While women have largely been left out of the conversation when it comes to HIV/AIDS, activists from all over the world were in full force at the 21st International AIDS Conference in Durban, South Africa, last month, trying to change this. IWHC spoke with four feminist champions who are making major contributions to the HIV and women’s rights movements in different ways.
Brenda works with the International Community of Women Living with HIV Eastern Africa. She was inspired to get involved last year because she felt that women living with HIV deserve to have their voices heard; because of strong stigma around HIV, they are often ashamed to speak out. “In society, women are considered the lesser species, when they have HIV they become even lesser,” she said.
The biggest challenge, noted Brenda, is that they are not involved in making the decisions that affect their lives—including those about their own health and futures. For example, in Uganda—where ICW Eastern Africa is based—forced sterilization is illegal, yet health providers often sterilize women who are living with HIV without their knowledge and against their will. This most often occurs when HIV-positive women deliver by c-section, and health workers feel that they have the authority to do what they think is best following the delivery. It is often done without the consent of the woman, who may not even know she has been sterilized until she tries to conceive later on. Sometimes they ask a relative to give the consent or coerce the woman immediately after she has given birth and is not in the right state of mind to make this decision.
ICW Eastern Africa released a report last year highlighting this gross human rights violation, and Brenda spoke of the trauma it causes, “For women in Africa, being able to give birth is what makes you whole.” Denying women living with HIV the right to bear children must be stopped, and she hopes policymakers will finally take notice and make sure the current law is enforced. “We’re hoping the conference will give this research the exposure it deserves, so it can’t be ignored anymore.”
Kay Thi Win
“Sex work is work!” This is a message Kay Thi hopes comes through at the conference and back home. Kay became involved in the sex worker movement in 2005 in Myanmar and is now the Regional Coordinator for the Asia Pacific Network of Sex Workers, based in Bangkok. The Network opposes the criminalization of sex work, advocates for universal access to health care, challenges stigma and discrimination, and speaks out against violence.
Sex work has been decriminalized in only one country in the Asia Pacific Region—New Zealand. In the other 37 countries, it is criminalized. As a result, sex workers often experience violence and abuse from both police and their clients. Their work is highly stigmatized and driven underground, and they have severely limited access to sexual and reproductive health care, include HIV services.
When sex work is decriminalized, sex workers have protections. They can report crimes to the police without incriminating themselves or their clients. Kay is realistic about the movement for decriminalization; she knows it will be slow-going. But she notes some signs of progress in the region. Communities in Myanmar and Laos seem to be further along. In Vietnam, they used to detain sex workers in centers that were like prisons, she notes. But these centers were closed last year.
In Thailand, the picture is not so great. “Last month, one of the karaoke bars was shut down by the police, and many sex workers were arrested.”
Kay is not daunted. She has found support among her peers at the conference, from all over the world. “We came here to mobilize people and to make a united voice among sex workers and their allies. This is the one place we can be heard.”
She’s disappointed though that community empowerment and engagement haven’t been part of the main, plenary sessions of the conference. She sees sex workers as a critical part of the HIV and human rights movement, and they should have been more involved in the conference. “It’s not only about the science,” she says.
“It’s been 16 years since the International AIDS Conference was last in Durban, and you wouldn’t think that we would still be talking about the vulnerability of women, but we are. While we’ve seen progress, women and girls remain vulnerable.” Glenda works with the South African human rights organization Access Chapter 2, which focuses on women, LGBTI individuals, youth, and other marginalized communities. The group is named after the country’s Bill of Rights, Chapter 2 of its constitution.
Glenda recognized the great need to make sure women were not left out of the conference, so she coordinated a networking zone, which was a safe space for women to share experiences, explore issues, and help galvanize the movement—which they may not have been able to do elsewhere.
After all the money spent on HIV/AIDS programs, she said, women are not better off than when the epidemic started. “Women remain vulnerable. Women remain without services. Women remain without education—without information they can impart to the younger generation.”
She identified empowering young women as critical and spoke about the importance of comprehensive sexuality education and health services that are youth-friendly—provided in a confidential and nonjudgmental way. “Health care workers are not sensitive about issues of confidentiality, and there’s still stigma and discrimination against young people because they’re seen as wanting to have sex too early,”
The problem is that young women are not asked about what it is they need; they are not given a seat at the table, Glenda noted. But she is optimistic about the young women she’s met through her work and at the conference, and their potential to overcome—if they are given more of a role. “Young women should be given a platform to say what it is that they need. They are ready to take these leadership positions.”
Over the more than six years that Duduzile has been involved as an organizer with the sex worker movement in South Africa, she has seen encouraging changes. The size of the collective has grown, with women less reluctant now to identify themselves as sex workers. “Even though the stigma is still there, they are being strong and standing up for themselves. They have more knowledge about their rights.”
But they still have a way to go until these rights are met. Because sex work is criminalized in the country, women engaged in it often face violence, exploitation, and discrimination. And health services are largely out of reach. As a result, the rate of HIV among sex workers is extremely high; HIV prevalence among female sex workers can be as high as 72 percent in certain areas.
As a sex worker and mother, Duduzile has seen the impact of HIV and the current laws first-hand. When she started out, she was frustrated by the gaps in health care and support. She knew pregnant women who were engaged in sex work who had nowhere to turn; they did not have access to high-quality sexual and reproductive health services and were forced to have unsafe abortions.
And she’s seen the damaging effects of these injustices on children of sex workers, who are highly vulnerable and marginalized. “My child is experiencing stigma and discrimination because of the work that I do.” Over the years, Duduzile’s determination to fight for her rights and those of other sex workers grew.
In 2013, she started Mothers for the Future to empower women who are sex workers and to provide them with health care, legal services, child care, and social support. The organization also advocates for the decriminalization of sex work.
The South African government is supposed to be releasing a report documenting sex work in the country, and Duduzile and other activists are hoping it recommends decriminalization. But the government has had the report since 2014 and keeps pushing back its release. “The fight continues,” she says. “We’re not going to lose hope.”
She was buoyed by the AIDS conference though, which could mark a turning point. “There has been a mind-shift in the way people think about sex workers and the children of sex workers. Their understanding is growing. It’s very positive.”