National Emergency Response Council on HIV/AIDS

Communities must take a stand against GBV

In the country, the month of November has become synonymous with the World AIDS Campaign (WAC) where the country’s HIV response stakeholders concentrate their efforts to raising awareness around HIV and AIDS issues, as they prepare for the national commemoration of World AIDS Day (WAD) on December 1. The various run-up events consist of engagements in imiphakatsi (communities) and sub-populations in a selected Inkhundla, that culminate in a “Report-Back” regional sessions at the host Inkhundla, led by NERCHA in partnership with regional HI response stakeholders. The community-based activities serve to increase awareness among people, on available HIV services including testing and treatment as well as to discuss HIV prevention options.

All WAC/WAD activities are carried out under the guidance of a global theme provided by the Joint United Nations Programme on HIV/AIDS (UNAIDS) which sets the agenda that countries and organizations strive to achieve within the campaign. The WAC/WAD activities are however not the only key national activities that take place in the country and globally, during November. The 16 Days of Activism against Gender Based Violence Campaign takes place from 25 November (International Day for the Elimination of Violence against Women) to 10 December (International Human Rights Day). In a sense, the key WAC/WAD activity (World AIDS Day commemoration) occurs during and complements this key international human rights awareness-raising campaign.

The interaction of WAC/WAD and the 16 Days of Activism

Violence against women and girls is a devastating violation of human rights that is widespread in the country. Largely referred to as Gender Based Violence (GBV), it includes sexual abuse of children, domestic violence, sexual assault, financial abuse, emotional abuse and human trafficking. GBV has adverse effects not only on public health, but also handicaps the ability of women and girls to contribute to developing the country. Women play an integral role in supporting their families and communities, and therefore, their absence or weakened capacity due to abuse, HIV infection, injuries or unwanted pregnancy has a telling effect on economic development and community health.

GBV or fear of it, remains a daunting challenge for the country and the response to HIV and AIDS because it may limit the ability of the abused person to negotiate for safer sexual acts or refuse sex. It can further interfere with their ability to access treatment and care, and the ability to maintain adherence to treatment. For women with newborn babies, GBV can result in wrong infant feeding choices. In children and adolescents, GBV increases the risk of horizontal HIV transmission.

 

HIV infection in Eswatini is primarily acquired through heterosexual relations - which are greatly influenced by socio-cultural factors, underlined by gender power imbalances. Gender inequality is prevalent in all aspects of socio-cultural, economic and political areas of the society. Expressions of masculinity are characterized by risk taking including engaging in risky sexual behavior and reluctance to seek health care on time, which renders them as not only vulnerable to acquiring HIV, but also increases their risk of infecting their partners.

 

The Eswatini HIV Stigma Index Report 2019 key informants reveal that in some instances, women choose not to disclose their HIV status because of fear of being hurt by their partners. “Women live in silence for fear of rejection and violence”, said one respondent. Others highlighted that stigma and discrimination is experienced differently between men and women, as there are men who wait to get their HIV status results through their partners. “Usually it is women who go to hospitals for PMTCT and we hear they get assaulted when men demand to know their HIV status” said a law enforcement officer.

 

The Stigma Index Report also reveals that in some instances, the HIV disclosure process leads to gender-based violence, while the first report reported that living with HIV can constitute a risk factor for GBV, with 7.7% of people living with HIV reporting experiences of physical assault. This establishes a vicious cycle of increasing vulnerabilities to both GBV and HI., making it crystal clear that we cannot stop the epidemic of HIV unless we also address the epidemic of violence against women.

 

The 16 days of activism

The seventeen (17) goals of the 2030 Agenda for Sustainable Development call for global action (beginning in 2015 and spurning 15 years) to address the 3 dimensions of sustainable development: economic, social and environmental. Goal 5 recognizes gender equality and the empowerment of women as a key priority, pledging that “no one will be left behind”.

The 16 Days of Activism against Gender-Based Violence is an annual international campaign started by activists at the inaugural Women’s Global Leadership Institute in 1991 and continues to be coordinated each year by the Centre for Women’s Global Leadership. It is used as an organizing strategy by individuals and organizations around the world to call for the prevention and elimination of violence against women and girls. Locally, it is run under the Coordinating Assembly of NGOs’ Gender Consortium that constitutes such organizations as SWAGAA, World Vision, WLSA (Eswatini) and many others. 

In 2019, the campaign theme is, “Orange the World: Generation Equality Stands against Rape!” While the names, times and contexts may differ, women and girls universally experience rape, sexual violence, and abuse, in times of peace or war. Rape is rooted in a complex set of patriarchal belief, power, and control that continue to create a social environment in which sexual violence is pervasive and normalized. Exact number of rape and sexual assaults are notoriously difficult to confirm due to frequent latitude and impunity for perpetrators, stigma towards survivors, and their subsequent silence.

In her remarks at the UN Security Council Open Debate on Women, Peace and Security held in New York n October this year, UN Under-Secretary-General and Executive Director of UN Women, Phumzile Mlambo-Ngcuka noted that progress is too slow, political will is not strong enough, and pushback against the needs and interests of women is threatening the progress made and pushing further away those who need the resolve and support most.

“This is despite the many good word, agreements, discussions and events that have taken place. Change is not as real as it needs to be. As I address the Council today, I urge that we heed the call of these women” she added.

Mlambo-Ngcuka also stated that there is a stark contrast between the expressed support fromMember States and regional and international organizations, to women, peace and security, and the reality. Therefore, as the country rolls out the 2019 WAC/WAD under the banner, “Communities make the Difference”, the onus is on all of us to change the reality of the many adolescent girls and women that suffer due to the indifference of the various communities that we live in – be it geographical and the sub-populations we align with.

The Government of the Kingdom of Swaziland Eswatini in realization of the role of GBV in HIV issues and has prioritized GBV as a key intervention area in the HIV response as reflected in the National Multisectoral HIV and AIDS Framework (NSF) 2018-2023. The 2030 Agenda also clearly posits that all women and girls, regardless of their location, situation, and circumstances or migratory status, should be entitled to a life free from violence and its consequences.

 

We are all aware of the ill-effects of GBV and during the 16 Days of Activism, individuals, the family, the church, communities, government and partners must spring into action. All are encouraged to give their own cry for help and for increased protection of our women and girls, from gender-based violence. There is enough evidence that GBV increases women’s risk of HIV acquisition but the role of GBV in the HIV testing to care continuum is less clear. Though there is not enough literature, there exists evidence that GBV is an impediment to the uptake of HIV testing and treatment and care services like enrolling on antiretroviral treatment (ART) and accessing Pre-Exposure Prophylaxis (PrEP) and Post Exposure Prophylaxis (PEP).

 

As the WAC/WAD focuses on creating awareness and demand for the use of combination prevention, there is need to address how best to meet women’s HIV care needs, especially those that have and /or continue to experience GBV. NERCHA joins SWAGAA and partners in the Gender Consortium in calling all Emaswati to learn more and take a stand against the pervasive rape culture that surrounds us. The on-going community based dialogues that are taking place at Hosea Inkhundla (Shiselweni) and those to start this Friday at KaNgcamphalala and KaMkhweli in Siphofaneni Inkhundla under the Lubombo Region should be used to bring out issues for consideration in programming – how to counter the impact of GBV on accessing HIV services, as well as the situation of key populations.

 

Communities make the difference, let us act together to End AIDS and as “Generation Equality’ stand against RAPE!.