8TH INTERNATIONAL CONGRESS ON AIDS IN
ASIA & THE PACIFIC
Colombo, Sri Lanka, 19-23 August
2007
Gender and
HIV/AIDS
Gender roles and relations powerfully influence the course and impact
of the HIV/AIDS epidemic. Gender-related factors shape the extent to which
men, women, boys and girls are vulnerable to HIV infection, the ways in
which AIDS affects them, and the kinds of responses that are feasible in
different communities and societies.
Gender-based inequalities overlap with other social, cultural, economic
and political inequalities—and affect women and men of all ages.
Experience shows that controlling the epidemic depends in large measure on
communities’ and families’ abilities to confront the gender-driven
behaviour that increases the chances of infection for girls and boys, men
and women.
Social risk factors such as illiteracy, lack of awareness, violence
against women together with the powerlessness of women in a patriarchal
society makes women more vulnerable to HIV. Biologically it is twice as
easy for women to contract HIV from men and the physiology of women
increases their risk to HIV (e.g.: menstruation, intercourse). Pregnancy
associated conditions such as hemorrhage increase the need for blood
transfusions in women. According to UNAIDS, 40% of PLWHA in the world are
women.
Innovative activities targeting boys and girls are needed to promote
more equitable and mutually respectful attitudes and behaviour, especially
in sexual relationships. Also needed are targeted anti-poverty programmes
that extend credit and other forms of support to both women and men in
need, as well as measures that address the special needs of widows and
child-headed households.
| Skills Building Workshop Themes for the 8th
ICAAP
Care and
Support
While access to medicines is extremely important, the needs of
people with HIV/AIDS extend far beyond drugs and health care.
HIV/AIDS care strategies therefore need to be comprehensive. Social
security for PLWHA is considered as part of the right to a life with
dignity in the face of HIV. Incorporating rights to treatment, food
and nutrition, livelihood, employment and education, to fulfill the
social, psychological, nutritional and economical needs of PLWHA.
Care and support must also address stigma and discrimination faced
by infected and affected people. It requires social support to help
HIV-positive people, their families and their communities cope with
the economic and social consequences of sickness and death due to
AIDS. Prevention as part of care and support should be promoted.
Home based care of infected people should be encouraged rather than
institutionalized care. HIV should be an integral part of the
primary health care system, ensuring quality treatment without
stigma and discrimination. Micro credit, also known as
micro-finance, is an effective poverty-alleviation instrument and a
mechanism to support will support PLWHA and their
families.
Advocacy
and Leadership
Advocacy is a process of communication which is different from
the mere dissemination of information and education (IEC). Advocacy
goes beyond this and first seeks support, commitment and recognition
from policy and decision-makers and the general public about the
problem. Advocacy provides solutions and support in tackling issues.
Advocacy is important in HIV prevention because it can enable things
to be done which a single organization could not do on its own;
partnerships are key and create support for an HIV/AIDS prevention
programme in a number of ways.
Advocacy work should include creating awareness of the magnitude
and seriousness of the problem, diminishing discriminatory practices
and removing policy and other barriers to prevention and care
activities, and campaigning for effective and sustainable action. It
should aim to influence the highest authorities in the country to
provide leadership, political support and commitment. Advocating for
national and international policies that enhance the right to
universal access to free, comprehensive and sustainable care and
support. Promote advocacy for the ethical use of drug trials and
practices in Sri Lanka. Budget tracking and keeping states
accountable to their commitment to HIV/AIDS initiatives. Human
rights of PLWHA are protected through state practices and policies.
Involving people with HIV/AIDS in policy design, planning and the
implementation of AIDS-related work is itself an important aspect of
advocacy.
Community
Participation
Increasing importance of community-based participation in
prevention, care and treatment of HIV/AIDS is recognised. A range of
outreach activities across the country will draw communities into
the Conference and bring the Conference to communities. Experiences
of countries with a vibrant and varied grass-roots NGO movement
could be shared. This is an opportunity for communities living with
HIV/AIDS to learn and share their experiences, recognising the
increasingly important role of community in prevention, care and
treatment. It can include workshops and sessions to encourage
dialogue and explore new community-based approaches and strategies
to further the goal of Access for All.
The Stepping stones’ training package is a participatory tool
practiced by ActionAid International, aiming at behavioural change
for prevention and control of STI/HIV/AIDS. It was developed to
address the vulnerability of women and young people when it comes to
decision making about sexual behaviour. It is based on the following
principles, the best prevention strategies are those developed by
community members themselves; Peer groups need their own time and
space to identify and explore their own needs; Behaviour change will
be more effective and sustained when all members of the community
are involved.
