Walking the Talk - VSO

Prevention, treatment and care and supportIn every aspect of prevention, treatment and care and support, women and girls are regularly unable toexercise their rights to access HIV and AIDS services. In this report we detail the barriers for women andgirls in terms of prevention, treatment and care and support, and suggest recommendations. We summarisethese recommendations below.Prevention“…my husband tested positive before me,but my aunties, together with my latehusband, disapproved of condom use,arguing that he had paid up all the bridewealth and therefore [I] was supposed notto deny him sex, unprotected or not… theyaccused condom use with lack of love formy late husband… everyone was againstme and [I] had no option…”Strategies to prevent HIV infection often fail to take intoaccount the real lives of women and girls. Preventionstrategies based on abstinence, being faithful and usinga condom ignore the lack of control most women haveover their sexuality and the violence women face,particularly within marriage. The development ofprevention methods that women can control (femalecondoms and microbicides) will help, as will educationand public awareness campaigns that promotewomen’s rights.National and donor governments must only fundevidence-based, gender-sensitive preventionprogrammes that take a rights-based approach,including contributing their fair share to thedevelopment of microbicides and increasing access tothe female condom and other female-initiated HIVpreventionmethods.TreatmentZimbabwean woman living with HIV and AIDS“How can I get up at 3am then travel aloneduring the night to make sure I getantiretrovirals? But a man can easily walkduring the night.”Women are more likely to receive treatment than men, butour research suggests they may be less likely to adhere toit. Reasons given are the lack of privacy and the fear ofviolence or abandonment if their positive status isdiscovered. Women also have less access to adequatenutrition, which they need to support their treatment. Ifaccess to treatment is to be increased, the particularbarriers for women will also have to be addressed.National governments must develop, fund andimplement their national treatment plans and budgetswith a strong emphasis on the access and adherenceof women and girls to treatment, particularly those inpoor and rural communities.Care and support“We walk for miles and miles in order toreach clients in other homesteads. Oncewe are there clients expect a lot from us,like food and even money. This putspressure on our personal resources.”Namibian care providerWomen living with HIV and AIDS face significantbarriers in getting the care and support they need.Leadership of support groups is often dominated bymen, with women and girls unable to raise theirconcerns. The problem is particularly difficult forwomen living in poverty, who don’t have access to theincome generation opportunities or state services theyneed to provide for themselves or their families.Furthermore, women and girls are the major careproviders, yet they are seldom paid and the value ofthis work is rarely recognised.Rwandan woman living with HIV and AIDSWalking the talk putting women's rights at the heart of the HIV and AIDS response 7