When You Think of Botswana and HIV/AIDS, Think of the Women

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When You Think of Botswana and HIV/AIDS, Think of the Women

Grace Sedio

Botswana's response to HIV widely heralded as a success -- but not all prevention and treatment programs fully protect the women's human rights.

Coverage of the International AIDS
in Mexico
City has once again pointed to Botswana as a "success story" in
the fight against HIV/AIDS.  Reporting on new data from the Joint United Nations
Programme on HIV/AIDS (UNAIDS)

Brenda Wilson of National Public
"Take Botswana, which had one of the highest rates of HIV in Southern
Africa.  And the government and international organizations put
in strong prevention and treatment programs. Prevalence among teen girls
dropped from 25 percent to 18 percent."

I have another side of the
story to tell. 

Botswana is a mid-income country
and so, was one of the first to provide antiretroviral treatment and
institute programs to prevent mother-to-child transmission of HIV.
This is one fundamental reason that we can claim some success. But Botswana
continues to have one of the highest HIV rates in the world, and most
of the new infections are among women and young people. Today, if you
meet 20 young women between the ages of 15 and 24 in Botswana, it is
likely that at least 3 of them are living with HIV. The situation in
Botswana is controversial because some organizations working in the
country have very little understanding of how the rights of women living
with HIV/AIDS are being violated.

Yesterday at the International
AIDS Conference, I spoke on a panel focusing on what the next phase
of the United States’ AIDS response (the President’s Emergency
Plan for AIDS Relief
should look like when it comes to women.  Mary Robinson, former
President of Ireland and now with Realizing Rights, opened the session by saying that
"We’ve not done better for women and girls [in the fight against
HIV/AIDS] because we have not respected their human rights from the

Sex. Abortion. Parenthood. Power.

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She is right, and my task on
the panel was to describe the situation for women within the PEPFAR-funded
programs and how, so often, their rights are not respected. 

Let me give you one recent

During the last three weeks,
I was in the field in Botswana. I came across a project working with
women who are pregnant and living with HIV.  The project intends
to provide these women with psychosocial support by linking them with
other women who are mothers living with HIV and trained counselors. 
The women who work as counselors are asked to sign a contract in order
to receive their stipend. The contract requires them to pledge to not
to become pregnant while counseling for the program-violating their
fundamental right to decide to have a baby or not.

My organization, Bomme Isago
Association, is currently involved in monitoring sexual and reproductive
health services for women living with HIV in the country.  Every
day, I hear similar stories similar to this one from women throughout

PEPFAR must do better for we
women in Botswana.

Here are just three recommendations
as PEPFAR enters in next five years of implementation:

  1. Support sexual
    and reproductive health services.
      Don’t tell us not to get
    pregnant.  Give us family planning and provide us with safe abortion
    services if we are pregnant and do not want to have a child.  I
    do not want to see any woman in Botswana giving birth to an infected
    child because she was denied full information and services, but the
    choice of whether to have child or not is hers.
  2. Support our human
      When I became infected with HIV, I only got the virus,
    I did not get superpowers.  Women living with HIV still need protection
    of their rights. My HIV-status does not take away my sexuality or the
    fact that I am a woman with basic rights over my body and health.
  3. Don’t give
    up on prevention.
    We are all grateful for the U.S. government’s
    commitment to providing treatment, but, prevention is equally important. 
    I do not want anyone else in Botswana to needlessly become infected.

I am optimistic that the world,
including PEPFAR, can do better for women.  But, no progress, including
that heralded in my country, will be truly secure without a fundamental
commitment to human rights.