If a couple is unable to have a baby there is a village custom of using a fisi [marriage hyena] to produce children. The man is often from the village and can be a friend, a relative or a younger man. This tradition is often encouraged, or even organised, by elders in the village. Most often this is done in secret and the man is not tested for sexually transmitted infections and HIV first.

This means the girl does not know the HIV status of the man she has sex with.

How far can HIV spread?

• If she is HIV+, then both the fisi and her husband can be infected. The fisi will also pass the HIV on to all the future women he sleeps with, and his wife if he is married.
• If the fisi is HIV+, he can infect her, the coming baby and her husband.
• If her husband is HIV+, then he can infect her wife and the coming baby, the fisi and all his future partners.

If you do decide to follow this practice make sure both parties have been tested and are not infected by HIV or STIs. If the fisi is positive, then another man should be found.

Alternatively, consider adopting children using legal methods or using a traditional way, where one of your relatives who has many children can ask you to take care of one.

It is hard to take a stand against an age-old practice. But a lack of knowledge about disease and HIV can cost your life. If you see this deadly practice happening in your village you need to share your knowledge and educate others.