Emily Sikazwe, Executive Director, Women for
Change, Zambia
1. With its demographic, social and economic
impact, the HIV/AIDS crisis has become more devastating than war.
In many countries, AIDS has progressed to a full-blown development
catastrophe affecting all sectors of society, rolling back years,
and in some cases decades, of hard-earned development gains.
2. With the spread of HIV/AIDS, the social
networks of many communities are eroding, and the informal social
institution of the extended family is silently breaking down.
More and more young girls and women, wives, mothers are affected
by the epidemic, and structures that have strengthened the stability
of the socio-economic fabric are being torn apart.
3. Women lose resources and rights once
their husbands die. Elderly people are left without care and dying
alone. Elderly women are increasingly becoming care providers
of orphans and sick family members when they themselves should
be looked after. A new generation of orphans brought up in poverty
will soon give rise to a generation of illiterate youth.
4. DFID's fight against HIV/AIDS can only
be undertaken successfully when there is a clear focus on women,
putting them at the centre of their strategy and implementation,
and ensuring that women take full control of their own bodies.
The strategy needs to fight against gender imbalances and cultural
practices that perpetuate power relations inimical to women's
health. HIV/AIDS in Africa and the rest of the world is about
power and about women's lack of it. Unless DFID contributes to
breaking down these barriers, they will not succeed in fighting
the HIV/AIDS pandemic.
GENDER AND
HIV/AIDS
5. Women are not just another "vulnerable
group", they represent more than 50% of the population and
the gender inequalities that render them more vulnerable to HIV/AIDS
must be addressed if we are to effectively reduce the spread of
the epidemic and prevent more families sinking into poverty.
6. Women are particularly vulnerable to
HIV infection. For example there are six women infected for every
five men. This is often due to the pressure of poverty and the
inequalities between men and women.
7. Men who often control the family income
can spend it on other sex partners since sex is being traded for
money. Women, in particular, are under pressure to exchanging
sex for the money they need to support themselves and their families.
For economic and cultural reasons, young women often have sex
with older men who do not reveal their HIV status and refuse to
protect themselves.
8. There are many sexually transmitted infections
(STIs) that go untreated for long periods of time. An untreated
STI makes a person more susceptible to infection with the HIV
virus. While this is true for both men and women, it is easier
for men to know that they have an STD. Men also have better access
to health care.
9. In marriage, it is difficult for a woman
to refuse to have sex with her husband, even if she knows that
he has other sexual partners. It is also difficult for a woman
to convince her husband to use a condom if he is having sex with
other women. It is even more difficult for a woman to leave her
husband, even if she knows she is in danger of being infected
and cannot get him to change his behaviour.
10. Cultural practices and traditional beliefs
contribute to increased risks of being infected. Men's attitudes
and sexual practices are putting not only themselves, but also
their wives and partners at risk.
11. There are statistics from almost every
country in the world showing that sexual violence against women
is at the heart of women's increased risk of infection. Sexual
violence against women by their partners is rampant. In some countries,
the first experience of sex for many girls is rape. Sexual abuse
of teenage girls by a relative or a friend of the family is common.
Commercial sex and rape during times of war, sexual violence in
refugee camps and amongst displaced populations, sexual services
and coercion in situations of economic or social dependency among
students, or at the work place, all put women at high risk. Sexual
violence against women is culturally and socially excused, and
often accepted.
12. It is critical for DFID's HIV/AIDS strategy
to have a strong gender focus and address the unequal power relations
between men and women that expose women to greater risk of HIV/AIDS.
DFID needs to also acknowledge and directly address the barriers
that women face in accessing and adhering to treatment (poverty,
food insecurity, gender inequalities, violence etc).
13. Men are part of the problem and must
be part of any solution that DFID develops. For example, gender
sensitive interventions that address men' socialisation are key
to encouraging men to go for voluntary counselling and testing
and providing support to their pregnant wives.
HIV/AIDS IS A
HUMAN RIGHTS
ISSUE
14. Prevention strategies put the blame
for the spread of the HIV virus on women, not on men. This reflects
a gender-biased conception of morality and religion. The clear
divide between "good women" and "bad women"
often determines the right to information and access to health
care and prevention. But these divisions are becoming blurred,
as all women have become a high- risk group.
15. The over-emphasis on HIV prevention
and cure, at the expense of treatment has resulted in an overall
reduction in the budget allocation for serious problems that affect
women such as anaemia, nutritional deficiencies, injuries due
to violence, maternal health and others. Access to health care
by poor women is becoming more and more remote.
16. The pressure to introduce mandatory
testing, especially of target groups, surfaces repeatedly. If
implemented, it will amount to custodial violation of a woman's
right to self determination. An alarmist and stigmatising HIV
& AIDS programme can result in practices of concrete disincentives.
In practice it is the woman who is tested because she seeks health
care during her pregnancy. In many cultures, Sexually Transmitted
Infections (STIs) are called "women's diseases".
17. If a woman is identified as being HIV
positive, she will be blamed and deprived of food and shelter
by her family. These poor, abandoned and homeless women, who are
entirely dependent on the government for their food and shelter,
will be totally compromised in their bargaining power and right
to refuse mandatory testing. The issue of informed consent is
shrouded in the reality of women's social and economic dependency.
LESSONS FROM
WOMEN FOR
CHANGE, ZAMBIA
18. As an organisation, Women for Change
prioritise the following in their fight against HIV/AIDS in Zambia.
(i) Intensifying advocacy for policies and practices
that are gender-sensitive, just and effectively respond to the
plight of the poor and those affected and or infected by HIV/AIDS.
(ii) Creating public awareness on rights of people/women
living with HIV/AIDS.
(iii) Intensifying activities in gender analysis
and awareness-raising to ensure that both women and men are sufficiently
gender sensitive and able to act on gender issues that perpetuate
contraction and transmission of HIV/AIDS infection.
(iv) Through the gender programme Women for Change
challenge the power relations that perpetuate the spread of HIV/AIDS
such as sexual cleansing, sexual violence, abuse and rape in homes.
(v) Working with traditional leaders to advocate
for the banning of negative cultural practices that put women
and men at risk of contracting the virus.
(vi) Support interventions aimed at enhancing
the quality of life for orphans and vulnerable children especially
girl children by:
(a)Facilitating support to the orphans and providing
them with school requisites.
(b)Facilitating capacity building for the out-of-school
orphans to enable them to look after themselves.
