Gender Mainstreaming in HIV/AIDS - Commonwealth Secretariat

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GENDER MAINST R E A M I NG IN HIV/AIDS: TA K I NG A MULT I S E C TORAL APPROACH all those member governments who supported the development of the GMS and encouraged us to move the project forward; participants at the first GMS meeting in Britain in February 1996 and at the GMS Workshop in Malta in April 1998, who provided valuable input and feedback; and the Steering Committee on the Plan of Action (SCOPA). The concept for this specific co-publication on Gender Mainstreaming in HIV/AIDS arose during a Commonwealth Secretariat GMS and Health Sector Workshop in Halifax, Canada in November 1999. In accordance with the spirit and principles of a broadbased partnership, the Canadian partners and Commonwealth Secretariat jointly identified the need for a dynamic publication to enhance the capacity of governments to adopt genderbased principles in the campaign against the HIV/AIDS pandemic. I am most grateful to Dr Carol Amaratunga and the Canadian editorial team, Dr Jacqueline Gahagan and Sandra Bentley, for their contributions to the text of this manual; to the Canadian authors; to Tina Johnson, Contributing Editor; to members of the Guest Editorial Committee; and to the staff of the Gender Affairs Department, Gender and Youth Affairs Division, particularly Dr Rawwida Baksh-Soodeen, GMS Series Co-ordinator, who conceptualised and guided the series through to publication. I also wish to acknowledge the significant contribution of The Women’s Health Bureau, Health Canada in enabling this co-publication and in contributing a number of key resources, supporting case studies and partnership funding. We share a common commitment to reducing the incidence and suffering caused by HIV/AIDS around the world and hope that this Manual will be of genuine use to you in your efforts to mainstream gender in this area. Nancy Spence Director, Gender and Youth Affairs Division Commonwealth Secretariat Preface In November 1999, during a Commonwealth GMS and Health Sector Workshop hosted by Health Canada in Halifax, Nova Scotia, Canada, the idea for a co-publication on Gender Mains t reaming in HIV/AIDS first emerged. We are extre m e l y g r a t e f u l for the funding support and commitment of the Women’s Health Bureau, Health Canada, throughout the cop u b l i c a t i o n ’s development. In July 2000, the project was further expanded to include the concept of a ‘transformative’ International Institute on Gender and HIV/AIDS. When it comes on stream in 2003, th e training institute – to be co-hosted by the Maritime (Atlantic) Centre of Excellence for Women’s Health (Dalhousie University and the IWK Health Centre) and the Commonwealth Secretariat – will provide comprehensive gender training in HIV/AIDS for Commonwealth country middle-level managers and ‘change agents’. The Institute will enable participants from government, voluntary and clinical sectors to design and deliver gender-sensitive approaches to national HIV/AIDS policy in the campaign against the pandemic. This co-publication is intended to serve as the ‘jewel in the crown’ – the first in a series of core curriculum reference materials for the Institute. To assess the feasibility of the Institute, an International Design Workshop on Gender and HIV/AIDS was convened in Halifax, Canada by the project partners, 16–18 January 2002. We are very grateful to the Women’s Health Bureau and International Affairs Directorate, Health Canada; the International Development Research Agency (IDRC) and the Canadian Institutes of Health Research (CIHR) for their generous contributions to this initiative. Thirty-one participants from 10 countries participated in the workshop and endorsed the concept of an international training institute. These participants also pledged their personal commitment to advance the International Institute on Gender and HIV/AIDS from concept to reality. We are also most grateful to Nancy Spence, Director of the Gender and Youth Affairs Division of the Commonwealth vi vii
GENDER MAINST R E A M I NG IN HIV/AIDS: TA K I NG A MULT I S E C TORAL APPROACH Secretariat, and to Dr Rawwida Baksh-Soodeen, GMS Series Co-ordinator, for their personal commitment, leadership and support for this co-publication and the training initiative. We wish to extend our sincere thanks to the Commonwealth Secretariat, IDRC, the CIHR and to Health Canada’s International Affairs Directorate and Women’s Health Bureau for the opportunity to participate in the global HIV/AIDS campaign through this co-publication and the International Design Workshop on Gender and HIV/AIDS. We are also grateful to the Canadian authors, peer review group and editorial team for their time, dedication and commitment in preparing this co-publication. Special thanks to Tina Johnson, Contributing Editor, for her contributions, synthesis and patient editing of the final version. Carol Amaratunga Executive Director Jacqueline Gahagan Deputy Director Sandra Bentley Co-Chair, Steering Committee Maritime Centre of Excellence for Women’s Health (Dalhousie University and IWK Health Centre) Executive Summary Current estimates show that 40 million people were living with HIV in December 2001 and 3 million died from HIV/ AIDS-related causes during that year. 24.8 million people died from HIV/AIDS between the beginning of the pandemic and the end of December 2001. Sub-Saharan Africa is by far the worst affected region in the world, but AIDS is also the leading cause of death in the Caribbean for those aged 15–45 and the number of cases is doubling every two or three years. Asia, where more people live than any other region, is seeing alarming increases in the number of infections. While AIDS was originally diagnosed in homosexual men, there has been a progressive shift towards heterosexual transmission as the epidemic has spread, and increasing infection rates in women. Almost as many women as men are now dying of HIV/AIDS, but the age patterns of infection vary significantly between the two sexes. Looking beyond the statistics, important differences can be identified in the underlying causes and consequences of HIV/AIDS infections in men and women, which stem from biology, sexual behaviour, social attitudes and pressures, economic power and vulnerability. These result in different rates of risk, infection patterns, access to health knowledge and protection, intervention and care management of illness. Efforts to contain the spread of HIV/AIDS challenge governments and communities to develop policies and programmes that meet the needs of the entire population, including those who are less able to respond to the threat or consequences of infection because of social, economic or gender disadvantage. Education and treatment approaches that do not take into account gender, cultural or social disparities do not use re s o u rces efficiently or effectively and are failing to impro v e long-term population health outcomes. With health systems stretched far beyond their limits by the pandemic, it is vital that the meagre resources available are used in a cost-effective viii ix
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List of Acronyms AAHAS Amherst Asso
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146 Appendix 1: UN Guidelines on HI
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