Zofeen Ebrahim* – IPS/TerraViva
COLOMBO, Aug 20 2007 (IPS) – The feminisation of HIV and AIDS continues in full swing in the Asia-Pacific, reflected in the fact that almost 40 percent of new HIV cases are among women, even if the newest estimates show that there are fewer people than originally estimated to be living with the virus in the region.
What is alarming for Dr Nafis Sadik, special adviser to the United Nations secretary-general and the U.N. Secretary-General #39s Special Envoy for HIV and AIDS in Asia and the Pacific, is the disproportionate rate of HIV among young married women. Marriage and fidelity seem to offer little protection from the disease and societal attitudes kept women powerless and poor, she said at the 8th International Congress on AIDS in Asia and the Pacific (ICAAP) underway here.
It is time to give them (married women) a face, a voice, said Prasada Rao, regional director for the Joint United Nations Programme on HIV and AIDS. Quoting a study by the United Nations Development Programme, Rao said that in South Asia, 40 percent of women leave their in-laws #39 homes after their husbands #39 death due to AIDS, and 80 percent of them are denied their property rights.
HIV, short for human immunodeficiency virus affects the immune system and causes acquired immune deficiency syndrome (AIDS).
The soaring HIV rates among younger women was partly due to the false notion that women #39s being ignorant about sex and sexuality until they get married is an asset, Sadik said. She emphasised the need for sex and AIDS education for young women as crucial to addressing the epidemic.
In countries like Thailand and Cambodia, more than 35 percent of new HIV cases are being reported among married women, trends that worry experts even if the latest official figures show that there are 5.4 million people and not the original estimate of 8.3 million living with HIV in the region.
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Annmaree O #39Keeffe of the Australian aid agency AusAID calls HIV and AIDS a justice issue, an education issue, a business issue, a women #39s issue and a development issue. She said: It is an issue that requires vision, leadership and commitment to address unpopular causes such as the rights and needs of stigmatised and socially marginalised minorities, and where necessary to challenge social norms regarding gender and sexuality.
Discrimination against women, unequal power relations between men and women constitute the basis of gender inequality that fuels the feminisation of the epidemic, said Sunila Abeysekera, executive director of Sri Lanka-based Inform, a documentation centre working on human rights in conflict and war situations. Even after three decades of commitment mostly lip service by governments to the protection of women #39s rights she considers the world an extremely perilous place for the female population.
Sexual violence and economic dependence increase women #39s vulnerability to HIV, agreed O #39Keeffe. The low economic and social status of women in many societies means that women are not in a sufficiently powerful position to negotiate safe sex. Thus, the ABC (abstinence, be faithful and consistent use of condom) model is not likely to succeed in protecting women unless broader contextual issues were addressed.
Just take a look at who usually has the upper hand in each of these three areas of sexual relations (abstinence-fidelity-condom use) and we appreciate how limited the woman #39s negotiating position often is, she added.
Abeysekera agrees, explaining that unequal power relationships make women more vulnerable to coercive and violent sex, which often put them at a disadvantage and leave them with little or no option to refuse sex, much less negotiate for safe and protected sex with her partners.
With women subjected to sexual exploitation, she emphasised the need to look at the nexus between the two intersecting pandemics violence against women and HIV and AIDS not just through the health lenses but to address it as social and cultural issues.
As much as both violence against women and HIV and AIDS are about physiology, epidemiology and bodies, they are also about political and social transformation, said Abeysekera.
But women #39s woes do not end there. Once they have HIV, these women become the target of further discrimination and violence because of their positive status. Fear of violence may lead to women not seeking information and testing and may prevent them from disclosing their HIV status and obtaining treatment and counseling.
Marriage is far from being a guarantee of safety from HIV for women, agreed O #39Keeffe, citing as examples Cambodia, India and Thailand where studies have shown that husbands were the primary source of HIV for women. And once women become HIV-positive, prevailing gender norms also increase the likelihood that they will be blamed, ostracised and rejected by their families.
Leaders were called upon to create enabling environments for women and to invest in female education, to give them economic opportunities, a necessary legal climate and frameworks that protect women from discrimination.
We must strengthen our resolve to create a world in which women and girls are able to live free of any form of discrimination, coercion and violence including sexual coercion and sexual violence, said Abeysekera, who called for a coherent gender analysis, adequate resource allocation and a commitment to human rights and women #39s empowerment.
At the political level, she urged leaders to aim for protection of women #39s rights under the law and to stem retrograde traditions and practices that make them second-class citizens. (*Terra Viva is an IPS Publication)