The Gender Agenda: Making HIV Responses Work for Key Affected Women and Girls. The health of women and girls across the world, particularly from HIV transmissions, is threatened by a long list of inequalities simply because they are females.
In a number of settings women and girls, adolescents and other young people, experience substantial impacts of the epidemic, and the specific needs of key affected women and girls remain neglected.
Often stigma, discrimination and criminalization of behaviors prevent women from reporting acts of violence against them and seeking redress. Sexual exploitation of women, girls and boys, including for commercial reasons can increase the vulnerability to HIV among key affected populations of sex workers.
The United Nations Economic and Social Commission for Asia and the Pacific, meeting in Bangkok this week on the Millennium Development Goals, is considering 10 targets and elimination commitments in recognition of women’s rights. A briefing paper, published by Asia Pacific Coalition of AIDS Service Organizations in collaboration with the Asia Pacific Alliance for Sexual and Reproductive Health and Rights and titled “Women and Girls: The 2011 Political Declaration on HIV/AIDS, Civil Society Perspectives on the 2011 HIV/AIDS High Level Meeting” looks at the 2011 Political Declaration made at the United Nations General Assembly High Level Meeting (HLM) on HIV/AIDS held in New York in 2011, and it is important here to reiterate its significant points.
The three most crucial of these goals are to reduce sexual transmission of HIV by 50 per cent by 2015, eliminate mother-to-child transmission of HIV by 2015 and substantially reduce AIDS-related maternal deaths and eliminate gender inequalities and gender-based abuse and violence and increase the capacity of women and girls to protect them from HIV
Reducing sexual transmission of HIV by 50 per cent by 2015 is a time-bound commitment. Women should be able to exercise their right over matters related to their sexual and reproductive health, without coercion, discrimination and violence. However, women have reported pressure by healthcare workers to have abortions or undergo sterilizations.
Often coupled with lack of information about health risks, such forced decisions are violations of human rights. Governments must commit to redouble HIV prevention methods efforts by investing in facilitating female initiated prevention methods and access to sexual and reproductive healthcare services.
The ESCAP report found that only 34 percent of young people possess accurate knowledge of HIV. The 2011 Declaration strongly recognizes that young people are being excluded from information and services, and offers solutions by ensuring access of both girls and boys to primary and secondary education, including HIV and AIDS, in curricula for adolescents, and ensuring safe environments especially for young girls.
Civil society has stressed the need for equitable access to treatment literature especially for marginalized women who often have less access to education, putting them at greater risk. Equal opportunities for education should be guaranteed for women and men.
Eliminating mother-to-child transmission of HIV by 2015 and substantially reducing AIDS-related maternal deaths is another time-bound commitment. Prevention of vertical HIV transmission should be part of a holistic HIV prevention, treatment, care and support package for women.
To achieve this, the governments have to ensure access for women of child-bearing age to HIV prevention-related services, access for pregnant women to antenatal care, counseling and other HIV services, and access for women and infants living with HIV to effective treatment. Laws and policies focused on key populations related to preventing vertical HIV transmission should adhere to principles of informed consent, confidentiality, pre and post-test counseling and proper referral to treatment, care and support services.
A time-bound commitment is made towards having 15 million people living with HIV on antiretroviral treatment by 2015. However, barriers for marginalized women to access treatment including stigma, discrimination, threat of violence, fear of disclosure, legal/policy barriers, still remain.
Eliminating gender inequalities and gender-based violence is a cross-cutting issue and critical to reach all goals and targets in the 2011 Declaration and the Universal Access agenda. Many countries in Asia and the Pacific are experiencing concentrated epidemics with key affected populations identified as most at risk.
Evidence also shows that women drug users are more likely than their male counterparts to acquire HIV and face a range of gender specific barriers to accessing HIV-related services. Migrants, especially female migrants, often experience conditions of high vulnerability, endure abuse, exploitation, violence, stigma and discrimination, and lack access to reproductive health services leading to sexually-transmitted infections, including HIV.
The 2011 Declaration calls for the elimination of all forms of violence against women and girls, and in particular “harmful traditional and customary practices, abuse, rape and other forms of sexual violence, battering and trafficking in women and girls”.
Asia Pacific governments are called upon to undertake measures to address discrimination and legal barriers to effective HIV responses, in particular with regard to key affected populations. They need to scale up actions for policies that address the rights of women and girls in the context of HIV, and the link between HIV and different forms of violence against all women and girls. These must be incorporated in national HIV response strategies and programs. Women’s groups call for active involvement/ meaningful participation of PLHIV, especially women and girls, in all aspects of HIV policies and program development and decision-making.
Governments must pledge to take all necessary measures for the empowerment of women to increase the capacity of women and adolescent girls to protect them from the risk of HIV infection. National responses should meet the specific needs of women and girls “through strengthening legal, policy, administrative and other measures for the promotion and protection of women’s full enjoyment of all human rights”. Furthermore, the role and engagement of men and boys in the achievement of gender equality is crucial.
It is hoped that the deliberations at the event will go a long way in addressing the needs and rights of key affected women and girls for HIV prevention, treatment and care services. (CNS)
(By Shobha Shukla Managing Editor of Citizen News Service (CNS). She has worked earlier with the State Planning Institute, UP and taught physics at India's prestigious Loreto Convent)