Part 2 Gender and HIV/AIDS HIV/AIDS IS A GENDER ISSUE BECAUSE: I Although HIV effects both men and women, women are more vulnerable because of biological, social, religious and economic factors. I Although HIV effects both men and women, women are more vulnerable because of biological, social, religious and economic factors.

Gender and HIV/AIDS According to UNAIDS global reports 2010 In 2002, 46% of 33.4 million adults living with HIV/AIDS were women. In 2002, 46% of 33.4 million adults living with HIV/AIDS were women. 55% of the 16,000 new infections occurring daily are women. 55% of the 16,000 new infections occurring daily are women.

Gender and HIV/AIDS A trend observed in some countries the male to female ratio among HIV infected persons has begun to equalise. A trend observed in some countries the male to female ratio among HIV infected persons has begun to equalise. In fact in some of the worst affected countries, women outnumber men. In fact in some of the worst affected countries, women outnumber men. Bottom line: In sub-Saharan Africa women increasingly make up the majority of People living with HIV/AIDS.

Gender and HIV/AIDS What is the number of women living with HIV/AIDS in your country?

Gender and HIV/AIDS II The rapidity of the spread of HIV/AIDS among women can be slowed only if changes are brought in the sexual behaviour of men. A behaviour study commissioned by USAID in India shows that 82% of the male STI patients had sexual intercourse with multiple partners within 12 months and only 12 percent had used a condom. A behaviour study commissioned by USAID in India shows that 82% of the male STI patients had sexual intercourse with multiple partners within 12 months and only 12 percent had used a condom.

Gender and HIV/AIDS A study of female youth in South Africa showed that 71% of the girls had experienced sex against their will. A study of female youth in South Africa showed that 71% of the girls had experienced sex against their will.

Gender and HIV/AIDS III feminized poverty and women’s limited voice in decision-making Poverty pushes some women into sex industry. Poverty pushes some women into sex industry. Young girls are particularly vulnerable and they often have no power to insist on safer sex. Young girls are particularly vulnerable and they often have no power to insist on safer sex.

Gender and HIV/AIDS Lack of education for girls results in low exposure to HIV/AIDS education messages due to low literacy rate. Lack of education for girls results in low exposure to HIV/AIDS education messages due to low literacy rate. The burden of care for sick family members falls on women in the family. The burden of care for sick family members falls on women in the family.

GBV and HIV/AIDS What is the link between HIV/AIDS and GBV?

GBV and HIV/AIDS Low power in relationship and intimate partner violence increase the risk of HIV infection incident. Low power in relationship and intimate partner violence increase the risk of HIV infection incident. Forced sex is correlated to HIV risk. Forced sex is correlated to HIV risk. Survivors of violence tend to engage in behaviors that put their health at risk. Survivors of violence tend to engage in behaviors that put their health at risk. Proposing condom use may increase women’s risk of violence. Proposing condom use may increase women’s risk of violence. Disclosing HIV status may increase risk of violence and abuse. Disclosing HIV status may increase risk of violence and abuse.

GBV and HIV/AIDS Why should Health/HIV project address GBV?

GBV and HIV/AIDS GBV is a major cause of death and disability among women. GBV is a major cause of death and disability among women. Health project can be more effective if it recognizes reproductive health (RH) implications of GBV. Health project can be more effective if it recognizes reproductive health (RH) implications of GBV. Health providers who do not ask about gender- based violence may misdiagnose survivors or offer inappropriate care. Health providers who do not ask about gender- based violence may misdiagnose survivors or offer inappropriate care.

GBV and HIV/AIDS Providers may be the first point of contact for women. Providers may be the first point of contact for women. Providers can assist women, rather than inadvertently putting women at further risk. Providers can assist women, rather than inadvertently putting women at further risk. Healthcare organizations can raise awareness of GBV as a public health problem. Healthcare organizations can raise awareness of GBV as a public health problem.

GBV and HIV/AIDS Use a “systems approach,” which entails: An institutional commitment to GBV An institutional commitment to GBV Sexual harassment policies Sexual harassment policies Patient privacy and confidentiality Patient privacy and confidentiality

GBV and HIV/AIDS Awareness of local GBV laws Awareness of local GBV laws Ongoing training and support for staff Ongoing training and support for staff Referral networks to link survivors to legal aid, counselling, shelters, etc. Referral networks to link survivors to legal aid, counselling, shelters, etc.