Gender
and HIV/AIDS
Gender roles and relations powerfully influence the course and
impact of the HIV/AIDS epidemic. Gender-related factors shape the
extent to which men, women, boys and girls are vulnerable to HIV
infection, the ways in which AIDS affects them, and the kinds of
responses that are feasible in different communities and
societies.
Gender-based inequalities overlap with other social, cultural,
economic and political inequalities—and affect women and men of all
ages. Experience shows that controlling the epidemic depends in
large measure on communities’ and families’ abilities to confront
the gender-driven behaviour that increases the chances of infection
for girls and boys, men and women.
Social risk factors such as illiteracy, lack of awareness,
violence against women together with the powerlessness of women in a
patriarchal society makes women more vulnerable to HIV. Biologically
it is twice as easy for women to contract HIV from men and the
physiology of women increases their risk to HIV (e.g.: menstruation,
intercourse). Pregnancy associated conditions such as hemorrhage
increase the need for blood transfusions in women. According to
UNAIDS, 40% of PLWHA in the world are women.
Innovative activities targeting boys and girls are needed to
promote more equitable and mutually respectful attitudes and
behaviour, especially in sexual relationships. Also needed are
targeted anti-poverty programmes that extend credit and other forms
of support to both women and men in need, as well as measures that
address the special needs of widows and child-headed
households.
Substance
Abuse
Substance abuse is the use of a drug or other substance for a
non-medical use, with the aim of producing some type of
'mind-altering' effect in the user. This includes both the use of
illegally produced substances, and the abuse of legal drugs, in a
use for which the substance was not intended. Often this involves
use of the substance in excessive quantities. Drug use is associated
with a variety of negative consequences, including increased risk of
serious drug use later in life, school failure, and poor judgment
which may put teens at risk for accidents, violence, unplanned and
unsafe sex, and suicide.
People using shared/contaminated needles and syringes or exchange
sex for drugs are in the high risk category for AIDS. Currently
shared/contaminated needles used by drug users accounts for
approximately 5 -10% of adult infections. Difficulties in preventing
drug addiction augment HIV prevention interventions with this group.
Alcohol increases the possibility of engaging in high risk
behaviour. Drug use and alcohol use are linked to poverty,
unemployment and lack of awareness on health issues.
Adolescence
Nearly 12 million youth around the world live with HIV/AIDS, of
who 62% are females. Youth are also especially vulnerable to the
infection due to powerlessness, illiteracy, poverty and lack of
information on reproductive and sexual health and rights. Youth are
also more prone to sexual and physical exploitation, increasing
their risk to HIV. Unemployment in youth drives them to unsafe
lifestyle practices increasing their susceptibility to HIV.
Worldwide every 15 seconds a child becomes orphaned by AIDS.
HIV/AIDS
in Disasters
Disasters such as the tsunami and war, results in a sudden
increase in displaced people, especially women and children. Women’s
health and safety in post-disaster situations is often not
prioritized, increasing their vulnerability to HIV. Positive
people’s medical needs are often neglected in post disaster
scenarios and they are relocated without proper consideration of
their access to medical care and support. The breakdown of social
and health infrastructure in disasters is seldom replaced – the
people who were accessing these services often left with no
replacement services and medical care. Women and children living in
camps are exposed to violence, unsafe environments and face lack of
food security. During war situations, women’s and girls’ bodies are
used as weapons of war.
Primary
Prevention
Primary prevention will include the following: • Guidelines
for HIV testing • Access to condoms • Antiretroviral
Postexposure Prophylaxis After Sexual, Injection-Drug Use, or Other
Nonoccupational Exposure to HIV • Incorporating HIV Prevention
into the Medical Care of Persons Living with HIV • Primary and
Secondary HIV Prevention - opportunities for and obstacles to HIV
prevention activities in clinical settings • HIV Transmission -
Addressing bodily fluids proven to spread HIV, behaviors associated
with a risk for HIV infection, and frequently asked questions about
HIV transmission • HIV Prevention Approaches and Strategies -
Behavior change counseling, models of behavior change, motivational
interviewing, safer sex interventions, and practical advice on
condoms • Taking Patients' Sexual and Substance Use Histories,
and HIV risk associated with sexual activities • Challenges of
HIV prevention - provider frustration and "prevention burnout •
HIV prevention among IDUs
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