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HEALTH-AFRICA: Time for Joint Action on HIV/AIDS and Violence

Joyce Mulama

NAIROBI, Oct 15 2008 (IPS) - The war against HIV/AIDS, it is emerging, will not be won unless sexual and gender-based violence is tackled.

Participants at a recent regional meeting looking at linkages between violence against women and girls and HIV/AIDS described the two as dual pandemics that needed to be addressed concurrently for the HIV/AIDS fight to be successful.

“We have continued to treat these two issues separately, yet they go hand in hand. The complexity of HIV/AIDS calls upon us to join together and seriously address sexual violence,” noted Ludfine Anyango of the United Nations Development Programme.

Held in Nairobi, the conference on Strengthening Linkages between Sexual and Reproductive Health and HIV/AIDS Services, gathered donors, civil society and government officers working in the health sector in 13 countries in East, Central and Southern Africa.

The severity of sexual violence in Africa was reiterated by Nduku Kilonzo, the director of Liverpool VCT, a Kenyan non-governmental organisation advocating for HIV prevention, treatment and care, which organised the conference.

“Sexual violence is fundamentally a public health problem that often times results in HIV/AIDS. We know that due to violence, many women are prone to the risk of contracting HIV/AIDS. For this reason, we must start to look at sexual and gender-based violence as a key intervention when addressing HIV/AIDS,” she asserted.

Her remarks echo those of the World Health Organisation (WHO) which has it that the risk of HIV transmission is greater when sex is forced and therefore the need to address sexual violence in countries HIV/AIDS plans. A report by WHO, presented at the meeting shows that 39 percent of sexually active girls in South Africa say they have been forced to have sex. This in a country with approximately 5.7 million people living with HIV/AIDS, the highest in the world, according to 2008 statistics from the joint United Nations Programme on HIV/AIDS (UNAIDS).

Sexual and gender violence is also widespread in East Africa, where states like Kenya have continued to record an increase in the number of sexually abused women and girls. The 2003 Kenya Demographic Health Survey (which is the latest) indicates that 43 percent of 15-49 year old women reported having experienced some form of gender based violence in their lifetime, with 29 percent reporting an experience in the previous year. About 16 percent of women reported having ever been sexually assaulted, up from 13 percent in the previous year.

Statistics like these have prompted critics to ask why legislation outlawing sexual violence is failing. International and regional instruments that require signatories to address violence against women and girls have come under the spotlight.

Examples that come to mind include the Convention on the Elimination of All Forms of Discrimination against Women adopted by the United Nations General Assembly in 1979, which recognises women’s right to violence-free lives, the Beijing Platform for Action adopted in 1995 which calls upon governments to take measures to address violence against women.

More recently, the UN Security Council declaration 1325 – passed in 2000 – made an urgent call to end impunity for sexual violence. In 2005, a Protocol condemning violence against women and girl children was ratified and added to the African Charter on Human and People’s Rights.

It is argued that lax implementation of these instruments stems from the fact that there are no sanctions or punitive measures against countries that fail to adhere to them.

Domestic laws that seek to address sexual violence have been criticised as lenient and overtly flawed. In Kenya and Uganda, the maximum sentence for rape is life imprisonment, but the minimum sentence for rape is life imprisonment, but the law is silent on the minimum sentence.

Kenya’s Sexual Offences Act, passed two years ago, leaves it to the discretion of the magistrate – civil society groups are concerned that this paves the way for magistrates to hand down sentences sentences that would not reflect the severity of sexual offences.

However, even as the clamour for these laws intensifies, the issue of rape within the context of marriage is even more serious. In most countries across Africa, marital rape is not acknowledged by the law as a form of sexual violence, exposing many women to the HIV infection by their partners.

The WHO report presented at the Nairobi meeting indicates that increasing numbers of married women are getting infected due to their partners’ behaviour. The report cites three studies in India, in which over 80 percent of HIV positive women were monogamous.

This scenario is reflected in several parts of Africa where where women – even those who know their partner are HIV positive – are unable to practice safer sex.

“Many women are afraid to say no to sex with their spouses because they may be beaten. They cannot even ask their partners to use condoms because they will be battered or suspected to be having other affairs. In the end, they are forced to have sex without protection and may end up getting infected,” Vivian Sebahire, coordinator of Solidarity Women for Development in Congo, told IPS at the conference.

Such incidents are causing fear of increasing cases of HIV/AIDS in a country whose prevalence rate is at 4.1 percent.

What came out clearly at the conference was the fact that in most African countries, organisations working on the prevention of violence against women are not specifically addressing women’s vulnerability to HIV/AIDS infection and vice versa, jeopardising effective action.

It is therefore imperative, analysts argue, that countries enact laws that recognise and specifically address sexual violence – particularly within marriage – in order to win the war against HIV/AIDS.