Much work is being done in the region to tackle the spread of HIV, but little of it focuses specifically on gender or the needs of women. Even when women are the target groups, as in mother-to-child transmission programmes, the approach is often not gender sensitive and does not seek to empower the women. Thailand has the highest HIV incidence in the region, but Myanmar and Cambodia in particular, both with much smaller populations than Thailand, are fast catching up.

Since the mechanisms for the transmission of HIV infections are intimately embedded in gender relations, a gendered approach is required in all AIDS programming.

CEDAW 9th Session (1990) General Recommendation No.15 which advocates "Avoidance of discrimination against women in national strategies for prevention and control of AIDS" with four specific recommendations for action, has been ratified by all countries in Southeast Asia except Brunei Darussalam, the Democratic Republic of Korea, and East Timor.

The Beijing Declaration and Platform for Action at the first World Conference for Women (Beijing 1995) had as Strategic Objective C3, to "undertake gender-sensitive initiatives that address sexually transmitted diseases, HIV/AIDS and sexual and reproductive health issues." Its plan for action included ensuring the involvement of women infected with, or by, HIV/AIDS.

The International Conference on Population and Development (Cairo, 1994) identified actions to "prevent, reduce the incidence of, and provide treatment for, sexually transmitted diseases, including HIV/AIDS, and the complications of sexually transmitted diseases such as infertility, with special attention to girls and women."

The 2nd International Consultation on HIV/AIDS and Human Rights (Geneva, 1996): "States in collaboration with and through the community, should promote a supportive and enabling environment for women (and) children ... by addressing underlying prejudices and inequalities through community dialogue, specially designed social and health services and support to community groups."

EFFORTS TO REDUCE INDIVIDUAL RISK

Given limited resources and the alarming rapidity with which HIV often spreads among the most vulnerable groups, typically priority has been given to designing individual risk reduction programmes for these groups such as prostitutes, homosexual men and highly mobile men.

Yet research shows that wider segments of society that are not epidemiologically identified as high risk, such as women and children, have become increasingly vulnerable. Risk reduction messages should be designed for them as well. The key strategies for gender sensitive programmes to reduce individual risk to HIV/AIDS include:

Combat Ignorance

Improve the access of girls to formal schooling.
Ensure women and girls have information about their own bodies, education about AIDS and the other STD's, and the skills to say no to unwanted or unsafe sex.
Promote gender awareness in HIV prevention programmes, and routinely provide sex-disaggregated figures for all service statistics and research.

"Sexual Knowledge, Attitudes and Behaviour in Cambodia and the Threat of Sexually Transmitted Diseases" (1997) was a study in Cambodia by Australian Red Cross and Cambodian Red Cross focused on attitudes and behaviour. Although it gathered data on the vulnerability of women and men in Cambodia, the usefulness of the report is severely limited by the failure to disaggregate the data by sex.

Provide Women Friendly Services

Exercise cultural and social sensitivity in the provision of health care, HIV/STD prevention services, condoms and STD care, making them available when and where women need them.

Positive Women Victoria, a support group for women with HIV/AIDS, is run by women living with HIV/AIDS. It has worked for greater attention for gender issues in HIV/AIDS, particularly in the areas of medical treatment, research and prevention education. Seventeen years after its inception, it rtemains the only group of its kind directly funded by government.

REDUCE SOCIETAL RISK

Although the bulk of studies show that the broader gender-related determinants of vulnerability have increased in importance since the late 1980s, responses to those factors have evolved slowly. Only a limited number of programmes have so far addressed gender and societal vulnerability. A wider recognition of the link between the socio-cultural and economic contexts of men's and women's differential vulnerability to HIV is needed:

Reinforce Women's Economic Independence

Multiply and strengthen existing training opportunities for women, women's credit programmes, saving schemes and cooperatives, and link them with AIDS prevention.
Provide alternatives to sex work, particularly in areas where migration of young women to enter sex work has become an established pattern, and in areas where sex workers operate.

The Daughters Education Programme is a community-based grassroots initiative in Mae Sai, Chiang Rai, with the three-fold aim of preventing girls from being forced into the sex industry due to outside pressure and a lack of educational and employment alternatives; improving the material, social and spiritual quality of life for these girls and their communities; and encouraging girls, especially those from hilltribe villages, to be proud of their culture and traditions.

Involve Men

Educate boys and men to respect girls and women, to engage in responsible sexual behaviour, and to share the responsibility for protecting themselves, their partners and their children from HIV and STD's.

Mainstreaming a Gender Approach to AIDS in Infrastructure Projects

The Asian Development Bank Project on the East-West Transport Corridor (1999): The ADB is funding the building of a major highway from Vietnam to Laos. Gender and HIV/AIDS are being mainstreamed in the following ways:

Any road building along the corridor has to include an HIV/AIDS awareness campaign explaining the nature and spread of the disease to workers and communities along the corridor.
The project contract requires that all border officials be trained in issues regarding the trafficking of women and girls.
Supervising contractors are required by ADB to provide information to local communities and workers on HIV/AIDS, STD's and use of condoms as part of their services.
Supervising contractors are also required to bring in an independent consultant at various phases of the project to monitor the HIV campaign and its effectiveness.

Reduce Vulnerability Through Policy Change

Policies from community to national level must be reshaped if women's vulnerability to HIV is to be reduced. Among other things, this means protecting women's human rights and fundamental freedoms and improving their economic independence and legal status. This cannot be achieved without a greater political voice for women.

Contradictions in policy and practice abound in relation to prostitution and the sex industry. In most countries, it is illegal yet tolerated. In Northern Lao, for example, free distribution of condoms, although discourage by some provincial administrators who fear that it could be interpreted as advocating prostitution, is in fact carried out by the Provincial Committee for the Control of AIDS.

Home : About UNIFEM : Projects by Country and Theme : Gender Resources : Newsroom : Staff : Contact