Progress on the HIV/AIDS response is hampered because gender inequality and violations on women’s rights still exist. Furthermore, resources to protect and respect women’s rights are insufficient because policies on women and gender equality are often not translated into practice.
Global Situation of HIV and Women
At the end of 2008, an estimated 33 million people were living with HIV worldwide. Although the 
global epidemic stabilized since 2001, new infections in other countries have offset the dwindling number of cases in several countries, with most number of cases in Sub-Saharan Africa (22 million) followed by South and South East Asia (4.2 million) and Latin America (1.7 million). Globally, women account for half of those infected by HIV. In Africa, the number of women with HIV has increased to 12 million (almost 75% of these women are from Sub-Saharan Africa) compared to 8.3 million African men living with HIV. The main mode of transmission in this region is through heterosexual sex. In the Caribbean, young women are 2.5 times more likely to get infected by HIV. Commercial sex is also the major factor of the spread of HIV in Latin America, with 30% of women being infected. In Asia, among the 47 million PLHIV (People Living with HIV), 35% are women who generally acquired the virus from their long-time partners who engage in sexual activities with multiple partners, or from partners who inject drugs, as in the case in Indonesia.
Vulnerabilities of Women to HIV
Biologically, females, especially young girls, are more vulnerable than men to HIV because of the sensitive nature of the female genital tract. Moreover, women often experience the impact of HIV more than men because of existing gender inequalities in societies. Fewer choices available to women regarding their sexual behavior limit their capacity to deal with the risk of infection. Women who have experienced abuse and who are financially dependent on their spouses often have difficulty negotiating for safer sex with their husbands due to low self-esteem and confidence.
Even if women are becoming independent, oftentimes, this independence is only reflected in their careers. Pressures to conform to traditional roles still exist at home. The traditional role as caregivers often puts burden on women to care for relatives as well as children orphaned by AIDS. Women’s childbearing role also means that they also have to contend with issues such as mother-to-child transmission of HIV.
Also, trafficked women are likely to be among those with least access to reproductive health information and services. Due to the nature of the work, many of them are highly vulnerable to sexual abuse and physical violence, unwanted pregnancy, Sexually Transmitted Diseases and HIV/AIDS. Often, these women have no access to adequate health care due to their illegal status. In Northern Thailand, ethnic girls are trafficked and forced into the sex industry. These girls are reputed to be preferred as sexual partners by the Chinese as they are perceived to be free from HIV infection.
Migrant workers returning to Lao PDR from Thailand, for example, have been found to have higher rates of HIV infection than among the general population, even though the overall prevalence in Lao PDR is low. In the aftermath of the tsunami in Thailand, the needs of Burmese illegal migrant women, who were wives of fishermen, were neglected by the Thai government due to their illegal status. Their reluctance to come forward and access necessary RH services was further aggravated due to the threat of being prosecuted. Receiving countries often have strict regulations sometimes including mandatory HIV testing to migrants entering their borders. There have been several cases among Filipina migrants who were deported after being found HIV positive. These Filipina migrants’ rights to confidentiality and to access pre- and post-test counseling are violated as the HIV test results are often disclosed, not to the client, but to the potential employers and officials of embassies and immigration offices.
HIV Funding Woes
In the 2006 High Level Meeting on AIDS, all member states of the United Nations, including donor countries, have pledged to uplift women’s rights and “eliminate gender inequalities, gender-based 
abuse and violence and to increase the capacity of women and adolescent girls to protect themselves from the risk of HIV infection” through the provision of necessary health and support services and by creating an enabling environment to empower women towards their economic independence and strengthening male involvement in achieving gender equality.
Four years after, activists took the stage and flashed banners demanding donors to not retreat from funding necessary HIV programs during the recently concluded XVIII AIDS Conference in Vienna. This outburst from the activists was due to the dwindling fund source for HIV prevention and treatment programs, which has harmful consequences to HIV programs that benefit women.
