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HOME: POPULATION ISSUES: PREVENTING HIV INFECTION: Strategic Guidance on HIV/AIDS Prevention
Preventing HIV Infection
Strategic Guidance
on HIV/AIDS Prevention
Purpose of the Guidance Note
Strategic Orientation for UNFPA Action
Integrating HIV/AIDS Issues into the Country Programming Process
Country Situations
Core Support
Creating an Enabling Environment for HIV Prevention
Advances in New Technologies and Issues
The Way Forward
Glossary
ICPD+5 Goals
Regional HIV/AIDS Statistics
Creating an Enabling Environment for HIV Prevention

In all three core areas, key strategies would entail the creation of an enabling environment to promote the prevention of HIV through attention to gender perspectives; capacity-building both within and outside UNFPA aimed at strengthening national capacities to respond to the pandemic and at building and utilizing knowledge; the promotion, strengthening and coordination of partnerships; and advocacy.

Mainstreaming Gender Concerns
Population Development Concerns
Advocacy and Partnerships for HIV Prevention
Capacity Building

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Mainstreaming Gender Concerns

UNFPA emphasizes gender dimensions in the design of population programmes, stressing equity, equality and the empowerment of women; advocacy for the reduction of violence against women; and male involvement in reproductive and sexual health.

Human rights, including sexual and reproductive rights and women’s rights, are all part of international commitments and agreed conventions, as outlined in the ICPD Programme of Action and the Convention on the Elimination of All Forms of Discrimination against Women.

The adoption of a gender perspective in the prevention of HIV/AIDS is an essential step towards effective programmes.


Women’s Vulnerability to HIV Infection

Addressing HIV/AIDS from a gender perspective is crucial because the risks of infection and the attendant consequences are vastly different for men and women.

The epidemic is spreading much faster among women than men. Globally, between 1997 and 2000, the proportion of female adults living with HIV increased from 41 per cent to 47 per cent, respectively. In sub-Saharan Africa, 12 to 13 women become newly infected with HIV for every 10 men, and in many sub-Saharan countries teenage girls are infected at a rate of 5 to 6 times greater than are their male counterparts.


The UNGASS Declaration of Commitment indicated several areas in which gender and HIV/AIDS intersect and calls on countries to:
"develop and accelerate the implementation of national strategies that promote the advancement of women and women's full enjoyment of all human rights; promote shared responsibility of men and women to ensure safe sex; and empower women to have control over and decide freely and responsibly on matters related to their sexuality to increase their ability to protect themselves from HIV infection." (paragraph 59)

Social, cultural and economic as well as biological factors heighten women’s vulnerability to HIV infection. Cultural practices such as widow inheritance, female genital mutilation (FGM), early and forced marriages and sexual practices may contribute to women’s vulnerability to infection, particularly in countries with high infection rates.

In many cultures, prevailing gender systems prevent women from making important decisions and critical choices for their lives. Often, this means that they cannot negotiate for safer sex, including condom use with their partners.

Girls living in poverty may be forced or sold into sexual trafficking, obliged to enter sex work or take on “sugar daddies” for financial support for survival, school fees or other necessities.

It is estimated that 2 million girls between the ages of 5 and 15 years are victims of sexual trafficking. Violence against women has been identified as one of the strongest co-factors in HIV infection. In addition, HIV-positive women face more discrimination than do HIV-positive men, often resulting in isolation, violence and rejection.

To address the gender dimensions of HIV prevention, it is necessary to address specifically the distinct needs of men and women, boys and girls. This requires the development of gender- and age-specific strategies that reach each group in addition to other general approaches. An important strategy for preventing HIV among women and girls is to recognize and build on their strengths rather than treating them only as victims who need protection.


Men’s Vulnerability to HIV Infection

For men, risk and vulnerability are heightened by norms that make it difficult for men to acknowledge gaps in their knowledge about sexuality; by the link between socializing and alcohol use; by the frequency of drug abuse, including by injection; and by predominantly male occupations e.g., truck driving, military) that entail mobility and family disruption.


Male Involvement in Preventing HIV Infection

Male responsibility for the prevention of HIV infection should be factored more prominently into the design and implementation of UNFPA programmes. Men are involved in almost every sexual transmission of the virus. They also have the power to stop this mode of transmission, given the overwhelming leverage they exert in sexual relations.

When men fail to protect themselves and others, it is often due to social and cultural factors. Family, religion, customs and beliefs, power structures, gender roles and relations, and social expectations all play a part in encouraging men to take risks and to disregard women’s feelings and needs. Men and boys also have peer pressure to live up to expected norms of masculinity, including that of having many sexual partners.

A long term strategy to reach men with more long-lasting effect is to socialize children at an early age to adopt safer behaviours, including to respect the rights of women and to fight sexual exploitation and other violence against women.


Activities

In promoting gender equity and equality, the aims must be to empower women and girls; to foster constructive roles for men and boys, including support for the establishment of male networks and utilization of the workplace to reach men; to introduce concepts of shared responsibility and increased communication on sexual issues between women and men; to support capacity- building for women’s organizations in HIV/AIDS policy development and implementation; and to improve sexual and reproductive health services for both men and women.

UNFPA should consider including the following in country programmes:

  • Advocate with respect to the legislative framework, addressing discrimination and sexual and reproductive rights, such as inheritance of property, widow inheritance, FGM, early marriage and sexual violence. This includes support to human rights education, including measures to address violations of such rights, especially for women and girls but also for community leaders and national policymakers;


  • Undertake socio-cultural research that identifies negative cultural practices and even more importantly, that identifies positive cultural practices as a basis on which to build HIV prevention programmes;


  • Advocate and support the integration of HIV/AIDS and sexuality education in national education programmes which should also address roles and responsibilities of girls and boys;


  • Promote awareness and BCC programmes that address practices and behaviours that fuel the epidemic;


  • Build national capacities in gender analysis and gender mainstreaming as the foundation for relevant and effective HIV-prevention programming;


  • Advocate for gender-sensitive national policies and legislative reforms on women’s rights and their protection from discriminatory practices that makes them disproportionately susceptible to HIV/AIDS. Needed are policies, laws, and public and community mobilization that create a supportive environment for girls and women, while encouraging male responsibility;


  • Expand gender-specific and gender-responsive communication strategies, including through peer education, mass media, social marketing and entertainment. Special care should be taken to ensure that the messages do not reinforce harmful gender stereotypes but rather offer positive values, benefits and alternatives regarding gender relations and attitudes. A thorough understanding of the socio-cultural context of gender roles and gender-specific reasons for health-related decision-making is necessary to tailor messages effectively. Political, community, spiritual and other influential leaders should be enlisted as male spokespersons to encourage men of all ages to develop positive, respectful attitudes and behaviours towards women. Young peer educators of both sexes can serve as community role models of gender equality and responsible behaviour; and


  • Promote gender-sensitive and user-friendly services. Reproductive health implementers at all levels, should be sensitized on gender and reproductive health and rights, including on STI/HIV issues. Training in gender- sensitive interpersonal skills and counselling should be emphasized for health providers and peer educators, including such topics as women’s limited power in negotiating condom use, male attitudes and resistance, implications of partner abuse (for method options, security issues), and implications of encouraging pre- and post-test couple counselling. Both male and female condoms should be made available, including practical skills training.

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