by Susanna J. Smith and Whitney Welshimer
The BBC's recent story on Tamali Mbogella, a Tanzanian woman who was beaten by her husband after she sought an HIV test ("Outcry at Tanzanian HIV beating"), sadly illustrates what we have known for too long: until we secure women's rights and respect within relationships, the world will fail at protecting women and girls against HIV/AIDS.
Globally, one in three women will be raped, beaten, or abused in her lifetime. In regions where the prevalence of HIV/AIDS is particularly high, violence against women puts them at a significantly greater risk for contracting HIV or other sexually transmitted infections (STIs). For too many girls, their first sexual experiences are coerced or forced. In South Africa, 30 percent of girls say their first intercourse was forced, and 71 percent report being subjected to sex against their will in the past.
When women cannot control when or with whom they have sex, they cannot negotiate condom use or take the steps needed to protect their health. In South Africa, women who are in abusive relationships are 50 percent more likely to contract HIV. Violence may also lead women to engage in more risky behaviors such as having multiple, concurrent sexual partners. In South Africa, women who were abused by their partners were two to three times more likely to engage in transactional sex.
The 1993 United Nations Declaration on the Elimination of Violence against Women affirmed the need for comprehensive programs that prevent violence against women. This requires increasing investments in programs that uphold women's rights and health, and reduce stigma for women living with HIV. By strong investments in comprehensive sexuality education, we can raise awareness on how gender inequalities and attitudes about sexuality fuel the HIV/AIDS pandemic. Yet even as groups around the world tackle this challenge, we must also provide a means of protection that can be initiated by women.
Susanna J. Smith is Communications Program Officer for the International Women's Health Coalition. Whitney Welshimer is IWHC's Communications Assistant. Since standard prevention options-abstinence, mutual monogamy and male condoms-are irrelevant for the majority of women, governments, donors, health practitioners, and civil society must advocate for stronger investments in programs that put the power of prevention in women's hands. Female condoms provide women with control over prevention, but currently there is only one female condom available for every 700 male condoms.
More money must also be put into microbicide research. The use of microbicides - a clear, undetectable gel - could preclude violence, or fear of it, that might inhibit women from negotiating condom use. Studies estimate that an effective microbicide could prevent more than two million HIV infections worldwide over three years. But without more investments, microbicides are ten years away.
Today, the International Women's Health Coalition is leading a major campaign for funding and political commitment to empower women and girls against HIV/AIDS by protecting their sexual and reproductive rights and health. With Women Worldwide: A Compact to End HIV and AIDS is the action agenda we created, which is supported by 260 organizations from 50 countries. The campaign aims to persuade global policymakers and donors to invest more in female-centered HIV prevention such as microbicide development and female condoms, as well as sexuality education to change the way that future generations of men and women treat each other.
All of us who care about women must redouble our efforts to ensure that women have a range of safe, accessible tools to protect themselves from HIV as well as violence. Doing anything less means denying women their fundamental rights to preserve their health and to live in a world free of abuse.
Picture via jonrawlinson's flickR account