The dawning of the day is an HIV infection of more than 7,000 girls and women. To date, the largest numbers of AIDS victims are registered among the women in sub-Saharan Africa and the Caribbean.
On the mother continent, girls and women account for almost 57% of people with HIV. In South Africa, Zambia and Zimbabwe, young women between the ages of 15 and 24 are most often exposed to new infections.
According to the global coalition for women and AIDS, a number of traditional HIV prevention strategies tend to focus primarily on & # 39; ABC & # 39; to concentrate: remember, be faithful, use a condom.
Although the ABC approach undoubtedly prevented a large number of people becoming infected, many of the women in the world are simply not in the position to refrain from sex, to rely on loyalty or to negotiate condom use. ABC can only be a viable and effective prevention tool for women and girls if it is implemented as part of a multifaceted package of interventions that seek to restore deep-rooted gender imbalances.
The global coalition for women and AIDS therefore calls for a more holistic approach to tackling HIV and AIDS.
This means arguing for the empowerment of women and the promotion of women's and girls' rights. Addressing the current unequal gender norms that reduce the ability of young women and girls to make informed choices about their own sexuality is essential to reverse the dramatic upward trend of HIV infection among young women and girls. At the same time, the coalition is calling for coordinated action in a number of specific areas, which, if taken now, can significantly increase women's chances of protecting themselves and ensure that they do not pass on the infection to others.
Condom use has been presented as a feasible solution. Research shows that condoms (male and female) are effective in preventing HIV infection. Programs that are designed to promote the use of condoms are reportedly successful. In Mwanza, Tanzania, the distribution and promotion of condoms by peer educators from youth in 1998 caused a significant increase in reported condom use among young people.
In Nepal, a promotional campaign is aimed at sex workers and their truck drivers. Providing condoms and information along truck routes helped reduce the risky behavior of both sex workers and truck drivers. Between 1994 and 1996, condom use by sex workers doubled along the routes to almost 61%.
Currently, however, more than half of all people at risk for HIV infection are able to obtain condoms. Only 4.9% of married women of reproductive age worldwide use them. That figure drops to 1.3% in Africa. There are many reasons why the usage figures are so low, but a major obstacle is the lack of access. Condoms may not be available (partly due to the global shortage of supplies); people may not know where to go to get them, otherwise they may feel embarrassed to get them.
The global coalition for women and AIDS thus suggests an urgent need to increase production, increase availability, lower prices and overcome the shame factor through awareness activities at community level and sessions of life skills in schools. At the same time, reproductive health professionals can play a greater role in counseling patients about HIV protection, informing them of the dual benefits the condom offers to women who want to control the number of children they have and want to protect themselves against HIV infection. . Whether partners are willing to use condoms, especially in a marriage, remains debatable, as recent studies have shown that nine out of ten men in Zimbabwe do not like to use condoms with their wives.
The female condom remains an underused option. Although efforts to improve existing models are welcome, the female condom in its current form is still the only viable option that allows women to take the prevention initiative. As is clear from reproductive health workers in developing countries, the demand is high. If the female condom were easier and cheaper to sell, many more women would be able to protect themselves against HIV and sexually transmitted diseases (STDs). For example, in sub-Saharan Africa, many women get HIV and STIs from their husbands and need to be able to protect themselves stubbornly. Again, the sentiment of spouses with regard to the use of the female condom indicates reluctance.
In many African countries, including a number with a high number of HIV infections, girls are married in their teens – often as a strategy for poverty reduction. In the next decade, more than 100 million girls in developing countries will marry before their 18th birthday – mostly to older men and often against their will. Today, most of the sexually active girls between the ages of 15 and 19 are married in developing countries. Ironically, these girls have a significantly higher number of infections than their sexually active, unmarried peers.
In this relatively early stage of their physical development girls are particularly susceptible to HIV infection. When they marry older men, who probably had previous sexual partners and who also have less tendency to use condoms, the risk of infection is multiplied. In Kisumu, Kenya, 30% of the male partners of married adolescent girls were infected with HIV. Unmarried but sexually active girls more often have a relationship with younger men, who are more inclined to promote condom use.
To help create a climate in which girls can get married and have their first sexual relationships later in life, it is important to make the public aware of the risks of marriage for teenage girls, and to involve families. encourage to try to delay the marriage as long as possible. If, for economic reasons, families are unable to do so, efforts must be made to ensure that young brides have access to both reproductive and sexual health services and stay in school. This will enable them to continue developing skills that will enable them to support themselves and their families later in life and help increase their self-respect. An example from the many studies that found a link between education level and safe sexual behavior is a study that was conducted in four sub-Saharan African cities: Yaounde, Cameroon; Cotonou, Benin; Ndola, Zambia; and Kisumu, Kenya, where a higher level of education was strongly associated with condom use.
Meanwhile, there is an urgent need for guidelines for the links between child marriage and HIV infection. National Aids strategies can then bring these to the attention and provide information to legislators who support the postponement of the legal marriage age. Even the postponement of a young girl's marriage by one year could significantly reduce her chance of getting infected.
Access to sexual and reproductive health services remains a matter of concern, especially in developing countries worldwide, only one fifth of those who need prevention services actually have access to them. This may be because there are no facilities in the area or because they can not travel to places where they do exist. Even if people can go to facilities, they may not be able to pay the costs charged. Moreover, girls and women may be reluctant to seek advice, for fear of stigmatization. They can also be put off by the unhelpful and discriminating attitude of the staff in some centers. It will therefore be crucial to remove some obstacles that keep women and girls away from sexual and reproductive health services. For example, sensitization programs can help reduce stigma and training activities for healthcare professionals could make services more user-friendly.
HIV prevention strategies must also meet the needs of women with HIV. Positive women must have access to sexual and reproductive health services, without fear of stigmatization and discrimination. When people with HIV feel at ease to be open about their status and where they can receive counseling and treatment to keep them healthy for longer and have a safe and satisfying sex life, they will pass the virus to others less quickly.
At the same time, it will be important to help members of vulnerable groups with specific needs access to services. These include child brides and other groups of young people: people with HIV, people who work in the sex industry, men who have sex with men and inject drug users. (Article credits: the global coalition for women and AIDS).