UNIFEM (Geneva)
25 June 2001
document
Geneva, Switzerland — This background paper was prepared by UNIFEM, the United Nations Development Fund for Women, for a high-level panel of the UN Economic and Social Council, which is convening in Geneva, Switzerland in July.
An understanding of the gender dimensions of HIV/AIDS is one of the key challenges to sustainable development in Africa. This is not simply a "body count" of who has died or is dying from the disease- but of how women are affected through loss of family and community structures, loss of income and security, (including land and food security), increased responsibilities for caring for the ill, the social and economic costs that are not calculated in traditional economics, and the complex interactions between armed conflict and the spread of the HIV virus through sexual acts of violence and abuse.
Experts and governments worldwide now routinely acknowledge that gender inequality drives the HIV/AIDS pandemic and is resulting in alarming rates of infection in women and girls. In spite of the now universally recognized cause-and-effect relationship between women's low social status and HIV transmission, concrete solutions are absent from international resolutions and national strategic plans that address HIV/AIDS. Twenty years into the pandemic, it is not enough to acknowledge its deadly gender dimensions. Policy makers and society at large must find ways to share power and autonomy with women.
The HIV/AIDS virus has taken full advantage of humankind's social infirmities: its most effective allies are gender inequality and poverty. The virus travels with aggressive efficiency among those who lack the information, resources or power to put up effective barriers against it. Divested by society of status, authority and control over their own lives and bodies, it is increasingly females - especially poor and young females - who most often become the virus's unwilling and unwitting hosts.
The Social and Economic Costs of HIV/AIDS on Women's Lives Although very few women were among those infected in the early years of the epidemic, their numbers have since soared to 47 per cent of the 34.7 million adults living with HIV/AIDS worldwide by the end of 2000 and to 55 per cent of infected adults in sub-Saharan Africa. The reasons for this rapid escalation are undisputed. Wherever HIV/AIDS takes hold, females are at heightened risk for two reasons: biology works against them, but so do the societal and cultural norms that give men more control over decision-making at every level, from the personal to the political. Gender roles and expectations nearly guarantee that whenever HIV/AIDS insinuates itself into a family or a community, it is women and girls who will find themselves burdened most by its impact and supported least. It is not only women, but men as well who are in turn placed at higher risk due to these factors.
HIV/AIDS demolishes economic resources, and that wreckage, too, is suffered most acutely by women. Women's predominance in Africa's lower levels of the economy - including the informal sector and small and medium enterprise, where labour protections are nearly non-existent - increases their economic vulnerability. That same lack of effective legal protection divests many of homes, property and custody of their children when their husbands die of AIDS. In many cases, it is customary and religious law that deprives women of the independent legal right to resources through inheritance when a spouse dies. Women in such circumstances, who may also find remarriage impossible, are often forced into the further economic peril - and increased vulnerability to HIV infection - of migrant labour. Countless women and girls must make the horrific choice between certain death and possible survival through sex work. In such circumstances, the immediate risk of violence or income loss often pressures women into short-term survival activities that put their long-term health and lives at risk.
Girls and women, including the very young and very old, manage most of the care that sustains millions of people left sick, orphaned and incapacitated by the pandemic. Governments must first acknowledge and then address the fact that to understand that women are currently subsidizing the State by sustaining the social safety net for infected family members. Social service programmes and other emergency support services are needed to relieve women and girls of this inequitable and additional burden.
Societies' perceptions of female worth prevent many women from getting tested, and may cause them to delay or forego seeking health care. In 2000, 52 percent of the adults who have died of AIDS so far have been women. Studies in Africa show that women fall sick from any cause, they are less likely than men to be admitted to hospital or to have access to the family's resources. Studies have also shown that, when Anti-Retrovirals (ARVs) become available, doctors may not offer the drugs to HIV-positive women because they doubt that women can follow complicated medication regimens . Governments, as well as communities, have an obligation to care for - rather than isolate and stigmatize - HIV positive women who are trying to piece together their livelihoods and lives. Families need to be encouraged to share their resources to providing health care for their HIV-infected mothers, wives, sisters and daughters rather than only for the men.
An Epidemic Fueled by Violence Against Women The intertwining forces of conflict and gender equality threaten international peace and security. Rape and sexual violence continue to be used as weapons of war. Nearly all girls abducted into army groups are forced into sexual slavery. The vast majority become infected with sexually transmitted infections (STIs) and those increasingly include HIV/AIDS . The chaotic and brutal circumstances of war aggravate all the factors fuelling the HIV/AIDS crisis. This has a devastating impact on women and girls. In the absence of functioning health and education systems in conflict situations, emergency humanitarian relief must support HIV/AIDS awareness, prevention, care and treatment while contributing to the longer-term national policies. Even at times of peace, women and girls are frequently forced or coerced into sex, in and outside of marriage, which exposes them to HIV. When infected, it is not unusual for them to be abused, abandoned or murdered if their status becomes known. Women, often the first in the family to be tested when pregnant, are then commonly blamed for infecting their husbands and partners, although it is usually men who bring the virus into the family. Societies' perceptions of female worth prevent many women from getting tested, and may cause them to delay or forego seeking health care.
