- Lilian Akoth Juma, 27, who has wide cheekbones, short braids and eyes wearied by seven hard years of widowhood, said she did not want to have more babies after learning she had HIV in 2004.
“I wanted to be done,” Juma recalled as she sat in her dark, dirt-floored hut while infant son Javan suckled and his twin brother napped nearby. With their birth in April, Juma now has six children, not an unusual number in western Kenya, where many women live in deeply traditional villages nestled in the hills rising from the rocky shores of Lake Victoria.
Juma’s attempts at family planning were frustrated by a combination of poverty, limited access to birth control and medical problems that made it unsafe for her to use contraceptive pills or injections, she said.
The man who, in accordance with local tradition, inherited her after her husband died refused to use condoms, she said. And she lacked the means and the knowledge, she said, to travel to a regional hospital where she might have found access to IUDs, contraceptive implants or surgical sterilization