HIV and Gender Inequality

Although HIV infection is rooted in gender inequality, few interventions address this issue in a significant manner. Programmes advocate safe sex through condom use, abstinence, mutual monogomy - all of which are essential to limit the spread of the epidemic. But are they enough? Can programmes really protect men and women from HIV infection without touching on the man/woman thing?

The concepts of practical needs and strategic interests are useful in understanding how HIV programmes can incorporate gender.

Practical needs are related to the condition of women and their present workloads or responsibilities.
Strategic needs arise from the analysis of women's subordination to men and is related to changing the position of women vis-à-vis men.
A developmental programme that brings tube wells closer to villages addresses a practical need: it makes it easier for women to fetch water on a day-to-day level. But it doesn't touch on the gender issue lurking below: why do women have to fetch the water? Addressing this strategic interest would mean changing the position of women, not as individuals, but as a category.

Addressing practical needs
-Tends to be a short-term intervention
-Tends to involve women as beneficiaries or participants
-Can improve the condition of women's lives
-Generally does not alter traditional roles

Addressing strategic interests
-Is a long-term process
-Involves women as agents or enables women to become agents
-Can improve the position in society
-Can transform roles and relationships

A gendered response to HIV: what does it involve?
A gendered response to HIV is one that simultaneously addresses prevention at two levels: practical and strategic. In other words, a gendered response to HIV is one that advocates safe sex while challenging the underlying attitude of 'women are women' and 'men will be men'. This means changing ideas and social norms that keep women in their place - and men on top. It means achieving shared decision making between men and women at all levels: in relationships, community affairs, political and ecconomic bodies. It means creating structural changes to give women equal access to education, training and livelihood opportunities. Needless to say, this is an arduous social agenda that requires long-term institutional support and commitment.

It may be beyond the scope of an HIV intervention - whose mission is to prevent infection - to single-handedly take on the mantle of changing social roles. But interventions must address gender if they are to effectively prevent men and women from getting infected.

A gendered response to HIV could alter traditional gender roles by: Challenging inequalities of information

Educate women and adolescent girls about their bodies, sexuality, HIV and STDs
Promote values that encourage women to question and to seek information as a right
Provide women with skills in negotiating social and cultural barriers to condom use
Pro-actively counsel men on the need to notify partners of their HIV status without violating confidentiality requirements
Ensure that HIV messages and information do not inadvertently reinforce gender stereotypes for short-term gain
Challenging inequalities of access, care and treatment

Counsel families on the need to provide care and support to women
Respect women's withes and needs on pregnancy, breast-feeding, abortion and sterilization
Deal with the potential negative consequences of testing women, but not their partners
Create support groups to share personal experiences and model new behaviours
Challenging discrimination

Provide male and female role models of HIV-positive persons and families coping with HIV
Tackle the tendency to blame women for HIV infection
Push media to promote positive images of infected men and women
Challenging social norms that promote myths about masculinity and femininity

Promote gender training that creates alternative, positive self-images for men and women
Demystify myths about virginity, semen production, male promiscuity etc
Challenge the notion that me will be men
Instill the notion that women also have sexual needs
Address the issue of domestic violence that inhibits women's agency
Challenging women's ecconomic dependence

Establish livelihood opportunities for women, or link up with organizations doing so
Actively provide HIV information through economic interventions already in place, such as credit groups, savings schemes, employment programmes etc
Challenging structures and policies that prioritize men over women

Advocate for research on female-controlled methods to prevent HIV/STD infection
Lobby for better implementation of laws on rape, sexual harassment, property rights, violence
Campaign for the creation of a law against domestic violence
Actively promote the voices of women in policy-making platforms
Continue to uphold fundamental human rights of men and women while pushing for women-centered policies and programmes