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HEALTH: Cultural Double Standards Undercut HIV/AIDS Fight

Thalif Deen

UNITED NATIONS, Jun 13 2008 (IPS) - The United Nations says religion and culture continue to have a significant impact – both good and bad – on the spread and prevention of HIV/AIDS worldwide.

The practice of male circumcision, prevalent in some cultures, has decreased the risk of HIV transmission in men, while male sexual promiscuity in some societies has put married women at high risk of contracting the deadly disease.

But the jury is still out on polygamy – where men demand their right to have multiple wives – long considered a key factor in the spread of HIV infections in Africa.

A 248-page study by the U.N. Commission on HIV/AIDS and Governance in Africa (CHGA), released last week, says the evidence on polygamy is inconsistent.

“Polygamous behaviour has been considered one of the major factors promoting the spread of HIV in Africa, where higher rates of HIV infection often are found in areas with high rates of polygamy,” it noted.

Still, in Ghana, where 44 percent of marriages in the north are polygamous, the prevalence of HIV infection was the lowest.

As of December 2007, there was an estimated 33.2 million people worldwide living with HIV, according to the United Nations. But the annual number of AIDS deaths has declined, from 3.9 million in 2001 to 2.1 million in 2007.

The cultural double standards on the sexual behaviour of men and women are also a key factor in the spread of HIV/AIDS.

At a CGHA interactive session in Africa, one participant is quoted as saying: “In our societies, men have a ‘cultural license’ to demand sex, unprotected, at any time, and the woman cannot say no, even if she knows he is infected. This has to change.”

“In our polygamous society,” another participant complained, “it is accepted that men have multiple partners, while women have to be faithful to one.”

The role of religion, on the other hand, has often been a positive factor in the fight against HIV/AIDS.

Conscious of the importance of religion in most societies, the United Nations is deploying religious leaders and faith-based organisations to raise awareness on AIDS.

Under its HIV/AIDS regional programme in the Arab states, the U.N. Development Programme (UNDP) held its first-ever training programme on AIDS awareness for 135 Sunni and Shiite religious leaders in Bahrain last year.

In Somalia, some 130 religious leaders attended seminars, while 500 women attended lectures on HIV/AIDS. And in Djibouti, 24 imams have received voluntary counseling and testing for HIV, thereby reducing the social stigma attached to the disease.

The United Nations also says that HIV/AIDS education kits, with references from the Quran or the Bible, are increasingly popular advocacy tools for religious leaders worldwide. The government of Morocco is using these kits for HIV education to all 31,000 imams in that country.

Sr. Maura O’ Donohue of Caritas International says that governments give a very rosy picture of what is happening in their countries.

“But they very rarely acknowledge that NGOs, faith-based organisations, and other grassroots organisations are providing at least 30 percent of the services for five percent of the money,” she added.

Addressing a panel discussion on the margins of a high-level General Assembly meeting on AIDS, the executive director of the U.N. Development Fund for Women (UNIFEM), Ines Alberdi, said because HIV is most often transmitted sexually, unequal relationships between men and women, together with gender stereotypes, fuel its spread.

“We need to empower young women to know and exercise their rights – to education, health services, economic opportunities, and freedom from violence,” she said.

Secondly, she said, “We need to find ways to engage men and boys in combating gender-based stereotypes and behaviour that fuel this (AIDS) pandemic, starting in the home.”

“Action is needed to promote male behaviour that is based on respect for women’s rights, responsibility, and that is non-violence and non-abusive,” she declared.

She also quoted Elizabeth Mataka, the U.N. special envoy on HIV/AIDS in Africa, who said that in addition to more money, “We need to use those funds to be bold, and challenge the cultures and norms that generate behaviours like violence against women and perpetuate the spread of this deadly pandemic.”

Thoraya Ahmed Obaid, executive director of the U.N. Population Fund (UNFPA), said: “We need to pay more attention to women and young people, especially those who are living with HIV, and engage them as experts in the response.”

“Young people have called for greater engagement in plans, policies and programmes and a dramatic expansion of AIDS education and youth-friendly services. Let us work with them to scale up the services they need,” she told IPS.

Obaid also said: “We need to integrate interventions for AIDS and for sexual and reproductive health so that they are mutually reinforcing.”

The overwhelming majority of HIV infections, she pointed out, are sexually transmitted or associated with pregnancy, childbirth and breastfeeding. Thus, integrated services are essential to meet the needs of women and couples.

To be effective, we must redouble efforts to address gender inequities, she added.

At the conclusion of the high-level meeting, Jun. 10-12, the president of the General Assembly, Srgjan Kerim, said that an effective response to the pandemic must have human rights and gender equality at its core.

Besides several heads of state and health ministers, the participants at the meeting also included more than 500 representatives from civil society organisations.

Linda Hartke, of the Ecumenical Advocacy Alliance, was more blunt. “We have heard millions of words and hundreds of speakers in these three days and all of them agree that the response to HIV is urgent, and shamefully that we are falling behind.”

“All governments must do more and do better, turning the words into actions. And each and every citizen is called to hold their government accountable,” she added.

Meanwhile about 60 non-governmental organisations signed a statement urging national governments and the U.N. system to keep their promises to men and girls who continue to be at an alarming risk of HIV infection and of receiving inadequate prevention, treatment, care and support.

These shortcomings, the statement said, was the result of persisting social, cultural and economic subordination, structural inequalities, as well as pervasive violence in homes, communities, schools, workplaces, streets, markets, police stations, hospitals, and situations of institutional confinement.