1 December 2015

Africa: Ending Aids Depends On Ending Violence Against Women and Girls

Johannesburg — One of the ten targets in the UNAIDS fast track strategy to End AIDS by 2020 released in October is that "90% of women and girls live free from gender inequality and gender-based violence to mitigate risk and impact of HIV".

The same strategy notes that nearly half of new global HIV infections in 2014 were in East and Southern Africa, with the highest burden of new infections being in young women and adolescent girls. In our region adolescent girls acquire HIV infection five to seven years before young men.

UNAIDS has warned that at this rate we will not end AIDS. UNAIDS has therefore called on the world to invest even more energy in the fight against AIDS in the next five years.

On World AIDS Day let us all join the fight to End AIDS in our communities, towns, cities and districts by 2020. Let us begin by making every home and community a No Gender Based Violence zone. Let us teach our children not to perpetrate violence and to say No to violence when it is perpetrated against them. Women, men, boys and girls must all be actively involved if we are to succeed.

The aim is to achieve the three zeros: Zero new infections, Zero AIDS related deaths and Zero discrimination. We must move much faster to the three nineties which are 90 per cent of all people living with HIV tested; 90 per cent of those who know that they are living with HIV on treatment and 90 per cent of those on treatment adhering to the treatment.

While globally the mortality or death rate as a result of HIV has fallen drastically in most age cohorts since the introduction of antiretroviral therapy (ART), the death rate as a result of HIV has continued to rise in adolescents. In Africa AIDS is now the leading cause of death in adolescents. It is the second leading cause of death in adolescents in other parts of the world. There is clearly a need to focus much greater attention on prevention of HIV infection for adolescents and particularly for adolescent girls.

This means that we must all come together to address the root causes of HIV infection in adolescent girls. The world joined forces to do what we believed was impossible - to make it possible for millions of people in very poor parts of the world to access complex treatment.

The first goal was three million people on antiretroviral treatment globally by 2005 (3 by 5). As an international community we met the 15 million people on treatment by 2015 (15 by 15) target nine months ahead of schedule. These achievements are truly remarkable, but treatment alone cannot end AIDS.

We are called now to bring the same passion and energy to the fight to prevent new infections. In Africa the statistics tell us very clearly that we have to prevent new infections in adolescent girls and young women.

The evidence shows that intimate partner violence increases the risks of HIV infection by 50 per cent and that there is a direct link between childhood abuse and HIV infection - both immediately and in later life.

Studies on violence against children in East and Southern Africa show high levels of violence - from just over 20 per cent of girls and 15 per cent of boys in Malawi to over 35% of girls in Swaziland. Globally, one in ten girls or 120 million girls, have experienced forced sexual acts or forced intercourse.

The levels of physical violence against children are much higher - from 40 per cent of girls and just over 50 per cent of boys in Malawi to over 60 per cent of girls and 75 per cent of boys in Zimbabwe and 65 per cent of girls and just over 70% of boys in Kenya.

Violence against children often happens in our homes, schools, places of worship and communities and is often perpetrated by people that are known to and even trusted by the girls and boys. Children who have experienced violence often become perpetrators of violence. They tend to accept this violence as normal and may not resist it or take action to prevent it.

We need especially to address violence in schools where children should spend at least twelve years of their lives. Schools should be places where children learn how to interact with each other to make the world better. However, they are often the opposite - places where children experience bullying from each other and violence or harassment from the adults that should be protecting them.

Learning cannot take place in schools which are not safe. Young girls who stay in school longer have lower levels of HIV infection than those that drop out. Children are more likely to stay in schools which are safe and encourage girls and boys to learn.

We must all come together to urgently address gender based violence against girls and boys and intimate partner violence. To break the cycle of physical and sexual violence against children and intimate partner violence against women, we must make all our communities - rural, urban and peri urban safe for women and children of all ages.

All leaders at every level of society from national to provincial to district to community and in every sector - be it government or traditional or religious - must clearly commit themselves to working with their constituents to making every community and nation a safe place for women and children.

(Lynette Mudekunye is a public health professional whom is an advisor with REPPSI. This article is part of a special series for the Sixteen Days of Activism being produced by the Gender Links New Service).

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