GREAT WOMEN’S ROLE IN AIDS FIGHT

HERE in Swaziland, the HIV infection rate amongst women is four times or quadruple, the infection rate of men. 
This finding has prompted calls from health officials and health and social welfare organisations for greater participation of women in this paramount health issue – not just here but in other AIDS-affected countries. 
The preponderance of women who live with HIV is an international situation.  A new report highlighting the disparity in the number of infected women compared to men has raised support for women’s involvement that echoes last month’s call for a greater ‘participants’ role.
An earlier AIDS LIFELINE column delved into the issue of giving HIV-positive people a greater say in AIDS policy making, because it is they who are most directly affected by the disease. 
Health leaders around the world feel that HIV-positive people should be consulted and have a hand in drafting policy that deals with AIDS prevention, mitigation and treatment.
A similar view is being expressed concerning the desire for an expanded role for HIV-positive women in particular and all women in general, for amongst the two sexes all women are more vulnerable to contracting the disease.
 In Swaziland, as stated at the beginning of this column, four women are infected with HIV to every man.
This is unusually high.  When the entire Sub-Saharan region is considered, 61% of people infected with HIV are women – less than two women to every man.
But that number has doubled in less than 20 years.  In 1980, only one third of HIV-positive people living in Southern Africa were women.  They were outnumbered by HIV-positive men by two to one.
Ten years ago, the statistics showed equality.  Women numbered half of all HIV-positive people in Sub-Saharan Africa.
These findings are included in a new study released this month: “Moving Beyond Gender as Usual.”
cautions
The report cautions that the fights against AIDS will ultimately fail if focus remains on the HIV virus at the expense of the factors that are responsible for people contracting the disease.
For instance, why in this age of well-disseminated AIDS information are people still not using condoms?  What are the conditions that account for the ballooning number of HIV-positive women in Swaziland and elsewhere – so that concerns might be raised that the number of healthy women are insufficient to produce new generations?
“Factors that contribute to gender inequality, such as gender-based violence, unequal access to resources and cultural gender norms, can all contribute to greater infection risk and fewer treatment options for women,” notes the report.
Readers of our local newspapers this week know of one household where a man exiled his female relative from their home because she was HIV positive and he feared contagion.  (Perhaps information on how HIV is contracted may not be that widely disseminated after all.)  How many such incidents go unreported?
Researchers have found that in countries where the HIV and AIDS stigma is high, women fearful of their partners’ and families’ reactions will shy away from testing, hide results if they are tested positive, and abstain from life-saving treatment, including anti-retroviral drugs (ARVs).
Discrimination, gender-based violence and women’s inability to travel and access public facilities with the ease of men also contributed to HIV’s spread amongst women.
The report found that women who are uneducated are more likely to become HIV positive. 
One organisation, Population Action International, has produced an impressive figure from its studies: For every year of education that a woman receives, she has a 7 percent decreased risk of HIV infection.
A woman who completes secondary school, according to this model, has a 75% better chance of not becoming HIV-positive, because she can understand the prevention message in AIDS literature and follow such prescriptions.
Of course, education is just one factor in determining who becomes infected.  Even an educated woman can contract HIV if she suffers unequal status at home, and is unable to influence her husband to use a condom.
“Gender norms often limit women and girls’ ability to negotiate the limits of their sexual behaviour,” stated an HIV and AIDS researcher Kim Ashburn, employed by the International Centre for Research on Women (ICRW).
Three Southern African countries have dedicated legislation to addressing ‘gender inequality’ that contributes to HIV amongst women.  Uganda, Mozambique and Zambia have national gender-based AIDS policies. 
However, the effectiveness of these policies has been called into question.  There has been no implementation or follow through to truly bring change to the lives of women on the ground.
Consequently, it is not to politicians but to women themselves that the ICRW, the World Bank, UN agencies and international donors are calling to participate more.
Next month, August, is dedicated to women in most Southern African countries, and the gender-based AIDS link will be raised at several forums.

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