Walking the Talk - VSO

imprisonment of their husbands and the consequentloss of income if they reported sexual violence by theirpartners.” 49 Early marriage and relationships with ‘sugardaddies’ often represent a form of economic exchangewhich leave women and girls with little power. Insituations of extreme poverty, sex serves as a survivalstrategy, where women balance immediate needs offood or shelter with the more distant and abstractprospect of contracting a disease.This same economic dependency forces many womenand girls to disclose their HIV status and ask their malepartners or guardians for money for medication ortransport. 50 According to the Zimbabwe study, “somewomen living with HIV and AIDS had been deserted bytheir husbands,” and “many were facing problems inraising funds for AIDS treatment, including CD4 cellcounting services”. Even when her partner stands byher, such dependency can leave women morevulnerable to interruptions in their treatment. In Uganda,for example, “if the husband dies, most of the widowsare dependent and their lives change so abruptly”. 51In fact, socio-economic barriers are a major reasonwomen are unable to access treatment, care andsupport. In many countries, prohibitively high hospitalfees combined with other expenses are a major barrierto access. According to research in Nepal undertakenfor this report, “The major obstacles faced by thesewomen… are associated with regular cost toKathmandu, and to clinics for CD4 count and ARTcoupled with the time lost due to long travel time andfew days stay in Kathmandu and thus time lost fromregular income generation work and childcare.” 52The burden of HIV and AIDS care places a heavy tollon women and girls, affecting their financialproductivity, among other things. Up to 90% of care isprovided in the home, and the principal givers ofphysical and psychosocial support are women andgirls. 53 In one region in Ethiopia, for example, about85% of care providers (the majority of whom arewomen) spend their time providing care and supportto home-based patients and have no other sources ofincome to support their families. 54 It is often taken forgranted that such women will continue to provideunremunerated care and support to infected andaffected family and community members. Lesserknown is the cost of this care, how it affectseconomic, societal and familial relations, and – last butnot least – the women and girls themselves (seeChapter 5).2.4. Recommendations Donor governments1) Donor governments should consult with women’smovements, local networks and movements ofwomen living with HIV and AIDS to ensure donorfunding reflects local priorities of the people livingwith and affected by HIV and AIDS. They shouldalso ensure that their policies and programmes donot reinforce inequalities.2) Donor governments should fund civil society andlegal aid organisations to support women living withHIV and AIDS to establish test cases, research,monitor and report women’s rights violations, andto lobby and advocate for reform of laws andpolicies that discriminate against women.3) Donor governments should ensure long-term,predictable funding for the strengthening of healthsystems, in particular to ensure women-friendlyhealth systems that integrate HIV and sexual andreproductive health rights (SRHR) services.18 Walking the talk putting women's rights at the heart of the HIV and AIDS response