I C WI C W

International Community International Community of Women Living with of Women Living with HIV/AIDSHIV/AIDS

Gender inequities, HIV, Gender inequities, HIV, vulnerability and impact vulnerability and impact

across the Commonwealthacross the Commonwealth

Commonwealth Parliamentarians AssociationCommonwealth Parliamentarians AssociationLondon Nov 2006London Nov 2006

ICW - Patron: Mary RobinsonICW - Patron: Mary Robinson

The The BurdenBurden of HIV/AIDS of HIV/AIDS on womenon women in Commonwealth Countriesin Commonwealth Countries

The Commonwealth has:The Commonwealth has:

66% = 25 million of all 38 million people with 66% = 25 million of all 38 million people with HIV/AIDSHIV/AIDS

72% 72% == 12.2 million of all 17 million 12.2 million of all 17 million women with HIV/AIDSwomen with HIV/AIDS

4 million of the 6 million people in need of ARV 4 million of the 6 million people in need of ARV treatment (and also treatment (and also carecare at home from at home from womenwomen))

Relatively much more HIV in Africa, Asia and the Relatively much more HIV in Africa, Asia and the Caribbean (ie where Caribbean (ie where womenwomen are are poorestpoorest))

11 Marriage Marriage has now been recognised as a risk has now been recognised as a risk factor for HIV for women in many parts factor for HIV for women in many parts of……..of……..

sub-Saharan Africa, Asia and L Americasub-Saharan Africa, Asia and L America

HIV: Global Facts 2005HIV: Global Facts 2005Some more facts (UNAIDS)Some more facts (UNAIDS)

New HIV infections in young people: sub-Saharan Africa

76%

24%

Young women

Young men

Source: UNAIDS 2004

WOMEN and GIRLSWOMEN and GIRLS

WHY?WHY?

International Community of International Community of Women Living with HIV/AIDS Women Living with HIV/AIDS (ICW)(ICW)

Most Most of our members in 130 of our members in 130 countries of the worldcountries of the world never never thought themselves to be at risk thought themselves to be at risk of HIV………..of HIV………..

……… ………and of those that did, most and of those that did, most hadhad no power no power to reduce their riskto reduce their risk

International Community of International Community of Women Living with HIV/AIDSWomen Living with HIV/AIDS

““FiveFive of my six of my six sisterssisters, all , all educated, married, intelligent educated, married, intelligent women, in senior career jobs, like women, in senior career jobs, like me, are now me, are now deaddead. . They realised They realised too late that they were at too late that they were at riskrisk – – and even then, what could they do and even then, what could they do about it? We just have about it? We just have no equality no equality in our marriages.”in our marriages.”

International Community of International Community of Women Living with HIV/AIDSWomen Living with HIV/AIDS

“ “ Some of my friends from student Some of my friends from student days 30 years ago decided they days 30 years ago decided they just wanted to just wanted to have children have children without getting marriedwithout getting married, to avoid , to avoid the ties of marriage. At the time the ties of marriage. At the time many criticised them. Now we many criticised them. Now we have realised that they were the have realised that they were the wise oneswise ones…….”…….”

GenderGender

““In all societies, gender is In all societies, gender is important in determining what important in determining what women and men are expected towomen and men are expected to know know about sexual matters, how about sexual matters, how they are expected tothey are expected to behave behave and and their their attitudesattitudes in relation to sex” in relation to sex”

(DFID report: Hansard, 2001)(DFID report: Hansard, 2001)

International Community of International Community of Women Living with HIV/AIDSWomen Living with HIV/AIDS

Men .…Men .… Women & girls…Women & girls…

DECISION-MAKINGDECISION-MAKING being being TESTEDTESTED (in ANCs) (in ANCs)

In relationships andIn relationships and

InIn governmentgovernment being being BLAMEDBLAMED

giving giving CARE to the CARE to the sicksick

Getting (some) Getting (some) TREATMENTTREATMENT…. …. ButBut….….

““We have been told by the MoH to promote We have been told by the MoH to promote ante-ante-natal testingnatal testing to stop MTCT. But one young to stop MTCT. But one young pregnant woman who tested pregnant woman who tested positivepositive here last here last month has just told us that she has been month has just told us that she has been beatenbeaten and and thrown outthrown out of her home by her husband and of her home by her husband and her parents won’t take her back either. What will her parents won’t take her back either. What will happen to her and her child now? happen to her and her child now? This policy This policy pains us too: it is no good without pains us too: it is no good without community understanding….” community understanding….” (Govt. nurse, E Africa)(Govt. nurse, E Africa)

Health workers see policiesHealth workers see policiesbackfirebackfire……

X Forced Depo-provera…. (“no sex”…)X Forced Depo-provera…. (“no sex”…)X No condomsX No condomsX No treatment for other STIs, eg herpesX No treatment for other STIs, eg herpesX Have to PAY for other testsX Have to PAY for other testsX Have to return several times for test X Have to return several times for test resultsresultsX No privacyX No privacyX At home – guilt, theft of drugs, no foodX At home – guilt, theft of drugs, no foodX Sharing drugs with children too…X Sharing drugs with children too…X Some women sell drugs for food……X Some women sell drugs for food……

When women do receive When women do receive treatment…..treatment…..

““My dream, what I was – a nurse known by My dream, what I was – a nurse known by all, with prestige, loved by everyone – had all, with prestige, loved by everyone – had gone. I fell into depression and forgot gone. I fell into depression and forgot everyone in the world” everyone in the world”

(ICW member)(ICW member)

Health workers often add to Health workers often add to stigma too…stigma too…

HHEALTHEALTH

unbiased care and respectunbiased care and respect

full sexual and reproductive rightsfull sexual and reproductive rights

Positive workplace policies…Positive workplace policies…

VCT first (then ANC)…. VCT first (then ANC)….

Meaningful involvementMeaningful involvement

of Positive women… of Positive women… LLAW REFORMAW REFORM $$$$$$$$$$$$$$ EEDUCATIONDUCATION

an end to violence an end to violence education education

child custody rightschild custody rights & &

property and inheritance rights property and inheritance rights good sex education good sex education

EECONOMICSCONOMICS

sustainable livelihoods sustainable livelihoods

free access to treatmentfree access to treatment

moremore orphans orphans

no no farmersfarmers

no no carerscarers of the sick of the sick

no no educatorseducators of children of children

no no communitiescommunities

no no futurefuture

KeepKeep HIVHIV positivepositive womenwomen Alive, Well, and Respected…. Alive, Well, and Respected…. oror……

International Community of International Community of Women Living with HIV/AIDSWomen Living with HIV/AIDS

www.icw.orgwww.icw.org

the only international network run by and the only international network run by and for HIV positive womenfor HIV positive women

November 2006 November 2006 LondonLondon Dr Alice Welbourn Dr Alice Welbourn

ICWICW

I C WI C W