BRIDGE Report 5: Women, HIV/AIDS and Development: Towards Gender Appropriate Strategies in South East Asia and the South Pacific

Author: S. Baden
Publisher: Institute of Development Studies UK
Publication Date: Oct 1992
How does HIV/AIDS epidemic affect the lives of women in South East Asia and the South Pacific' How can prevention and control strategies more effectively incorporate gender concerns' This report provides an overview of the gender implications of HIV/AIDS programmes in these regions. HIV has not yet reached the extreme levels of other regions, but this leads to the urgent need for effective prevention and control strategies to limit its further spread. Both men and women must be consulted in this process, as both have significant contributions to make and roles to play. In particular, strategies such as incorporating HIV/AIDS education into primary health care, targeting a wider age range, and expanding current prevention/awareness activities with sex workers to include women who are not in the sex industry, are required.

You cannot separate HIV/AIDS awareness and prevention from gender and sexuality issues. Women have very little power in sexual relationships, and this combined with increasing levels of heterosexual HIV transmission underscores the importance of incorporating women's concerns into HIV prevention and control strategies. While it is essential to work with men in these areas, women (and not only female sex workers) must be included. While there is considerable diversity between countries in the region, the following general observations apply: . Heterosexual intercourse is the main, increasingly significant route of transmission of HIV/AIDS. . Men are reluctant to use condoms as their use is negatively associated by society with prostitution and promiscuity. . Women lack the power in sexual relationships to refuse to have sex or insist on condom use. . Migration of young women to enter sex work has become an established pattern, due to poor alternative economic options for women from poor rural areas. . HIV continues to be associated with sex workers. This means that other women may not consider themselves to be at risk. . Men are commonly perceived as 'victims' of AIDS, and women are thought of as 'transmitters' of HIV. . The social and psychological burden adds to women's work burden as the primary carer for those affected. There is clearly a need for ongoing research on sexual behaviour of both men and women, and the consequent implications for HIV/AIDS programmes. Meanwhile, the following recommendations should be considered: . Develop prevention technologies that are both inexpensive and controlled by women, such as virucides (chemicals that destroy viruses) and female condoms (for insertion into the vagina). Until these are developed, male condom use should be promoted. . Incorporate prevention and care strategies into primary health care programmes. In addition, both men and women should be targeted for HIV/AIDS awareness education. . Target different age groups, particularly younger women and school dropouts. . Expand and diversify present programmes for female sex workers to target and reach all women in the community, and tailor to their different needs. . Introduce economic development initiatives to provide more alternatives for sex workers, which place them at less risk. . Focus awareness raising on the clients of sex workers and their regular partners, and improve the negotiation skills of sex workers themselves through life skills training. . Give more attention to the counselling of HIV- positive men and women in positive living and skills for coping with the disease. . Encourage and support women's organisations in taking initiatives in HIV/ AIDS related work, and support networking and experience exchange between them.