Make a plan to stop GBV

Gender based violence (GBV) is one of the biggest drivers of HIV in women and girls and South Africa has a significant and well-publicised GBV problem. Yet there is still no national strategic plan to address it.

Studies show that women who have been exposed to gender based violence are 1.5 times more likely to acquire HIV. Particularly vulnerable are children, sex workers and lesbian, bisexual and transgender women.

Gender based violence is a fundamental violation of human rights, as enshrined in our constitution. Although we have supportive legal and policy frameworks in place to tackle gender inequality and violence, the issue in South Africa is a lack of coordination and poor implementation of the laws and policies already in place to safeguard girls.

Without a coherent, coordinated and budgeted plan to address GBV, it will continue to ravage our communities, perpetuated by an inter-generational cycle of violence. It is vital to sensitise and train frontline workers like the police, teachers, health and social workers and community care givers so that they provide compassionate and appropriate care to survivors of GBV.

Addressing gender equality is critical. Worldwide, support for women’s movements has been found to be a significant predictor of government action to redress violence against women.

We call for ZERO for women and girls in the National Strategic Plan (2017 – 2021) as well as a National Strategic Plan to stop GBV. Academics, civil society groups, NGOs and concerned citizens from across the country are calling on the South African Government to make a plan now to stop GBV.

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Prevention for women needs more than just lip service

HIV incidence among women between 15 and 49 is increasing in South Africa while rates in other groups decline. Prevention needs more than lip service to reverse this deadly trend. With more than 2.5 million people now on antiretroviral (ARV) treatment, an increasing national focus on treatment and adherence means that women-centred prevention strategies are being neglected.

Disappointing findings that vaginal microbicide gel is not effective in preventing HIV highlights the urgent need for research into a range of HIV prevention options that will fit more easily into the lives of women. We must step-up the procurement and promotion of female condoms and create the demand for this life-saving product.

With gender based violence at epidemic levels and encouraging Pre-Exposure Prophylaxis (PrEP) research findings (a CDC trial in Botswana, for example, found that PrEP reduced the risk of heterosexual transmission of HIV by roughly 63% in the study group overall), we must identify at-risk women and start trialling PrEP treatment.

According to the World Health Organisation, some studies suggest that women using progestogen-only injectable contraception may be at increased risk of HIV acquisition. Thorough counselling on hormonal contraception must therefore be given to women across South Africa, especially HIV positive women. We must ensure that healthcare workers are properly trained to discuss the benefits and risks of all forms of contraception and how they interact with HIV and AIDS.

Perhaps most importantly, addressing the structural drivers of HIV – inequality and discrimination, stigma, unemployment, poverty, poor educational opportunities and gender based violence – must form a critical part of the country’s prevention agenda.

We call for ZERO for women and girls in the NSP (2017 – 2021).

South Africa’s women and girls need a range of prevention technologies and strategies which address their diverse realities and integrate with their lives – we need more than lip service.

Bring back our girls from HIV & AIDS

A young woman in South Africa is four times more likely to be HIV positive than her male counterpart – our young women and girls are disappearing to HIV in huge numbers. Globally, girls between 15 and 19 account for two out of three new HIV infections but in sub-Saharan Africa, the figure is nearly eight out of ten. According to UNAIDS and UNICEF, more than 800 girls in this age group are infected with HIV every week in South Africa [1]. Women and girls are also much more likely to be caring for those infected and affected by HIV [2], limiting their education, work and life opportunities.

Harmful attitudes, gender inequality and social norms create HIV risk factors for young women such as early sexual debut and early and unwanted pregnancy. In a LoveLife study in 2005, 15.5% of 15 to 19-year-olds reported having been pregnant and 66% said the pregnancies were unwanted [3].

Poverty and the heavy burden of domestic care on women and girls mean that girls are more likely to engage in transactional sex (sex in exchange for money, goods or favours) and inter-generational sex (sex with older men), both of which are well-documented HIV risk factors. Girls in families affected by AIDS are even more likely to engage in sex in exchange for money, school fees, transport or shelter. [4]

Sexual violence is one of the biggest drivers of HIV. Around 70% of reported cases at sexual violence centres are under 18 and the vast majority are female. There are very few treatment, care and support services tailored to the specific needs of young women and girls. Care and treatment for survivors of sexual violence can prevent HIV infection and reduce the impact of trauma (which, unless addressed, can lead to mental health problems and risky behaviour in the future) but negative attitudes of health and justice workers towards survivors of rape reduces  young women’s access to these vital services.

Limited survivor services tailored to the needs of young women and girls, make it doubly difficult for girls to access post-exposure prophylaxis (antiretroviral treatment given to survivors after being raped to prevent them contracting HIV), support, counselling and, ultimately, justice in the form of court appearances and convictions for perpetrators.

It is critical to reduce economic vulnerability by encouraging girls to stay in school, gain qualifications and access employment. Funding for community programmes focusing on reducing gender based violence and cash transfer programmes that provide girls with economic empowerment and autonomy is essential.

We call for ZERO for women and girls in the National Strategic Plan (2017 – 2021). We can bring back our girls from high rates of HIV infection if we come together and work towards eliminating gender inequality.

[1] Lake A and Sidibé M (2015), Ending the HIV/Aids epidemic requires a focus on adolescents.
[2] Akintola, O. (2009) Unpaid HIV/AIDS Care in Southern Africa: Forms, Context, and Implications.
[3] Pettifor et al (2005) Young people’s sexual health in South Africa.
[4] Cluver L. (2011), Children of the AIDS pandemic