Ka-BLOG Day 7: "Just Die Quietly"--women and AIDS

December 1st is World AIDS Day. As women comprise approx. 48% of global cases of HIV/AIDS, I'd like to use Day 7 of the "16 Days" campaign & "Take Back the Tech" to address the undeniable role that gender-based violence plays in the global AIDS epidemic. But I don't want you to listen to me; listen to people-in-the-know and from the women themselves. First, let's hear from the Global AIDS Alliance:

Violence of all kinds is central to the HIV/AIDS epidemic. Women who have at any time been forced to have sex are more likely to use condoms inconsistently than women who have never been coerced. Children who experience violence are more likely to engage in behaviors known to be risky for HIV in adolescence and adulthood. Fear of violence can prevent women and adolescent girls from negotiating safe sex, even when it is consensual. Violence or the fear of violence, can prevent women from seeking voluntary counseling and testing (VCT), returning for their test results, disclosing their serostatus, or getting treatment if they are HIV positive. The global lack of well-trained health care workers compounds these problems because there is often no one to recognize the symptoms of violence or to provide potentially lifesaving care to those experiencing it.

What do they mean by "negotiating safe sex"? Here's a first-hand account from a Ugandan woman (featured in Human Rights Watch's 2003 "Just Die Quietly: Domestic Violence and Women’s Vulnerability" pg. 3):

He used to force me to have sex with him. He would beat me and slap me when I refused. I never used a condom with him. . . . When I got pregnant I went for a medical check-up. When I gave birth, and the child had passed away, they told me I was HIV-positive. I cried. The doctor told me, “Wipe your tears, the whole world is sick.” --Interview with Harriet Abwoli, Mulago, January 9, 2003.

In "Our Bodies--their Battleground," we read gut-wrenching reports from the displaced women & girls of Darfur, Sudan:

I was sleeping when the attack on Disa started. I was taken away by the attackers, they were in uniforms. They took dozens of other girls and made us walk for three hours. During the day we were beaten and they were telling us: “you are black women, we will exterminate you, you have no god”. At night we were raped several times. The Arabs guarded us with arms and we were not given food for three days.

And from Eastern Congo [UNIFEM's "Gender-Based Violence in Populations Affected by Armed Conflict" pg.6]:

“I don’t just blame the soldier who did this to me. I think the war brought this to me. We [women] are victims of the war. We don’t take up arms but we, the women, suffer the most.” —Woman in Eastern Congo

But we know this isn't "just" a problem in Africa. Rape is one of the oldest weapons of war:

A European Community fact-finding team estimates that more than 20,000 Muslim women were raped during the war in Bosnia. [...]

94% of displaced households surveyed in Sierra Leone reported incidents of sexual assault, including rape, torture, and sexual slavery.

At least 250,000—perhaps as many as 500,000—women were raped during the 1994 genocide in Rwanda.

In Guatemala, a 1982 study of refugee women found that their most overwhelming fear was of being raped.

During the armed conflict in Bangladesh in 1971, it is estimated that 200,000 civilian women and girls were raped.

Sex-workers also face particularly difficult odds--no matter where they live. In "Aids: a feminist issue," Bianca Jagger writes...

I have visited Calcutta and spoken to many women and children in the red light area for whom safe sex is simply not an option. For tens of millions of sex workers worldwide, mostly young and the vast majority female, HIV is a daily risk. People involved in sex work have a human right to education, health, freedom from violence and support. Governments should stop treating sex workers as criminals, and provide support and education to help women who have become the victims of a global trade in female bodies, protect themselves from a potentially life-threatening disease.

And Western governments are letting fundamentalist dogma kill by witholding funding to countries that refuse to stigmatize sex-workers and promote condom-use. From Chiang Mai, Thailand:

But today, Thailand's success story is in danger. Since the late 1990s, the Thai government has cut its HIV/AIDS prevention budget by nearly two-thirds. That has forced the Thai HIV/AIDS organizations and activists who do prevention work to look increasingly to foreign funding, including the President's Emergency Plan for AIDS Relief, or PEPFAR, the Bush administration's five-year, $15 billion effort to combat AIDS abroad. However, despite having more than a half-million people infected with the virus — the biggest HIV-positive population in Southeast Asia — Thailand is being allocated only a small share of PEPFAR funding. And PEPFAR's strategies, in particular its preference for promoting abstinence over condom use and its concern with the sex trade, have put local activists who reach out to sex workers in a difficult predicament. For sex workers such as Jennie, it means that increasingly, they must dip into their own meager incomes to buy condoms — or simply do without them.

Clearly, women require access to preventative tools that don't require male 'assent'. This is where Canada can have a tremendous impact. The first vaginal anti-HIV microbicides were discovered here in Canada in the late 1990s. Now there are over 23 gels/creams in the clinical investigation-stage (to varying degrees of approval). Why the urgency?

Their best features, however, are that they are relatively inexpensive, easy to manufacture and distribute in jars and squeeze tubes and, most importantly, as WHO points out, can be applied by women without the co-operation, consent or even knowledge of their partners. In the sneaky world of marital sex, this is a definite power-changer for those who might lack the confidence or social skills to negotiate condom use.

So. Pretty bleak, but this 16 days campaign is all about activism. That means action! Here are some worthy ideas for making a difference:

• Speak out against ignorance: don't let anybody get away with spreading misinformation about HIV/AIDS; particularly "who" is at risk.
  
• If you have a blog, website, journal, spread the word! And not just today--it is almost Dec 2nd here in Eastern Standard Time. Any day is a good day to talk openly about HIV/AIDS and/or violence against women. The ribbons may come and go (and change colour), but these are long-term battles.
• Blog or blog-less, let your voice be heard! Write your MP and demand greater committments. If they make committments, hold them to their words and remind them. Politicians are very keen to wear ribbons and stand in-front of banners for photo-ops, but it's not enough...let them know.
• If you are in a position to do so, please consider contributing to "Give a Day to World AIDS" (by donating one-day's salary), The Stephen Lewis Foundation, Grandmothers to Grandmothers, or any number of worthy GRASSROOTS organizations (I don't want to leave anyone out!).

With that, I'll leave you with a few words from outgoing UN Envoy for HIV/AIDS in Africa, Stephen Lewis [December 1, 2006]:

My closest colleagues and I have of course been preoccupied with HIV/AIDS these last several years. We believe real progress is possible: that when this women's agency [a new, independent, international agency for women] comes into being, it will significantly reduce the carnage of the pandemic. It will turn the corner for women at the grassroots by supporting the activist groups in every country, and their participation as partners on policy and programmes. It would confront all the most grievous issues, from sexual violence to onerous burdens of care and the desperate need for facilities to prevent mother-to-child transmission. It would be a growing salvation for the women of Africa, including those whose voices are so seldom heard; the young and the old. [...] We're talking about what could be the most dramatic breakthrough for women in the history of the United Nations. It should galvanize activists around the world. The proposal of an international agency for women is not so much an idea whose time has come, as an idea whose time is sixty years late in coming.

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