Born in a small rural village in the West African country of Cameroon, Marie was only 4 when her father died, leaving the family destitute. Her destiny should have been bleak in a country that's poor and getting poorer: From 1985 to 1995, Cameroon's economy declined by more than 10 percent. But working as a domestic servant, Marie's mother raised seven children and even managed to send one, Marie, all the way through school. "She walked barefoot and didn't eat so she could pay my school fees," says 22-year-old Marie, who tested HIV positive two years ago. "So I haven't been courageous enough to tell her." For this interview, Marie asked that her last name not be used.
But Marie is hardly hiding. She is one of very few in her country to publicly speak of her HIV status. She does this away from home, though, attending AIDS workshops several times a year, where she identifies herself as living with HIV and stresses the importance of safer sex. Back home, Marie puts herself on the line as a post-test counselor at a local hospital. When a patient tests positive for HIV, Marie confides that she, too, is positive, offering herself as proof that people with the virus can build meaningful lives.
Marie does all this in a country without red ribbons or walkathons. There are very few support groups, and when people test HIV positive, their doctors often don't tell them. Since physicians can do almost nothing for Cameroonians with HIV, informing them is painful, for the overworked doctors often have only a few minutes per patient.
To ask for HIV results, people have to be ready to face the shame this society assigns to AIDS. Of about 6.3 million adults in Cameroon, 310,000 have HIV, but only two have ever discussed their status on television. By taking the steps she has taken, Marie is helping to break Cameroon's AIDS silence.
It is a role she never envisioned as a teen. Wanting to secure that diploma for which her mother had toiled so hard, she waited on sex until age 19. Then she was intimate with only two men. But within a year, she suffered recurring fevers. When she was hospitalized, her doctors suggested a blood test -- she never knew they meant for HIV. A week later, in a room covered with AIDS posters, two counselors broke the news. She remembers thinking, "There must be some mistake."
There wasn't. She hadn't insisted that her boyfriends use condoms because, as she puts it, she was "young and naive" while they -- in a common dynamic for this part of Africa -- were five and six years older. Poised and fine-featured, she now tells people, "I look as I do, yet I am capable of transmitting the virus."
"But people tell me, 'I don't believe it,'" she says. Because many Cameroonians cannot read, most of their AIDS knowledge comes from pictures on posters or brochures. Usually hand-drawn on inexpensive paper, such images are common all across Africa, and their purpose is to make the disease scary and more real. But they also, as Marie puts it, propagate "a vision of people with AIDS as thin, losing hair, covered with spots." A new effort shows a group of healthy people and asks, "Can you guess which one has HIV?" But the new message hasn't sunk in yet; Marie still struggles to convince people that she, too, represents a face of AIDS.
At this year's prestigious Society of Women and AIDS Conference in Dakar, Senegal, many with HIV said they were tired of merely telling their stories. Marie, who spoke at the opening, increasingly shares such angry pragmatism. "As far as taking care of HIV positive people, nothing is being done," she says. "In Cameroon people with AIDS just wait for death. We cannot spend our whole life witnessing."
Still, Marie says, it "felt good" to tell her story at the conference, and she's now gathering the courage to tell her mother. She's also planning to expand her HIV education work. But she wants more. Turning the tables on her interviewer, she asks bluntly, "What use is it for me to witness in the United States?"