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HIV spread by violence against women - Bertil Lindblad, UNAIDS
5 March 2003. UNAIDS Statement.
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At the heart of the global HIV/AIDS epidemic lies gender inequality. At the end of 2002, women for the first time comprised 50 percent of the 42 million people living with HIV/AIDS worldwide. In sub-Saharan Africa, there are 17 million women living with HIV/AIDS, 58 percent of the total.
Women bear the main burden of care; women are the last in the queue for treatment; women and girls are denied information and education and women are denied the power to negotiate their sexual safety because they do not have control over income and property.
Women and girls often lack information about HIV/AIDS. A recent UNICEF survey found that up to 50 percent of young women in high prevalence countries did not know basic facts about HIV/AIDS. Girls do not sleep with older men because they think it is safe. They may do so to be able to pay their school fees. Sex workers do not agree to sex without condoms because they do not know their benefits. They do so because they get paid up to five times as much money. Women do not breastfeed their babies because they are unaware of the risks. They do so because they do not know their HIV status and they are afraid of condemnation or they cannot afford to use breast milk substitutes safely. The point is that women need more than advice. They need resources, education, jobs - real options to live safely and productively in a world with HIV/AIDS.
The interplay between gender inequality and HIV/AIDS is therefore central to the world's pledges to do better. It is a key component of the action plans in follow up to the World Conference on Women and the International Conference on Population and Development. Likewise, a pervasive theme throughout the 2001 Declaration of Commitment on HIV/AIDS, adopted at the UN General Assembly Special Session on AIDS in June 2001, is the importance of gender equality and women's empowerment as a core long-term strategy to reduce the vulnerability of women to HIV/AIDS.
Women's empowerment - the full realisation of women's human rights - reduces their vulnerability to HIV/AIDS. This year's theme of the Commission - women's human rights and the elimination of all forms of violence against women and girls - is particularly important in defeating the epidemic. Strategies to protect women from sexual aggression and violence are not only important in their own right, but will markedly increase women's protection against HIV infection. The varied forms of violence against women, and the economic dependence which makes violent situations harder to escape from, fuel the spread of HIV/AIDS. Between 10 and 50 per cent of women worldwide report physical abuse by their partners. The fear of intimidation prevents the risk of contracting HIV from being discussed and worse, results in HIV infection In a number of countries, HIV-positive women were found to be 10 times more likely to have experienced male violence than those that are HIV-negative.
At the same time, HIV positive women have in many cases not sought care or treatment for the same fears of physical violence, stigma, discrimination and ostracism. This despite the fact that for millions of women worldwide, their only 'risk factor' for HIV/AIDS has been sex with their spouse. Findings of recent research have shown that in many cases, the majority of HIV positive women were infected by their husbands. For example, in a city in Asia, more than 90 percent of women being treated for sexually transmitted diseases admitted to having only one sex partner in their whole life - their husband, and 14 percent of the women had been infected with HIV/AIDS.
Conflict situations greatly increase the vulnerability of women and girls and the risk of contracting HIV/AIDS. The breakdown of social systems, lack of access to care and education services, and increased levels of sexual violence all contribute to this risk. UNAIDS is working closely with the UN Department of Peacekeeping Operations to ensure that wherever they are deployed, UN peacekeepers are also warriors against HIV/AIDS. Similarly, special HIV/AIDS gender advisers have been attached to peacekeeping operations to work with both uniformed personnel and affected civilian populations to try to break the link between conflict and HIV transmission.
The UNAIDS partnership comprising the eight Cosponsoring organizations and the Secretariat is giving particular attention to the gender dimensions of the epidemic across their full mandate. So, for example, ensuring that the goals of Education for All are met by ensuring that girls are not pulled out of school when a crisis strikes, is a fundamental action to protect against HIV/AIDS. Likewise, the UNAIDS' partnership with UNIFEM is raising awareness of the centrality of the realisation of women's human rights to the HIV/AIDS epidemic.
Overcoming the gender inequality that drives the global HIV/AIDS epidemic therefore requires targeted action on many fronts:
- Attacking stigma and discrimination;
- Enacting and strengthening legislation to give women economic rights and access to credit;
- Expanding access to prevention services, including prevention of mother to child transmission, as well as access to antenatal care and real options available to HIV-infected women in choosing not to breastfeed;
- Training uniformed services and health personnel;
- Protecting orphans, particularly girl orphans.
Women's empowerment, gender equality and reversing the spread of the HIV/AIDS epidemic are inextricably linked. As the Secretary General's Special Envoy for Humanitarian Needs in Southern Africa, Mr. James Morris, concluded in September 2002: "An immediate, strongly led and broadly implemented joint United Nations drive to take action on gender and HIV/AIDS -involving all UN partners, actively engaging governments and substantially increasing support to civil society organizations - must be initiated without delay".
Substantial though the task may be, it is not hopeless. To take one example of action under way, in Southern Africa, where girls are infected with HIV/AIDS at four times the rate of boys, UNAIDS is supporting a youth HIV/AIDS initiative with a special emphasis on adolescent girls. Working with eight different countries, community-based interventions are expanding reproductive health services, training peer educators, extending micro-credit and health insurance, and supporting training and employment.
There are hopeful signs emerging across the world, and often, it is young women who have been the harbingers of hope. HIV/AIDS rates among young women have fallen -- in parts of Zambia, among young South Africans, in Addis Ababa, in Malawi, in Cambodia and elsewhere.
This message of hope needs to be central in the deliberations of the Commission. The link between violence against women and the spread of HIV/AIDS can be broken if and when concerted action is taken against these twin evils.
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