Walking the Talk - VSO

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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
Multilateral organisations1) The Joint United Nations Programme on HIV/AIDS(UNAIDS) and the World Health Organizationshould develop clear guidelines and a strategy tosupport country governments to develop a humanrights-based analysis of the barriers faced bywomen and girls for scaling up HIV and AIDSaction. This can be done in conjunction with localHuman Rights Commissions.2) The Global Fund to Fight AIDS, Tuberculosis andMalaria should improve expertise on women’srights at all levels of the decision-making processand develop adequate indicators to ensure thatcountry coordinating mechanisms are reflecting thepriorities and rights of women and girls.3) The second independent evaluation of UNAIDSmust analyse the degree to which women's rightsin relation to HIV and AIDS are addressed byUNAIDS and its co-sponsors. It must make clearrecommendations around women's rights toimprove UNAIDS’ effectiveness.Developing country governments1) National governments should base national HIVand AIDS strategies on a human rights-basedanalysis of the barriers faced by women and girls inregard to HIV prevention, treatment, care andsupport services. This should have the participationof women and girls, living with and affected by HIVand AIDS, at its heart.2) National governments should tackle stigma anddiscrimination head on by establishing andenforcing anti-discrimination laws, investing innational stigma reduction campaigns and byproviding training for doctors and healthcareworkers on the rights of women and girls living withHIV and AIDS. Governments, donors and civilsociety should also be careful about how publicinformation campaigns transmit messages in orderto avoid stigmatising messages.3) National governments should provide training andfunding and put systems in place to ensure thatadequate staffing, diagnostics, medicines and otherprovisions are made to treat opportunisticinfections that particularly affect women and girls,such as cervical cancer. Governments must investin training female healthcare workers and othermedical professionals.Civil society organisations1) Civil society should prioritise capacity building inwomen’s rights-based programming in their HIVand AIDS responses.2) Civil society organisations in developed anddeveloping countries should prioritise women’srights advocacy and campaigns at all levels.3) Civil society should ensure that a human rightsapproach to the barriers faced by women and girlsis at the heart of their programmatic interventions.Walking the talk putting women's rights at the heart of the HIV and AIDS response 19
Page 1 and 2: Walkingthe talkPutting women's righ
Page 3 and 4: ContentsContents 1Glossary 2Definit
Page 5 and 6: DefinitionsUniversal Universal acce
Page 7 and 8: Gideon Mendel/Corbis/ActionAidAdero
Page 9 and 10: Prevention, treatment and care and
Page 11 and 12: Gideon Mendel/Corbis/ActionAidStree
Page 13: Figure 1: Number of women and men l
Page 17 and 18: marriage, harassment or other socie
Page 19: childcare arrangements or to take t
Page 23 and 24: and testing. A few of the strategie
Page 25 and 26: Box 2. The Climbing to Manhood Proj
Page 27 and 28: some of the problems facing women a
Page 29 and 30: Box 3. The Gender Violence Recovery
Page 31 and 32: 3.5. Recommendations Donor governme
Page 33 and 34: non-discrimination. Failure to do s
Page 35 and 36: Box 4. The power of ART in Nigeria:
Page 37 and 38: 3) The Global Fund to Fight AIDS, T
Page 39 and 40: support. While their efforts suppor
Page 41 and 42: first point of contact for any illn
Page 43 and 44: ‘care provider’, rather than th
Page 45 and 46: In some circumstances, the cost of
Page 47 and 48: The stipends can also be hard to ac
Page 49 and 50: ecause they do not have access to t
Page 51 and 52: HIV rally, Nairobi, Kenya.Jess Hurd
Page 53 and 54: 2) The Global Fund to Fight AIDS, T
Page 55 and 56: 39Women’s rights and universal ac
Page 57 and 58: 114www.who.int/hiv/topics/prophylax
Page 59 and 60: 191USAID/UNICEF/UNAIDS/World FoodPr

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