The huge funders of HIV/AIDS Programs include the US President’s Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to fight AIDS, Tuberculosis and Malaria, and the World Bank Multi Country HIV/AIDS Programme (MAP). These organizations contribute financially to achieve MDG6. Despite existence of global initiatives and collaborations addressing the global HIV/AIDS challenge, majority of these funders have either unclear or slow implementation of gender-sensitive programs and insufficient indicators to measure progress in achieving women’s rights in the context of the HIV/AIDS. Most countries also rely on external funds, particularly from the Global Fund to Fight AIDS, TB and Malaria. However, the Global Fund faces a funding shortfall of $4 billion. In the US, HIV campaigners have been disappointed by President Obama’s decision to give $5 billion to the PEPFAR global HIV initiative, an amount representing a 30% shortfall of Bush’s funding.
In 2009, The World Bank issued a report which predicted that the continuity of HIV treatment may be threatened for around 70% of people currently on treatment in sub-Saharan Africa, 50% in Asia, and 25% in Russia and Central Asia. Official
Globally, women account for half of those infected by HIV. In Africa, the number of women with HIV has increased to 12 million (almost 75% of these women are from Sub-Saharan Africa) compared to 8.3 million African men living with HIV.
Development Aid, which contain HIV treatment money, was significantly reduced. In these conditions, it is common practice that public health financing is not prioritized and sexual health will be at the bottom of the list. Because of diminishing external financial support, countries now face the difficulty of mobilizing resources to sustain national HIV/AIDS Programs. Tanzania cut its AIDS budget by 25% because of the effect of the economic crisis. The government of Botswana issued a statement early last year stating that due to the deficits in the diamond export market, the country will only be able to provide treatment until 2016. In South Africa, more than half of those eligible for treatment had to wait over a year to actually receive it and another 20% of patients eligible for Anti-Retro Viral died waiting for them. To cope with the funding decline, some countries resort to alternative solutions. Most countries have policies providing free antiretroviral drugs, but recent trend in funding have forced governments to require many patients to pay ‘out-of-pocket’ costs such as diagnostic tests, treatments for opportunistic infections and transportation. These items can be quite considerable, especially to women who often are economically dependent. In 2008, India’s national rail service, Indian Railways, introduced discounted fares for HIV-positive people travelling to receive treatment but the low status of women prevent them from accessing RH services, even if the discounted fares are available. The AIDS response is further hindered by corruption and lack of accountability among governments, funders and CSOs as well. Paula Akugizibwe, Advocacy Coordinator at the AIDS and Rights Alliance for Southern Africa, remarked that accountability should extend to CSOs, as CSOs often evade their own responsibility. The International AIDS Society President Julio Montaner expressed during the Vienna AIDS Conference that the global AIDS response is at a crossroads, particularly after the G8 and G20 meetings failed to continue their pledge towards Universal Access and for not making clear-cut steps towards achieving the MDGs where gender is a cross-cutting issue.
Making women’s rights protection and gender equality a reality in the HIV response requires more than advocacy. Until women’s rights are realized, progress will be constrained. In the context of national responses, it requires a combination of political will, technical expertise and financial resources that turns women’s rights and gender equality into programmatic priorities that are budgeted and implemented. Civil societies working on HIV need to be more active and informed players in funding modalities that can provide support for women’s rights activities. In the context of international assistance and cooperation, it requires willingness to collectively remove barriers to women’s rights and commitment to ensure that sufficient funds are targeted towards the support of women’s rights.
REFERENCES:------------------------------------------------------------------------------------------
UNAIDS (2008). Report on the Global HIV/AIDS Epidemic 2008: Executive Summary. Accessed at www.unaids.org
UNAIDS (2008). Enhancing Results by Applying the Paris Declaration at Sector Level: Progress Update and Lessons Learnt from Aid Effectiveness in AIDS Responses. Accessed at www.unaids.org
UNAIDS (2007). Issue Paper: Engaging Donors in the Protection and Promotion of HIV-related Human Rights. UNAIDS Reference Group on HIV and Human Rights, 7th Meeting, 12-14 February 2007.
aidsmap.com. No retreat from AIDS funding, XVIII AIDS conference demands. Article published on July 18, 2010.
Myrna Maglahus is a country outreach officer with IBON International/Reality of Aid Network
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