GBV and HIV/AIDS Protocols for the care of survivors. Protocols for the care of survivors. Emergency supplies such as STI prophylaxis, post-exposure prophylaxis (PEP), and emergency contraception (EC), where supported by the government. Emergency supplies such as STI prophylaxis, post-exposure prophylaxis (PEP), and emergency contraception (EC), where supported by the government.

GBV and HIV/AIDS Educational materials on GBV for clients Educational materials on GBV for clients Data collection systems Data collection systems Monitoring and evaluation of quality of care Monitoring and evaluation of quality of care

GBV and HIV/AIDS How can Health/HIV project address GBV?

GBV and HIV/AIDS Support efforts to fully integrate attention to GBV within existing health programs, such as Long-term efforts to sensitize and train health professionals about GBV; Long-term efforts to sensitize and train health professionals about GBV; “Routine screening” or “routine enquiry” policies ONLY when programs have basic protections for women; and “Routine screening” or “routine enquiry” policies ONLY when programs have basic protections for women; and

GBV and HIV/AIDS Participation of healthcare organizations in broader prevention efforts, referral networks, advocacy campaigns. Participation of healthcare organizations in broader prevention efforts, referral networks, advocacy campaigns. Do not duplicate services that already exist. Do not duplicate services that already exist. Health programs should try to identify the most economically feasible, cost-effective, and sustainable social services to provide. Health programs should try to identify the most economically feasible, cost-effective, and sustainable social services to provide.

GBV and HIV/AIDS Why should Health Policy project address GBV?

GBV and HIV/AIDS Assist in drafting policies and approaches for the health service response to GBV. Assist in drafting policies and approaches for the health service response to GBV. Reframe the policy debate about GBV as a public health and human rights issue. Reframe the policy debate about GBV as a public health and human rights issue. Produce and use research on magnitude of GBV to convince policymakers that Produce and use research on magnitude of GBV to convince policymakers that They should address GBV; and They should address GBV; and Gaps exist in the legal and civil codes. Gaps exist in the legal and civil codes.

GBV and HIV/AIDS Standardize health sector policies and appropriate GBV interventions at the institutional level. Standardize health sector policies and appropriate GBV interventions at the institutional level.

GBV and HIV/AIDS How can Health Policy project address GBV?

GBV and HIV/AIDS Research and dissemination of GBV findings Research and dissemination of GBV findings Public and private coalitions that design and implement GBV public policy approaches Public and private coalitions that design and implement GBV public policy approaches Efforts to educate key groups and broader population about GBV as a public health problem and the linkage to HIV/AIDS Efforts to educate key groups and broader population about GBV as a public health problem and the linkage to HIV/AIDS

GBV and HIV/AIDS Why is it important working with Youth in addressing GBV and HIV/AIDS?

GBV and HIV/AIDS Substantial proportions of girls and young women experience sexual violence around the world. Substantial proportions of girls and young women experience sexual violence around the world. Violence by intimate partners often begins within the first years of dating and marriage. Violence by intimate partners often begins within the first years of dating and marriage. Sexual abuse in childhood and adolescence has been linked to numerous poor health consequences. Sexual abuse in childhood and adolescence has been linked to numerous poor health consequences.

GBV and HIV/AIDS Youth sexual activity is not always voluntary or consensual. Youth sexual activity is not always voluntary or consensual. Youth programs are an ideal opportunity to further GBV prevention because attitudes gender and violence are still forming. Youth programs are an ideal opportunity to further GBV prevention because attitudes gender and violence are still forming.

GBV and HIV/AIDS How can Youth work address GBV and HIV/AIDS?

GBV and HIV/AIDS Require all reproductive health programming for youth to address sexual coercion and abuse Require all reproductive health programming for youth to address sexual coercion and abuse Support initiatives that improve family, peer, and community environments, such as Support initiatives that improve family, peer, and community environments, such as Efforts to promote gender-equitable norms and non-violence among young men Efforts to promote gender-equitable norms and non-violence among young men

GBV and HIV/AIDS Efforts to empower girls. Efforts to empower girls. Efforts to improve the institutional response to young survivors of GBV. Efforts to improve the institutional response to young survivors of GBV. Efforts to increase safety of girls and young women in educational settings. Efforts to increase safety of girls and young women in educational settings.

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