Dispatches from AIDS 2008: Challenges for Women and Girls and HIV/AIDS

As part of the OSI Public Health Program activities at the 2008 International AIDS Conference in Mexico City, Juliana Rincón Parra of Global Voices is posting a series of dispatches on conference events that address the human rights and health needs of marginalized persons.

At the International AIDS Women’s Caucus Challenges for Women and Girls and HIV/AIDS. Five minutes to the hour, the audience starts shuffling in. Women wearing blue jeans, dresses, suits, and saris fill in the audience.

After opening words from Mabel Blanco and Serra Sipple with the Center of Gender and Equity promoting sexual and reproductive rights for the developing world, Steven Lewis then opens the session. He gives the context, that the struggle for the rights of women is an endless struggle, after all the conferences on behalf of women of the world, the compromises, the commitments and promises to improve the situation have not been kept. We see the constant feminization of the AIDS pandemic, 61 percent of the people living with the virus in Africa are women.

Sexual and reproductive rights and health information is vital and imperative for HIV/AIDS prevention. Girls in Africa usually don’t get to high-school due to high costs, this means that they are denied the only sexual education they might receive. Among girls and young women between 15 and 24, only 38 percent know about the pandemic of HIV/AIDS and don’t know how to protect themselves.

In areas of conflict, rape and sexual violence augment the rates of the pandemic, and after conflict situations, he says that the worst place in the world for women is the Congo. In the last month of June 2008, 2,000 women were raped in the north of the Congo. With 150,000 people driven from their homes, rape and sexual violence have become a strategy of war. Women are attacked because attacking women destroys the fabric of society in the same way their genitals are destroyed. Steven Lewis is passionate about the injustice done to women in sexual violence. His indignation permeates his criticisms to the UN, and their failures to control the situation in the Congo.

The relationship between sexual health and HIV/AIDS will be discussed during the round table.

Purnima Mane is the Deputy Executive Director (Program) of the UNFPA. Although it seems like an obvious connection, it was important to establish that linking HIV and sexual reproductive health works. This connection increases access to and the uptake of services, it improves health and behavioral outcomes, including condom use, increases knowledge of HIV and other STIs and it improves quality of services, meeting clients’ needs more completely.

There needs to be more work with including other vulnerable groups, and it isn’t just about adding services. Brazil is used as an example: With an integrated plan to combat the feminization of the AIDS epidemic and other STDs in March 2008. Also Haiti represents an example of including all health services under the roof, it has been proven to improve assistance to all the services, and efforts are being taken to eliminate the stigma attached to seeking HIV information.

Alessandra Nilo warns us that she’s pessimistic regarding the support of women’s issues in the fight against AIDS. She goes point by point with examples of how policies are designed by ignoring women and girls. She suggests working closer with female centered organizations so that AIDS becomes a topic discussed when women are discussed. She insists that leadership is needed.

Lynn Francis brings us stories of individuals behind the percentages that Lewis pointed out. Where women are sterilized by force, genitally mutilated, and women are victims of intergenerational sex, it was believed that children born of HIV+ mothers wouldn’t survive after 5 years of age, so it wasn’t a concern: now these children have grown up and they aren’t being educated about love, sex, family, and how to negotiate around these issues.

Francis gave a presentation back in 1993 on sexuality after seropositivity, although the common thought is that positive status means abstinence. In Zimbabwe, the government has included the female condom in health plans, but they are not available in reality.

She also speaks about the negation and the loss of sexual identity as a positive woman, that there is a belief that after HIV you can’t date, love or have sex, and that has to do with the lack of information about how to deal with sexuality after HIV.

Liz Maguire from IPAS speaks about unsafe abortions. These respond to unmet needs of HIV-positive women and wanted pregnancies. More than 1.8 million HIV positive women become pregnant each year, and they are wanted babies. The vast majority lack access to ARVs, they are not believed fit to be mothers, and some are pressured to have abortions, a human rights abuse if anything. Among HIV positive women with unwanted pregnancies, access to safe abortions is not available, and with the only option being unsafe abortions, they are left out of the loop. Sometimes health care providers refuse attention out of fear, the women are stigmatized and discriminated against, they are pressured to get sterilized, and the poor quality of the clinics poses risks to HIV-positive women.

There are documents that provide options for HIV women regarding pregnancies and abortions, however, many policy restrictions remain in place, and they have been silenced. What she suggests is including unwanted pregnancy and abortion into AIDS policy discussions, also to include assisted conception and adoption facilitation in comprehensive reproductive health. Advocates should ensure access to abortion for all legal indications, avoid singling out HIV-positive status as an abortion indication in actual laws as well as promote WHO’s guidelines on abortion and HIV/AIDS, building a movement to promote safe pregnancies and safe abortions.

María Consuelo Mejía from Catholics for the Right to Decide spoke next, saying the Catholic church hierarchy’s relationship to HIV/AIDS incidence is direct. The Vatican, the Catholic church’s seat, would not allow a HIV-positive man to use a condom with his wife, that he should abstain, however if it were impossible to abstain or the marriage were in danger of falling apart, he should have sex with his wife, without a condom. Misogyny in the Catholic church is to blame for the spread of HIV, Mejía said. Since Eve, women have been blamed for man’s downfall. According to the church hierarchy, women are submitted to God through submission to a male figure. In spite of advances in human rights regarding women, the woman is still subjected to men, and should be punished through violence. Women are denied the right to demand the usage of condoms in marriage, or refuse sexual relations with their husbands. They call out to the church to make true that one should love one’s neighbor as one loves oneself and allow the usage of condoms.

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