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Q&A: “Condoms Have To Be Used To Be Useful”

Interview with Nazneen Damji of UNIFEM

MEXICO CITY, Aug 5 2008 (IPS) - Of the over 30 million people living with HIV, half are women and the rate of infections in women is rising, particularly in sub-Saharan Africa. What’s more, women’s rights groups say gender inequalities are fuelling the epidemic – there is an irrefutable feminisation of HIV.

On the sidelines of the XVII International AIDS Conference being held here, Nazneen Damji, programme specialist on gender equality and HIV/AIDS at the United Nations Development Fund for Women (UNIFEM), explained the hard facts behind the stark AIDS statistics to IPS correspondent Zofeen Ebrahim.

More women are becoming infected, Ebrahim explained, many are also carrying the double burden of caring for the sick and dying. Widows are being thrown out of their homes, deprived of inheritance. Young women – the most vulnerable to infection – are least able to protect themselves, if they do not have access to information, services and a voice.

Women, especially those impacted by the epidemic can no longer be left out of policy formulation, implementation and allocation of funds, according to Ebrahim, and unless global and national polices are gender-sensitive the spread of HIV and AIDS is unlikely to abate.

Excerpts from the interview:

IPS: Do you get a sense that at this AIDS forum, women and gender issues are being elbowed out by talks of MSM (men having sex with men) and homophobia? Nazneen Damji: I can sense that issues around women and their rights are not really going to surface. I do get a feeling that there will be less talk on these important issues, but the conference has just started, let’s wait and see. Given the Latin American context, issues pertaining to MSM and homophobia cannot be ignored either.

It is important to note though that data indicates that ninety percent of the HIV-positive women in Mexico got infected not because of injecting drug use or blood transfusions but through heterosexual transmission. As in any other region, women here need to be as protected from getting infected through access to information, to testing and counselling, and to other health care services. They also need to be empowered to negotiate for condom use. Condoms have to be used to be useful.

It is important to ensure the response is tailored to the different contexts in different regions. This time around, stigma, discrimination and homophobia are being brought out in sharper focus. And this is important, as governments need to acknowledge and take action. These are important issues that are being raised… the response to HIV and AIDS needs to be comprehensive, taking into account the realities of all groups that are affected. We should not be forced to choose sides. What is even more important is bridging the gap in between these issues.

IPS: While women’s groups refuse to lie low or let gender issues be ignored, have they been successful in converting governments? Are the latter doing enough? ND: They may not be doing enough, but they are doing well and we do have examples where countries are actively ensuring gender equality dimensions are integrated into policies and plans.

Take the case of Nigeria. Their National Action Plan for HIV/AIDS is very gender-sensitive. They have even set up a Gender Technical Committee that supports the plan. It is critical that these strategies are implemented, through fully-costed plans that resource the needs of the women. Here, gender- responsive budgeting tools offer great potential for application in the context of HIV and AIDS programming.

UNIFEM has been contributing to building interest and capacity globally in over 30 countries on gender-responsive budgeting.

India too has integrated gender strategies in their National AIDS Control Organisation (NACO). In fact, they are working towards ensuring gender and HIV/AIDS are crosscutting themes across various sectors. UNIFEM and other UN partners have been working to support these efforts.

IPS: Are governments sincere in their endeavour? ND: Yes, I’m sure they are sincere. However, there also has to be the capacity to implement, and that means the public sector needs to be well trained. And, monitoring of progress needs to be emphasised.

IPS: There is a lot of talk about male circumcision at this conference, is there any co-relation between that and gender? ND: I think all issues need to be looked at through a gender lens. It is good that new evidence points towards reduced risks of HIV and AIDS for circumcised men, but let’s not have a one-sided approach. A comprehensive approach to prevention – that includes male circumcision and prevention efforts to reach all women – will help to reduce infections in women and men alike.

IPS: What is the relationship between violence against women and girls and HIV/AIDS? ND: Violence is an added dimension of HIV and AIDS. The good news is that, since the International AIDS Conference in Toronto, the way in which violence against women and the fear of such violence fuels the HIV/AIDS epidemic is increasingly recognised and addressed. But what remains to be seen is how to respond to and bring these intersections together.

Violence is both a cause and consequence of HIV and AIDS. But violence is an obstacle to prevention efforts. It prevents women from getting tested and limits their access to prevention and treatment. It also prevents them from making informed decisions about their health and their future. In many cases, victims of violence are afraid or unable to negotiate condom use.

IPS: Are gender policies well integrated in national HIV/AIDS programmes? ND: We are seeing promising results. For example, services for women are becoming integrated into the response to the twin pandemics. In many countries, health centres have been established that treat survivors of violence, and include services such as HIV counselling and testing as well as legal referrals.

Although still limited in number, they can become an important source of HIV education and treatment. Capacity is being developed, and partnerships among women’s groups, HIV/AIDS organisations, survivors of violence, women living with HIV and AIDS, and other stakeholders are increasing.

IPS: What has been the role of UNIFEM in combating violence against women in connection to HIV/AIDS? Fighting gender-based violence is a major concern for UNIFEM. It multiplies the power of its groundbreaking strategies through advocacy campaigns and close partnerships with governments, women’s groups and other branches of the U.N. system.

The U.N. Trust Fund to End Violence Against Women – managed by UNIFEM – is supporting a knowledge cohort of grantees from across Asia, Africa, Latin America and the Caribbean for the first-ever global learning initiative on addressing the linkages between violence against women and HIV and AIDS.