Leading up to the year 2015, the United Nations and civil society groups are organizing a series of consultations to help shape the post-2015 development agenda. Part of this process is a Global Online Discussion, which provides a platform for people worldwide to share their visions for building a just and sustainable world free from poverty. IWHC made the following contribution to the online discussion on “The Unfinished HIV Agenda.” Click here to read our contribution to the thematic consultation on Inequalities, specifically within the sub-discussion on “Inequalities faced by girls”.
Despite the highly gendered nature of the HIV/AIDS pandemic (women represent well over half of all people living with HIV worldwide), most prevention and treatment programming fails to account for the social determinants—violence against women, limited access to sexual and reproductive health (SRH) services, early and forced marriage, etc.—which make women and girls particularly vulnerable to the virus.
The International Women’s Health Coalition believes that effectively curbing the spread of HIV/AIDS relies fundamentally on the integration of sexual and reproductive health and rights (SRHR) with HIV/AIDS programming. The post-2015 development agenda must address the particular susceptibility of women and girls to HIV as well as the fundamental role that gender inequality plays in the spread of the virus.
Integrating SRH and HIV/AIDS services is a proven strategy for reducing new infections. When men and women have access to HIV testing and treatment in the same spaces they seek out family planning and maternal health services, they are more likely to find out their status, learn about prevention methods, and explore treatment options.
Research has also shown that the availability of HIV services alongside other SRH services can reduce the stigma typically associated with HIV-specific programs. Because the availability of treatment services for other STIs has been proven to reduce new HIV infections, expanding access to all forms of contraception and sexual health services through voluntary, rights-based, client-centered, and cost-effective programming is imperative.
Comprehensive Sexuality Education (CSE) should equip young people with protective sexual behaviors, the skills to effectively use condoms and other contraceptive methods, and should address gender and power, human rights and healthy relationships. While male and female condom use is proven to reduce new HIV infections, the distribution of condoms alone is not a sufficient prevention method. CSE should ensure that young people know how to use condoms correctly and should equip girls in particular with the tools to negotiate condom use and refuse unwanted sex.
In addition to equipping young people with scientifically sound and culturally appropriate information about sexuality, health, and rights, CSE should introduce empowering life skills to help young people navigate healthy and rewarding relationships, influence leaders in their community, and exercise their rights.
It is critical to invest in prevention efforts that target the most at-risk and overlooked populations of women and girls—adolescent girls, married girls and women, sex workers and women who use drugs. We must also ensure that treatment options are available and accessible to those living with HIV/AIDS, and that prevention and treatment efforts do not infringe on the rights of women living with the virus.
Women living with HIV/AIDS have a number of unique needs, and are particularly vulnerable to coercive sterilization practices, violence and discrimination. They still often provide the bulk of care and support for their families, they face unmet need for contraception, and they need support to prevent vertical transmission.
Prevention of Mother to Child Transmission efforts play an important role in reducing new HIV infections, but these programs tend to focus far more attention on the infant than the mother. The rights of HIV positive mothers must be fully protected and realized, including the right to informed consent and to choose the treatment regimens that best meet their needs.
The post-2015 development agenda must commit to addressing HIV/AIDS through targeted evidence-based prevention and treatment methods that account for the unique needs of women and girls. Curbing the spread of HIV hinges on the transformation of discriminatory gender norms and practices, and the expansion of SRHR programming and policies. When women are able to refuse sex, live free from violence, insist on condom use, and avoid early marriage, they are able to reduce their risk of HIV infection (not to mention attend school, participate in civic affairs, and engage in healthy and respectful relationships).
Like so many of our development priorities, addressing the HIV/AIDS pandemic is inherently linked to issues of gender equality. We must focus not only on the direct determinants of HIV infection, but also the profound gender inequalities and resulting discriminatory practices which make women more vulnerable to the virus and which stand squarely in the way of addressing its spread.