were 11.4 percent, 10.8 percent and 10.9 percent respectively of the South Africa’s population except those under two years.6 These figures are lower than those reported by USAID but has not shown any significant decline but rather remained unacceptably high. Among those living with the virus, women far outnumber the men. 1 The burden of this disease on the country is enormous and it is estimated that more than 500,000 South Africans have died of AIDS- related causes.7 By 2015, this number is projected to grow by a factor of 20, to more than 10 million deaths.6 Over 50% of adult deaths in South Africa were HIV/AIDS related between 2002 and 2004. 5 USAID in their 2008 global report state that South Africa has the highest number of orphans, including those affected by HIV, receiving some form of support (medical care, school assistance, financial support, or psychological services) among the nations in East and Southern Africa. 1 Information about HIV/AIDS and despite the distribution of condoms the latest report shows that about 12 million children (under age of 18) have lost one or both parents to HIV/AIDS in Sub-Saharan African and the number of children orphaned by the epidemic continues to rise.8 Despite the recent report of decrease in HIV incidence in South Africa;9 successful implementation of prevention of mother to child transmission (PMCT) programme across all nine provinces;10 increased roll-out of Anti-retroviral drugs and the new government national HIV counseling and testing campaign,11 the number of deaths attributed to HIV/AIDS remained unacceptably high. The number of deaths due to HIV & AIDS in 2009 was 310,000.10 The infant and maternal mortality rate are 46.9 per 1000 infants in 2010 10 and 625 per 100,000 live births in 2007 (quadruple of the figure in 1998 (150 per 100,000 live births)) 12 respectively. HIV/AIDS is the major contributing factor of these deaths accounting for up 5 Stellenbosch University https://scholar.sun.ac.za to 43.7 percent of maternal death between 2005 to 2007.12 This calls for a re-look into the strategies in fight against HIV/AIDS in South Africa. South Africa is reported to have one of the highest rates of sexual violence in the world 13 and has the worst known figures for gender-based violence for a country not at war.14 Data available shows that rape reported to the police (240 incidents of rape and attempted rape per 100,000 women each year) represents the tip of an ice-berg of sexual coercion. For example, in the 17-48 age groups there may be as many as 2,070 such incidents per 100,000 women per year.15 In 1995, the Human Rights Watch report on domestic violence and rape, dubbed South Africa “the rape capital of the world” citing a figure of 35 rapes for every one reported to the police.16 The Medical Research Council study in 2005 estimated that one in nine rape victims reports the crime to the police.17 In 1997, 55,000 South African women over the age of 16 years were rape victims with an incidence of 134/100,000 according to Statistic South Africa.18 South Africa Police Service report of 2009 -2010 showed that 27,417 children were victims of sexual crimes between April 2009 - March 2010.