Together We Must...End Violence against Women and Girls and HIV and AIDS

This report, a joint document from ActionAid and the United Nations Development Fund for Women (UNIFEM), draws attention to the knowledge, institutional capacity, and resources needed to address the intersection between HIV and AIDS and violence against women and girls (VAWG). Its aim is to stimulate debate and collaboration among practitioners and advocates about how to identify and promote effective prevention policies and practices that can be adapted to various contexts.

Recognising that violence against women and HIV and AIDS are mutually reinforcing pandemics, this report highlights key elements to consider in strategies addressing their intersection "by profiling organizations that employ human rights and gender-sensitive approaches to the dual pandemics; that empower marginalized sectors of society; that promote community ownership; that build the capacity of civil society; that encourage cross-sectoral integration; and that facilitate linkages between advocates and activists within the HIV&AIDS and VAWG movements." The four broad-based strategies for tackling the intersection are: community mobilisation to transform harmful gender norms; engagement of marginalised groups that are often more vulnerable to the twin pandemics; development of integrated approaches to support and care; and advocacy for greater accountability among funding agencies and policy makers.

• The first strategic approach - involving community groups to change harmful gender norms - profiles Sonke Gender Justice from South Africa, India’s MILANA, and Equal Access Nepal. For example, by emphasising the proactive roles of all community members in ending the pandemics, these organisations foster communities in which violence is not tolerated, and women and girls living with HIVandAIDS are supported to live safe, productive lives. "By working with a range of actors whose attitudes and behaviours help shape societal norms, [Sonke Gender Justice] encourage[s] community ownership and buy-in from even the most sceptical of stakeholders...and demonstrate[s] that the intersection of violence and HIV is more than just a 'woman’s issue'....[B]y probing deeply held cultural beliefs, ...[they] promote a more inclusive understanding of local culture to create true communities of support." Community involvement can include men, local governments and traditional leaders, provincial and national government leaders, and, as in the case of MILANA, a support network of women living with HIV&AIDS and their families. It can involve interpersonal meetings and, as in the case of Equal Access Nepal, radio broadcast and community discussion, training of both genders, and gathering and making available personal testimonies through broadcast, print, and personal presentation.
  
• The second approach - focusing on vulnerability rooted not only in gender inequalities, but in social disparities based on race, class, ethnicity, age, sexual orientation and other factors - highlights Brazil’s Criola, Women of Color United USA (WOCU), and Nigeria’s Girls Power Initiative (GPI). The strategy of these examples is to tackle the multiple forms of marginalisation that make women and girls vulnerable both to violence and HIV and AIDS. Criola develops tools to help women and girls deal with violence, raise their self-esteem, advocate for their rights, and embrace their Afro-Brazilian heritage and takes the tools into neighbourhoods of marginalised women and girls. WOCU works to raise awareness of the link between race, gender, and HIV status in the United States (US) through a network of organisations that collects data, advocates for more quantitative research, and holds policy makers accountable. GPI uses education to teach girls how to negotiate respectful relationships and protect themselves from unsafe sex.
  
• The third strategy - using health care as an entry point to comprehensively address the two pandemics - highlights Nairobi Women’s Hospital and the Fundación para Estudio e Investigación de la Mujer (FEIM). The hospital in Nairobi includes the Gender Violence Recovery Centre (GVRC) where women receive treatment, counselling, testing, and referrals for longer-term care, such as free anti-retroviral (ARV) therapy. Psychosocial support includes follow-up counselling and possible shelter and legal action services. In Argentina, FEIM created a protocol to specifically address linkages between violence and HIV&AIDS in healthcare and worked with the city’s Ministry of Health and the Chief of the Ministry’s HIV Unit to put pressure on hospitals to implement new gender-friendly policies, as well as to dispel the stigma and discrimination surrounding HIV status. Comprehensive care now includes psychological and legal services, as well as extensive follow-up by medical personnel.
  
• The last strategy - holding policy makers accountable for their efforts to address the linkages between the pandemics - highlights the global Women Won’t Wait (WWW) campaign and The Civil Resource, Development and Documentation Centre (CIRDDOC), of Nigeria, which promote gender-sensitive HIV and AIDS policies at all levels of decision-making and push for adequate funding and participation of women’s organisations in the design and implementation of programmes to address the intersection of VAWG and HIV&AIDS. WWW published a gender-based analysis of the international AIDS response. They mobilised the public and brought together the two civil society movements working on HIV and VAGW, bringing activists from different backgrounds together who share common goals. CIRDDOC established 15 community information centres in rural Nigeria equipped with generators, televisions, and video players to access news and legal information, legal services, and support. A team of paralegals, development information officers, and civic educators works with women to demystify and simplify the law, including step-by-step guidelines to access legal services. Civic educators further explore issues around gender, violence, and HIV&AIDS through workshops and community forums. Once a year, the Centre holds public tribunals for women to speak out against the abuses they have suffered, and to raise awareness around violence, HIV, and larger issues of sexual and reproductive rights. The audience of several hundred members includes government officials and legislators. CIRDDOC also offers trainings to legal and health workers, increasing their empathy by putting them in the place of the women with whom they work, and employees the Mutapola Framework, a rights-based approach putting women at the centre of the HIV and AIDS response.

The five concluding recommendations are the following:

1. More research is necessary to identify and evaluate effective strategies for addressing the intersection between HIV an d AIDS and VAWG, and to document the lessons learned.
   
2. National and global data on violence against women and girls and HIV and AIDS should be collected and disseminated as a means of holding policy makers accountable.
   
3. Standardised protocols and training for health care personnel are necessary to guide them on the connections between VAWG and HIV and AIDS.
   
4. Efforts must be made to engage excluded communities in the places where they live, work and play.
   
5. Community buy-in from a range of stakeholders is needed to address stigma and discrimination associated with VAWG and HIV and AIDS.