By Allyn Gaestel
Thursday, July 29, 2010
Some advocates at last week's International AIDS Conference greeted news of the results of an HIV gel coolly, saying more was needed than a "medicalized" response to an epidemic that travels a social pathway of infringed women's rights.
While some heralded the gel as an advance for women's control over their own protection, others worried that it might be treated as a substitute remedy for an underlying and deeper social issue: women's lack of agency to negotiate condom use or other protection measures.
Some activists see CAPRISA as emblematic of a wider simplification of women's risks and roles in the epidemic.
Given women's wide exposure to HIV risks, activists want to see an approach that stops focusing on individual women's risk groups and makes a broader link to women's overall rights.
"We will be talked about as mothers, we will be talked about as partners, they will talk about our roles…but they forget about our rights," said Everjoice Win, the international head of women's rights at ActionAid, an international anti-poverty agency.
Kiren, an HIV-positive woman from Malaysia, agreed with that criticism. "In order to tackle HIV we need to tackle the other issues surrounding HIV."
Part of the problem, according to a report published by UNIFEM at the conference, is that women are not included in the design and appraisal of HIV programs.
"Positive women, in particular, are actually not involved in the response in a meaningful way," said Nazneen Damji, co-author of the report. At best, women are involved "tokenistically or formally" but are not empowered to be in leadership or decision-making roles.
The report found a significant lack of documentation of women's participation as decision-makers in national and international HIV responses. One hundred women interviewed for the report cited barriers, including cultural factors and gender norms (79 percent) and economic disempowerment (58 percent) that prevented their full participation.
A broader, more integrated connection of women's rights to the anti-HIV agenda should be sought through coalition building among the various populations of affected women, said Meena Seshu, founder of SANGRAM, an HIV organization in India.
"Women who just identify as women, sex workers who identify as sex workers and…transgender women who identify as transgender women; these are not natural alliances," said Seshu. "But over the years I think one has started realizing that alliances…will have to be made if all women are to benefit."
Some organizations are seeking entry points for more integrative community care of HIV-AIDS.
Robin Smalley, international director of Mothers2Mothers, a multi-national nongovernmental organization that supports HIV-positive mothers in Africa, said that in countries with limited health infrastructure, prenatal checkups can be the only time women seek medical care.
"If we can take that time and engage her in a relationship of trust and support then through her we can engage her whole family," she said.
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Allyn Gaestel is an international freelance journalist.
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