What is a woman worth?

HIV
infections among women and girls have risen in every part of the world
in recent years. The numbers point to a fundamental and startling
reality – the HIV/AIDS pandemic is inextricably linked to the brutal
effects of sexism and gender inequality, most pronounced in Africa.

Consider these statistics: The latest reports
from the UNAIDS (Dec. 2007) show 33.2 million people are living with
HIV throughout the world. Sub-Saharan Africa has more than two-thirds
(22.6 million) of the total number of HIV infections. Sixty-two per
cent (14 million) of those infected are women and adolescent girls.
Seventy-five per cent of all HIV-positive women in the world are
African.Photo by Chuck Bigger

Why are we allowing women and girls to
die from this preventable and treatable disease? What is a woman worth
in our world today?

Gender Discrimination At the Core

"The toll on women and girls presents Africa and the world with a
practical and moral challenge, which places gender at the center of the
human condition. The practice of ignoring gender analysis has turned
out to be lethal…what has happened to women is …a gross and palpable violation of human rights," said Stephen Lewis, former UN Secretary-General’s Envoy to Africa, at the International AIDS Conference in Barcelona, Spain in 2002.

Many
forms of violence against African women contribute to, and worsen, the
devastation of women and girls from the HIV/AIDS virus. Women and girls
are often ill informed about sexual and reproductive matters and are
more likely than men and boys to be uneducated and illiterate.
Physiologically, women are two to four times more likely than men to
become infected with HIV, but they lack social power to insist on safer
sex or to reject sexual advances.

Gender Violence and Poverty are Disease Risks

Gender-based
violence and harmful traditional practices are some of the major risks
for contracting the HIV virus. These include sexual violence, marital
rape, domestic violence, early child marriage of young girls to older
men, forced marriage, wife inheritance, widow cleansing, polygamy, and
female genital mutilation.

Poverty forces many
women into subsistence sex work or transactional relationships that
preclude negotiating condom use. For economic reasons, women are often
unable to leave a relationship, even if they know that their partner
has been infected or exposed to HIV. In many African countries, women
are designated as minors, lack their own earning power, are unable to
obtain credit and cannot own or inherit property.

The
oppressive economic dependency of women on men is a core aspect of
gender relations in this region. This critical issue must be taken on
with real solutions and basic societal changes by governments, AIDS
programs, non-profit groups, and, most importantly, the women
themselves.

Thoraya Obaid, the executive director of the United Nations Population Fund
(UNFPA), said in 2006: "Women and girls are vulnerable to AIDS not
because of their individual behavior, but because of the discrimination
and violence they face, the unequal power relations. Even being married
is a risk factor for women…Female HIV infections are on the rise in
Asia, Eastern Europe, and Latin America, as well as in Africa. And AIDS
is the leading cause of death for 25-34-year-old African-American women
in the United States…only by addressing the needs and human rights of
women and ensuring their full participation will we change the course
of this disease."

Cures To Reverse the Spread of HIV/AIDS

So what is to be done?

To
reverse the spread of AIDS, women must have greater control of their
decisions, bodies and lives-as well as their governments and public
policies.

In 2004, UNAIDS launched the Global Coalition
on Women and AIDS, a worldwide alliance of civil society groups,
governments, UN organizations and networks of women living with
HIV/AIDS. The coalition’s platform calls for education, literacy, and
economic rights for women; equal access to antiretroviral treatment;
access to sexual and reproductive health services; changes in harmful
gender stereotypes; and zero tolerance for gender-based violence.

Three-quarters of all new HIV infections are sexually transmitted
between men and women. The behaviors of men are critical to prevention
efforts in Africa. They hold overwhelming power in decisions about
sexual matters, including whether to have sex or to use condoms. In
many societies, women are expected to know little about such matters
and those who raise the issue of condom use risk accusations of being unfaithful or promiscuous.