The rights of all people living with HIV/AIDS to information, treatment, quality care, confidentiality and privacy must be promoted, protected and respected. But it is especially critical that unprecedented efforts be made to ensure that women and girls can realize those rights at regional, national and community levels.
Women at the Forefront of Solutions to the HIV/AIDS Pandemic Women can and should drive the process of change. Women and girls take up the burden when families and communities fall on hard times. They are intimately familiar with the most critical needs that must be met and to responding at great cost to themselves to these needs, when HIV/AIDS takes its toll within households and extended families. It is this experience and knowledge that is able to lead a community toward integrated efforts to address the pandemic and to fairly distribute the work of attending to those most affected.
Women are not solely victims of HIV/AIDS, but they are also the hope for the future-as leaders in process for change in the family, community and nations of Africa. We can find inspiration in the many ways that women are responding to this epidemic. In all regions, there are inspiring examples of women organizing new livelihood opportunities for networks of women living with HIV/AIDS, launching community research and advocacy strategies to educate other women about their risks and rights, and linking strategies to end HIV/AIDS with strategies to end violence and poverty.
While it is devastating communities and countries, the HIV/AIDS epidemic can also be heard as a wake up call. UNIFEM is launching a new initiative inspired by the African Plan of Action from the African Development Forum at the end of last year, which stated "The struggle against HIV/AIDS will be won community by community, in every village, township and settlement across Africa." Building on this, UNIFEM will be supporting communities to develop gender equality zones. The initiative is inspired by an extraordinarily brave young woman named Gugu Dhlamini from KwaZulu, South Africa. After Gugu declared her status as a woman living with HIV/AIDS on World AIDS Day in December 1998, she was stoned to death by a group of young men in her community. This initiative seeks to create communities in which such acts are unthinkable. Other UN agencies are invited to work with UNIFEM in demonstrating that if we address the challenges of gender inequality and discrimination, and of the lack of rights of women and men living with HIV/AIDS, we can find a way to stem the rapid spread of the disease.
UNIFEM and its partners have been involved in numerous pilot projects that have yielded important information about how to address the scourge of HIV/AIDS. Now support and political will are needed to ensure that lessons learned underpin all policies and strategies related to ending HIV/AIDS, and that women are central to prevention and treatment plans, as well as to finding sustainable solutions to this pandemic.
Some specific areas that the international community should consider and pursue in regard to the gender dimension of HIV/AIDS, peace and economic security include the following:
An enabling environment for gender equality in strategies to address HIV/AIDS · Use CEDAW, and its overarching principles to ensure women's rights, as a guiding framework in the development of all HIV/AIDS prevention, treatment and care strategies; · Ensure that women's rights and gender equality are explicitly taken into account in the composition of and policies and programmes promoted by National AIDS Councils and in National AIDS strategies; and · Disaggregate by sex all data collected on the incidence and impact of HIV/AIDS so that policy-makes and planners can respond to gender-related trends and the particular needs and contributions of women and girls.
Gender-responsive prevention, care and treatment · Disseminate information about HIV/AIDS and Sexually Transmitted Infections that will reach girls and women -- especially those who are illiterate, outside of the normal channels of mainstream media, and need materials in indigenous languages - so that they can understand and act upon the information; · Rapidly accelerate research to improve and develop women-controlled prevention methods, including affordable female condoms and microbicides that women can use without fear of recrimination; · Support community-based NGO's and community leaders to address the harmful cultural practices that discriminate against women and result in spreading the virus. · Involve girls and women in production and dissemination of information about HIV/AIDS, education and communication (IEC) strategies; · Recognize and account for women's domestic and reproductive roles in caring for those infected by HIV/AIDS and in supporting families left destitute by the epidemic; · Establish free, accessible centres for voluntary and confidential counseling, testing and referrals in and outside of antenatal and health clinics to ensure privacy; · Produce and widely disseminate gender-sensitive materials to help adults introduce girls and boys to reproductive health education at home, in schools and in religious and community centres so that young people are aware of strategies to prevent HIV/AIDS before they become sexually active; and · Support NGOs and governments to develop training approaches and information materials that help women to negotiate safe sex and avoid unwanted and unprotected sex.
Addressing the impact of violence against women in peace and in war on HIV/AIDS transmission · Ensure gender-sensitive HIV/AIDS awareness, prevention, care and treatment in humanitarian assistance during conflict and as an integral part of post-conflict rehabilitation and reintegration programmes; · Call for the Code of Conduct for peacekeeping personnel to provide for the establishment of clear reporting mechanisms on sexual violence and accountability for perpetrators of sexual violence in a peacekeeping environment; and - Develop and enforce laws to end impunity for perpetrators of violence against women, including those who perpetrate marital rape, domestic violence, conflict-related abuse and abuse of minors.
Be the first to Write a Comment!
Copyright © 2001 UNIFEM. All rights reserved. Distributed by AllAfrica Global Media (allAfrica.com).
AllAfrica aggregates and indexes content from over 125 African news organizations, plus more than 200 other sources, who are responsible for their own reporting and views. Articles and commentaries that identify allAfrica.com as the publisher are produced or commissioned by AllAfrica.
