HIV – the (almost) missing link HIV – the (almost) missing link

SRHR, Gender and HIV/AIDSRHR, Gender and HIV/AIDS – parallel session at the S – parallel session at the “Gender and SRHR at the heart of the MDGs” “Gender and SRHR at the heart of the MDGs”

Conference, 8/9 November 2010Conference, 8/9 November 2010

Lydia Mungherera MD: Policy/Advocacy Officer, Lydia Mungherera MD: Policy/Advocacy Officer, TASO; & Founding Director, Mama’s Club;TASO; & Founding Director, Mama’s Club;

Alice Welbourn PhD: Founding Director Alice Welbourn PhD: Founding Director

Salamander Trust; Author Stepping StonesSalamander Trust; Author Stepping Stones

HIV and AIDS form an integral part of HIV and AIDS form an integral part of the landscape of SRHR and gender the landscape of SRHR and gender

globallyglobally

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IN AFRICA ALSO…IN AFRICA ALSO…

• HIV and AIDS bear a female face• Cultural, social, economic status of women…• Community determines a girl’s and woman’s

destiny• Men are seen just as the problem…• Huge access issues in rural areas: EOC etc…

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HEALTH STAFF CRISISHEALTH STAFF CRISIS• Lack of support for health staff with HIV…• Annual drop-outs (Shisana, Odetoyinbo et al)• Max. 10% HIV work-place-related

(WHO) • Female health staff no PEP (LVCT Kenya)• Health staff 80% female (WHO)• Lack of WHO GRC acceptance of TREAT…• Lack of WHO awareness of HIV/SRH linkages for

health staff….• MMC investments….. (WHiPT)

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Therefore…..Therefore…..

• Entire public health service under strain because of lack of attention to comprehensive SRHR, gender and HIV linkages within the health care setting

• Other female-staffed public sector services, eg education, equally affected by HIV

• Without sufficient staff in place, with full access to integrated SRH & HIV care in their own right, no MDGs will be achieved

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HIV and institutionalised violenceHIV and institutionalised violence

• Violence in ANC settings• Coerced sterilisations (Namibia, PNG, Chile,

Romania)• Avoidance of ANC or travelling out of area• Thus MDGs 4 and 5 undermined

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CRIMINALISATION OF HIV CRIMINALISATION OF HIV TRANSMISSIONTRANSMISSION

• Increasing numbers of countries rolling this out

• Including vertical transmission• 10 reasons why (ATHENA Network)• Increases fear of accessing health services• Undermines MDGs 3, 4, 5, and 6

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RESOURCES…..RESOURCES…..

• Active community responses but…• No grassroots resources, no support…..• Who is best placed to talk to a grassroots

woman?

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CONCLUSIONSCONCLUSIONS• SRHR and gender should be viewed holistically with

HIV, not with HIV as an add-on• Addressing HIV in relation to vertical transmission is

the entry point to reaching MDGs 4 and 5• Legal, medical, social, economic, educational and

political dimensions all inter-related, not separate• Good programmes include those most affected at

their core: eg Mama’s Club, From Pregnancy to Baby and Beyond, Stepping Stones, working with men..…

• RESOURCES, RESOURCES, RESOURCES• The WHO should take the lead in upholding health

workers’ SRH, HIV and related rights9

CONCLUSIONS contd…...CONCLUSIONS contd…...• PCB and Agenda for Accelerated Action on

Women, Girls and Gender Equality• Cochrane Review on linking SRH/HIV• Sex worker rights, drug user rights, LGBT

rights…..• Criminalisation issues• Violence HIV Violence• Sex-disaggregated data does NOT equal

gender-disaggregated data• MIWA, MIWA, MIWA…..

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USEFUL LINKSUSEFUL LINKS• Athena Network www.athenanetwork.org• Mama’s Club www.clubmamas.org• Salamander Trust www.salamandertrust.net• Stepping Stones www.steppingstonesfeedback.org • TASO www.taso.org• UNAIDS Agenda for Action www.unaids.org • WNZ 2010 resources: www.womeneurope.net

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