Photo by Chuck BiggerHIV
care and contraceptive management programs — two important elements of
women’s health — must begin to work together according to UNFPA. For
too long they have separated themselves because of the politicizations
and funding aspects of both of these issues. This is clearly
shortsighted, if women’s lives are to be saved.
Equal access to
antiretroviral treatment will help to safeguard a woman’s well being
and prevent HIV transmission to her children. Ethics and human rights
demand that women who are HIV positive are able to make informed
contraceptive decisions, including the ability to prevent unwanted
pregnancy. Voluntary contraception is integral to stemming the HIV
pandemic.

Hard Choices Make Hard Policy

Some
of the most effective steps to stemming the feminization of HIV/AIDS
are not about healthcare per se but about broad social changes. Dr.
Chinua Akuke of the Board of Directors of the Constituency for Africa
in Washington, D.C. and an adjunct professor of public health at George
Washington University, said: "The key question is whether African
leaders and elite are ready to make hard choices that would slow down
the rate of infections among women…The key is to focus on practical
solutions to a problem that can only get worse if nothing is done."

She describes ten critical steps for African leaders.

• Mount a comprehensive information, education and communication campaign
  against risk-behaving practices of men that put women at risk of HIV
  infection, with bans on sugar daddies, the rape of young girls by
  schoolteachers and the molestation of young girls by their own family
  members.
• Address cultural practices that put
  women at disadvantage, such as women’s subservience in sexual matters,
  the lack of property rights for widows and single women, the culture of
  wife inheritance after widowhood and the lack of opportunity for women
  to discuss sexual risks with their husbands.
• Invest in the long-term education of girls and women to end women’s disproportionate poverty.
• Build enabling environments for empowering African women to control
  their own generated income and to overcome cultural taboos and tightly
  controlled economic choices that severely constrict the capacity of
  African women to negotiate safer personal behaviors.
• Create political space for women. In order to fight AIDS, women must
  be in decision-making positions in government and in civil society.
• Develop the necessary legal framework to protect women from
  discrimination and the lack of due process. Law reform on rape, sexual
  molestation, domestic violence, favors-for-forced sexual relations and
  property rights are crucial, as are bans on discrimination of
  individuals living with HIV/AIDS.
• Establish
  public health services that are friendly and accessible to women, and
  run by women for women in a true feminist model. The fear of violence
  and lack of confidentiality prevent many women from accessing services
  for HIV or for other sexually transmitted infections and tuberculosis
  that facilitate HIV transmission.
• Make
  gender issues a major priority of international development assistance.
  National budgets should devote resources to ending gender inequalities
  and creating opportunities and protections for women.
• Lead the fight against sexual violence against women and put in place
  functional laws that deny sanctuary to the perpetrators of violence.
  The law must punish rapists and abusers — perpetrators who set off a
  chain of events that leave women emotionally scarred and at risk of
  HIV/AIDS.
• Fight against widespread
  poverty with programs that target women. Poverty is a major reason why
  women knowingly engage in high-risk behaviors. The feminization of
  AIDS is closely intertwined with women’s low status, deprivation and
  harsh living conditions and macroeconomic policies must create the
  opportunity for women to escape poverty.

Misogyny Kills

 

Women need gender-focused and
women-sensitive approaches to halting HIV/AIDS, according to UNFPA.
Solutions must be African-based and African-implemented, and women must
be integral to all of it. Women must be able to gain more control in
decisions affecting their lives.

Young men who
learn to respect women and understand their responsibilities in halting
HIV/AIDS are more likely to use condoms. Husbands can — and must — be
enlisted to protect their wives and future children against HIV and
other sexually transmitted infections.

What
we are really addressing in HIV-AIDS is the need to end misogyny-ending
sexist attitudes and behaviors against women that violate their very
beings.

What is a woman worth in this world? What are 14
million women worth? They are worth absolutely everything to
themselves, their families, their communities, their countries-and
their world. We desperately need their vitality, contributions,
insights, and power. Let us begin with the personal and political
empowerment of the women of Africa and let our African sisters know
that they are not alone in their struggle for respect, dignity and life.

This article first appeared in On the Issues Magazine, a feminist, progressive magazine newly launched as an Internet publication.

To share your thoughts about how the U.S. can better prioritize global women’s health, join our online forum on Tuesday, June 3rd, from 1pm to 4pm EST!