By Eliane Drakopoulos, Public Policy and Advocacy Officer, Elizabeth Glaser Pediatric AIDS Foundation
The Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) strongly welcomes the report submitted by the UNAIDS Secretariat regarding the importance of social protection in the HIV response, and today’s wide-ranging discussion on these issues, particularly the moving personal stories we have heard.
Within that context, EGPAF believes that increased attention must be paid to the role that gender inequality plays in limiting progress in preventing pediatric HIV, and in increasing testing, care and treatment for all women, including especially adolescent girls.
Traditional perceptions of masculinity often enable and encourage men to dominate sexual decision-making, engage in risky sexual behaviour, perpetrate violence against women, and refrain from seeking healthcare services—all of which place men, their female partners and children–especially adolescent girls–at risk of HIV.
In fact, data from several countries suggest that the risk of acquiring HIV is up to seven times higher for women with violent or controlling intimate partners. Pregnancy, in particular, is a period during which women often experience increased physical and sexual violence from their intimate partners.
Women’s perception of their partners’ approval of HIV testing has been identified as one of the strongest predictors of women’s willingness to test. Likewise, opposition from male partners is associated with low HIV testing uptake and failure to return for test results. Up to 75% of women in some countries say that their partners alone make health decisions for their families.
On the other hand, research shows that programmes that target transformation of gender roles, screen for intimate partner violence, promote gender equitable relationships, and constructively engage men as supportive partners for women’s health can improve health outcomes for women, men and children, including in the area of HIV.
International commitment to end paediatric AIDS is now greater than ever. Promoting gender equality, in conjunction with facility-based medical interventions, has the potential to produce so many gains. It can enable programmes to expand beyond just delivering ARVs to pregnant and other women and work towards enabling women to protect themselves from HIV, decide their own fertility, and access and continue to use HIV prevention, care and treatment services. By integrating these approaches into national HIV plans there is promise that governments and donors can achieve better results. On the other hand, without more widespread implementation of gender transformative HIV programmes, increasing treatment, care and support for women will be impossible, and the elimination of pediatric HIV will remain elusive.