Policy makers, health care providers, the mass media, development assistance agencies and others concerned with stemming this pandemic must take account of gender relations and power dynamics in order to devise effective solutions.
Promotion of condom use is critically important. However, unless women are able to say “NO!” and be heard as well as respected, the effects of such campaigns will be limited. In order for this to happen, prevailing gender relations need to be realigned and male behaviour and attitudes that sustain such relations need to be transformed, for which men’s involvement and support is essential.
Access to treatment in general is a privilege that men enjoy far more than women. As health services begin to work out ways to distribute drugs, differential access to treatment and care needs to be taken into account.
Women need economic independence so that they can escape from high-risk situations, sustain their families and negotiate issues ‘when’ and ‘how’ related to their sexual lives. Micro credit and productive employment programs can provide effective support.
Existing legal and policy need to be reviewed with a sensitive lens to ensure positive sustainable changes in laws relating to inheritance, marriage and cultural practices.
Despite encouraging new levels of awareness, gender plays an aggressively predominant role in spreading the virus and worsening its impact as consciousness does not lead automatically to commitment. Constant vigilance and the full participation of women in policy formulation, planning and resource allocation are essential if we are to turn the political will we are now witnessing into action.
Simultaneously, efforts must be made to deepen our understanding of the gender dimensions of HIV/AIDS, and unprecedented cooperation both at national and international levels will be required to translate gender awareness into targeted plans and programmes, equal access to information, services, commodities and protections, and the guarantee that a fair share of financial and other resources will benefit women and girls.
Recommendations therefore would include the flowing:
• A gender perspective in all policies and programmes;
• Sensitization of leaders about the gender concept and the role that they can play in positively transforming gender relations within their communities;
• Promotion of new images of masculinity that emphasize male involvement, respect for women’s reproductive rights, nurturing and negotiated conflict resolution;
• Promotion of research on masculinity and male sexuality in the African context;
• Promotion of women empowerment at all levels such as household, community and national levels to enable them to assert their sexual and reproductive rights;
• Undertaking coordinated action to eliminate gender-based violence;
• Promotion of equal educational opportunities for both boys and girls;
• Enable parents and other traditional socializing agents within the family and community, (such as grandparents, aunts), through education and sensitization, to offer sexuality information and education to young persons;
• Ensuring that family life education, in both school and out-of-school settings, covers sexuality and gender;
• Reviewing national legal frameworks to render them responsive to gender aspects of HIV/AIDS;
• Putting in place Legislation protecting women from violence and ensuring their equality, particularly in the choice of marriage partner;
• Demonstrating commitment by all members of society, especially the media, to addressing the burden of care and the socio-economic impact of HIV/AIDS on the health and economic status of families and nations;
• Mobilization by the press of communities and governments to do away with societal values that are damaging to women and promote those based on shared respect; and
• An understanding that ‘gender’ does not mean the female sex and a focus on priority interventions for male involvement in HIV/AIDS programmes.
It is known that young women and girls (15-24 years) make up 64% of young people in developing countries living with HIV or AIDS. In Sub-Saharan Africa, 4.65million women and girls are living with HIV or AIDS. Studies show that women can be 2.5 times more likely to be HIV-infected ad their male counterparts.
The factors that contribute to women and girls' greater vulnerability therefore can be said to be as follows: Inadequate knowledge about HIV and AIDS; Insufficient access to HIV prevention services, including Voluntary Counseling and Testing (VCT); Inability to negotiate safer sex; Lack of female-controlled HIV prevention methods such as female condoms and microbicides; Biological vulnerability to HIV; The culture of silence surrounding sexuality; Exploitative transactional and intergenerational sex; and Violence within relationships with boys and men
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