Washington, DC — If HIV/Aids is to be defeated, the world needs to work together to make a difference in the lives of those who have been infected and affected, especially women, Lapologang Lekoa, Botswana's Ambassador to the United States, said at a luncheon roundtable discussion on Women, Girls, and HIV/Aids in Washington, D.C. on November 30.
The conference was co-hosted by the CSIS Task Force on HIV/Aids and the Washington African Ambassadorial Corps. In keeping with this year's World Aids Day theme, "Reaching Women and Girls," panelists placed special emphasis on the acute vulnerabilities of women and girls to HIV/Aids infection and stigma, examined prevention strategies, identified challenges associated with routine HIV testing, and explored new ideas for crafting HIV/Aids interventions to reach women and girls.
Women are more vulnerable to HIV/Aids and face gender-specific biological, cultural, social and economic factors that increase the likelihood of infection, Lekoa said. "Transmission from male to female during sex is about twice as likely to occur as from female-to-male transmission," he said.
Another factor that makes women more vulnerable is gender inequality, particularly in the southern African region, Lekoa said, which is currently the most hard hit by the disease. Women and girls are more likely to be coerced into sex or raped, often by someone older who has already been infected with HIV.
Ambassador Lekoa said that the burden of caring for sick family members and orphaned children pushes women deeper into poverty. "They are then pressurized to resort to high-risk "transactional" sex - sex in exchange for money or goods or sex with older men who offer the illusion of material security. This lack of economic independence deprives them of the choice as to when and with whom to have sexual relationships," he said.
His analysis of women's economic dependency was shared by other panellists, who said that interventions to address gender inequity might not target women directly. "Whilst we address the women and girls, we should not forget that boys and men are an essential part of the solution," said Ambassador Mary M. Kanya of the Kingdom of Swaziland. "Actually, they should be at the center."
Ambassador Kanya called on governments, regional groupings, NGOs and donor agencies an to join hands and work on strategies that match the scale and extent of the Aids pandemic.
Asunta Wagura, executive director of the Kenya Network of Women with Aids (KENWA) added that she would like to see more people who are directly impacted by HIV involved in the creation and implementation of programs. "We want to be part of the programs and not just people for the programs," she said.
Wagura, who was prompted to form KENWA after she tested HIV positive 15 years ago, said that Kenyan hospitals often turn away terminally-ill Aids patients. This puts care taking in the hands of poor women who must now juggle their various responsibilities to care for sick family members. The demands of daily life can be overwhelming.
Wagura said her organization has 3000 members, 1200 of whom urgently require antiretroviral drugs. Only 64 are on ARVs, and KENWA has only lost one member since they started the treatment program. Wagura said this shows the value of ARV treatment, even though it is still difficult to access.
"The situation is pathetic because there are really bureaucracies and hidden costs before you access this treatment," she said. "Normally the publicity is that the [cost of] drugs has gone down. Some people even claim they are free, until you walk into a hospital and you are told there are consultancy fees, there is money for CD4 counts and so forth, sometimes quite an amount that adds up to not less than $110. This is just too much for the communities that we work with. Sometimes they go without a meal, sometimes they can not even afford [painkillers], let alone $110 as a procedural fee to access this treatment."
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Another issue discussed at yesterday's roundtable was the on-going debate about routine HIV testing. Phillip Nieburg, senior associate for the CSIS Task Force on HIV/Aids, said success in reaching global goals for HIV prevention, care, and treatment, including identification of people who could benefit from ARV treatment, requires that people get tested. He said this must be a first step because "knowledge of one's HIV status can be useful to both infected and uninfected persons in a number of ways."
