Women are being let down in efforts to stem HIV/AID

By Zosia Kmietowicz London

Women in developing countries, and in sub-Saharan Africa in particular, are being let down in efforts to stem the HIV/AIDS crisis because the issues that affect them are being ignored, said a new pressure group.

The ABC prevention strategy (A for abstinence, B for be faithful, and C for use a condom), which is being promoted by some charities in Africa, is wholly inappropriate in many countries where women know little if anything about HIV and are afraid to ask their husband or boyfriend to use a condom, said members of the Global Coalition on Women and AIDS.

Fear of violence and destitution stifles many HIV/AIDS education efforts in countries such as Kenya, Uganda, and Mozambique. Women found to have HIV in these places are often blamed for bringing the virus into the home and are abandoned by their families. Unequal property and inheritance rights also reduce women's security, which can lead them to endure abusive relationships and be left homeless when their partner dies of an AIDS related disease.

ANDY BUTTERTON/PA

Actress Emma Thompson, Ludfine Anyango (national HIV/AIDS coordinator for ActionAid Kenya), and Dr Peter Piot (of UNAIDS)

"We are deeply concerned that women's issues are still very marginal when it comes to responses to AIDS in the world," said Peter Piot, executive director of the joint United Nations programme on HIV/AIDS. "Because of their lack of social and economic power, many women and girls are unable to negotiate relationships based on abstinence, faithfulness, and use of condoms."

In sub-Saharan Africa women and girls make up 60% of those affected by the disease, he said. In addition, girls and young women are 2.5 times more likely to become infected with HIV than young men.

The coalition, comprising activists, government representatives, community workers, and celebrities, hopes to teach women skills to help them assert themselves in the bedroom. It also aims to tackle education issues about HIV with whole communities, so that women no longer fear being tested for HIV and can go forward for treatment and counselling.

They also hope to galvanise research into a microbicide, which women could use as a gel, film, sponge, or lubricant to reduce their risk of becoming infected. An estimated 2.5 million cases of HIV infection could be prevented in three years if a microbicide was available that was only 60% effective, say researchers at the London School for Hygiene and Tropical Medicine. However, research into a microbicide is severely underfunded.



studentBMJ 2004;12:89-132 March ISSN 0966-6494