Johannesburg — Sixteen Days of Activism, is also 16 Days of emotional upheaval. I have been sub-editing “I” Stories— women's first-hand accounts of men beating them, raping them, abusing their children and breaking them. Many of these accounts also express a deep resentment, because their abuse also led to their HIV positive status. These women not only have to live with lasting trauma, but also have to live with HIV. If we at the very least halve gender-based violence (GBV), we could surely contribute to zero new HIV infections and zero AIDS-related deaths, because this pandemic is driving the other.
Southern Africa remains the epicentre of the global HIV pandemic. The nine countries with the highest adult HIV prevalence rates in the world can all be found in SADC: Swaziland (26%), Botswana (23%), Lesotho (23%), South Africa (17%), Zimbabwe (15%), Namibia (13%), Zambia (13%), Mozambique (11%) and Malawi (10%).
Despite the high prevalence of HIV in the region, SADC has made some massive gains in alleviating and addressing the pandemic. AIDS-related deaths have decreased by 32% since 2001 due to the expansion of antiretroviral therapy. In seven of the 15 countries - Botswana, Namibia, South Africa, Zambia, Mauritius and Swaziland - coverage of antiretroviral for preventing mother-to-child transmission of HIV is higher than 80%.
Progress has also been made in cutting deaths from tuberculosis (TB) in people living with HIV. Between 2004 and 2011, TB-related AIDS deaths fell by 28% in sub-Saharan Africa. The last 24 months saw a 13% decrease in TB-related AIDS deaths. Zimbabwe adopted a progressive policy on care work. Several other countries, including Mozambique, Zambia and Malawi have begun work on the development of a care work policy.
However major gaps persist. In six of the 15 SADC countries, less than 50% of People Living with HIV and AIDS (PLWHA) receive antiretroviral drugs. In nine of the 15 countries, less than 50% of the 15-24 year old population has a comprehensive knowledge of HIV and AIDS. GBV remains one of the major drivers of HIV and AIDS in Southern Africa, and herein lies one of the biggest gaps in addressing HIV.
The 2009 UNAIDS Aids Epidemic Update, states that women who have experienced violence are up to three times more likely to be infected with HIV than those who have not. Country statistics compiled by the United Nations show that younger women in Africa are more likely to experience physical or sexual violence generally from an intimate partner. Women fearing violence are less able to protect themselves from infection. They do not have the power to negotiate safe sex or to refuse unwanted sex, they seldom get tested for HIV, and they fail to seek treatment after infection.
The 2013 SADC Gender Protocol Barometer finds that 35% of women who were raped in Gauteng, 44% in Botswana and 67% in Mauritius were clinically diagnosed of Sexually Transmitted Infections (STIs). 26% of women in Botswana and 11% in Gauteng who were abused by their intimate partners also tested HIV positive. 15% of women in Botswana and 5% in Gauteng who reported being raped also tested positive for HIV.
Provision of post exposure prophylaxis (PEP) after sexual assault has improved over the last several years - from only one country, South Africa, providing PEP from 2009-2012 to a total of six countries in 2013. The need to provide PEP must form a large part of lobbying and advocacy efforts in the other nine SADC countries.
As much as the region has made strides that are so important for lessening infection rates, contributing to the healthy lives of those living with HIV and mitigating the risk of women who have been raped or sexually assaulted, the GBV pandemic undermines this progress. World AIDS Day commemorations, HIV and AIDS awareness campaigns, state policies and action plans need to be fundamentally aligned with anti-GBV initiatives. For us to achieve zero new infections, we need to end GBV!
Katherine Robinson is editor and communications manager at Gender Links. This article is part of the Gender Links News Service, special series on 16 Days of Activism, providing fresh views on everyday news.