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)
Shobha Shukla
Asia Sentinel
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