It will be impossible to eliminate infections without paying attention
to women's needs
It is a grim fact that it will be
impossible to eliminate new HIV infections across Asia unless the unique needs
and perspectives of women and girls are attended to, a fact that the
male-dominated medical profession often ignores.
With more and more women falling
prey to the disease, the HIV epidemic increasingly has a female face and it is
young girls in the age group of 12-20 years who most need better prevention and
protection, Mitchell Warren, Executive Director of AVAC: Global Advocacy for
HIV Prevention, told CNS in an interview. There are now 35,000 women living
with HIV in Cambodia, 81,000 in Myanmar, 88,000 in Indonesia and 210,000 in
Thailand, according to World Health Organization statistics.
Women are particularly vulnerable
to HIV, which is transmitted by sexual intercourse and infected blood. Sexual
assault and other forms of violence against women are also important factors,
according to a previous study on African infected women. Biology can also make
women more susceptible to infection. But the factors that leave women most at
risk are economic, social and political. Most women find themselves totally
dependent on their male partners, limiting their negotiating power in terms of
safer sex.
Male-dominated governments also
often fail to consider the rights and needs of women and girls in their HIV
policies and planning, despite increasing numbers of women living with HIV in
Asean. Women and girls often face stigma and discrimination in health care
settings and are subject to human rights violations like forced sterilization,
forced abortion and compulsory HIV testing.
Earlier this week, young women,
female sex workers, transgender women, women who use drugs and women living
with HIV met in Luang Prabang, Laos, to call on the Association of Southeast
Asian Nations to support women and girls living with and affected by HIV.
Civil society and community
groups representing key affected women and girls called for scaling up action
and resources for policies and programs that address the rights of women and
girls in the context of HIV and AIDS.
Women and girls from civil
society including communities representing the voices from young women, female
sex workers, transgender women, women who use drugs and women living with HIV
came together under the umbrella of under the name Unzip the Lips. Their message
at the Laotian conclave was clear. They are a platform of individuals and
organizations working for the rights and meaningful participation of key
affected women and girls in the context of HIV and its intersections with other
gender issues in the Asia Pacific region.
As a united movement, the
delegates were able to play a leading role in the development of
recommendations arising from the meeting, in which delegates committed
themselves to repealing punitive laws and ensuring that existing laws, regulations
and policies of Asean member states address the rights of key affected women
and girls affected by HIV and AIDS.
The problems are manifold for
women. Across Asia, what has been called a culture of silence surrounds sex,
dictating that "good" women be ignorant about sex and passive in
sexual interactions, meaning women usually remain uninformed about risk
reduction and unable or unwilling to demand that their partners practice safe
sex.
Largely in these societies, women
are afraid to ask for information about sex for fear they will be thought to be
sexually active. In some societies, according to a paper by Geeta Rao Gupta of
the International Center for Research on Women in the US, there is an erroneous
belief that sex with a virgin can cleanse a man of infection. In addition, in
cultures where virginity is highly valued, Rao Gupta wrote, some young women
practice alternative sexual behaviors, such as anal sex, in order to preserve
their virginity, despite the fact that anal sex can put them at increased risk
of HIV.
Women’s risk increases in direct
inverse proportion to their poverty level. Economic vulnerability makes it more
likely that they will exchange sex for money, that they are less likely to
demand protection, and more likely that they will stay in a dangerous
relationship.
“And finally, the most disturbing
form of male power, violence against women, contributes both directly and
indirectly to women's vulnerability to HIV,” Rao Gupta wrote. “In
population-based studies conducted worldwide, anywhere from 10 to over 50
percent of women report physical assault by an intimate partner. And one-third
to one-half of physically abused women also report sexual coercion.”
“We are asking you to repeal laws
that the affect sex workers, men who have sex, trans people, people who use
drugs and people living with HIV,” Khartini, a sex worker and transgender woman
who attended the Laos conclave told Asean delegates, “Don’t talk about getting
to zero new HIV infections if you are not going to remove punitive laws and
policies that restrict our human rights.”
The delegates restated their
commitment to the Asean Declaration of Commitment: Getting to Zero new HIV
infections, zero discrimination, zero aids-related death. Community
representatives applauded these commitments but stressed the need for Asean
Member States to take action to fulfill their commitments.
“Asean member states have pledged
to eliminate gender inequalities and gender based abuse and violence and
increase the capacity of women and girls to protect themselves from HIV,” said
Baby Rivona, an activist living with HIV. “We want to live in a world where
these commitments are realized, where programs and funds, and resource are
reaching us, key affected women and girls, ensuring that we can live in dignity
and enjoy our human rights.”
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