The Face of HIV is Increasingly Younger
Early this week, on Tuesday 8th March, we joined the rest of the World in celebrating International Women’s Day. This year’s theme focuses on a gender-equal world. This means a world free of bias, stereotypes and discrimination. A world that is diverse, equitable, and inclusive. A world where difference is valued and celebrated, encouraging everyone to collectively #BreakTheBias.
Collective action and shared ownership for driving gender parity is what makes International Women's Day impactful. Gloria Steinem, world-renowned feminist, journalist and activist once explained "The story of women's struggle for equality belongs to no single feminist nor to any one organization but to the collective efforts of all who care about human rights."
Women today are faced with a myriad of challenges and social barriers such as discrimination and HIV stigma, all which have a major impact on their health and well-being. These factors prevent women from seeking and receiving high-quality health care, including HIV testing, treatment, and other HIV prevention services. Addressing these barriers and encouraging safe and supportive communities can help improve health outcomes for women.
In addition to the social issues that affect some women, other factors can increase the chances of getting or transmitting HIV:
Knowledge of HIV status. Women who do not know they have HIV cannot get the treatment they need to stay healthy and prevent transmitting HIV to their partners. Therefore, they may pass HIV to others without knowing it.
Sex partner’s risk factors. Because some women may be unaware of their male partner’s risk factors for HIV, they may not HIV prevention methods to avoid exposure.
Knowledge of PrEP (pre-exposure prophylaxis). PrEP is highly effective for preventing HIV, yet PrEP use among women remains very low. Barriers include lack of awareness, negative experiences with service providers, lack of confidence that providers know about PrEP, daily uptake, and negative response from partners.
Mental health. Women with HIV who experience depression, anxiety, or posttraumatic stress disorder may be less likely to seek HIV care or stay engaged in care.
Sexually Transmitted Infections (STIs). Some STIs, such as gonorrhea and syphilis, can increase the likelihood of getting or transmitting HIV.
Intimate partner violence (IPV). Women who have been exposed to IPV (for example, physical or sexual violence, stalking, or mental abuse by a current or past partner) may be more likely to engage in risky behaviours or be forced to have sex without a condom or medicines to prevent or treat HIV.
In light of the above social and structural issues affecting women, it is important to look at the situation in the country in order to better protect women from HIV acquisition. As it is, according to The Eswatini HIV Estimates and Projections Report of 2020, total new HIV infections among adults aged 15 years and older were 4,800 and are projected to drop to 4,000 in 2023. Among adolescents and young people, new HIV infections were 2,100. Overall, a third of all new HIV infections (1,600/4,800) occurred among adolescents and young women. This is an area of concern which calls for us to strengthen our prevention interventions.
This year’s Women’s Day theme affirms the global shift in the discussion on HIV and Gender; that while we pay more attention to women and girls, our interventions should become more inclusive of men and encourage better relationships for better outcomes. Men play a critical role. When we engage men for their own health and change harmful gender norms, we improve both men and women’s health. Men’s access to HIV services is important for their own health but it is also an important way to reduce vulnerability among women. Therefore, it is imperative that men are not left behind in this fight. This calls for us to be more intentional in our approach to influence behavioural change amongst men who engage in risky sexual behavior and gender-based violence.
There remains a great need to strengthen HIV prevention interventions as adolescents and young women continue to be vulnerable to HIV. Statistics show that the highest number of new infections are still being experienced among 15–24-year-old adolescents and young women. This is perpetuated by inequalities in power, status, rights and voice. This further presents the need for strategies to empower girls and young women to increase their voice, bodily autonomy and agency, thus decreasing their vulnerability to HIV infection. We must do more to protect young girls from the clutches of rich and powerful men who engage in inter-generational sex, transactional sex and many times have multiple sexual partners.
Gender-Based Violence (GBV) and other human rights violations in the context of HIV are profound. GBV is another pandemic creeping into our society. In Eswatini, GBV has proven to be a persistent challenge. It disproportionately affects young girls and women as 1 in 3 females have experienced some form of sexual abuse by age 18 years. Furthermore, 48% of women are reported to have experienced some form of sexual violence. Let us work together in addressing the root cause of this scourge and strive to end GBV.
Celebrate women's achievement. Raise awareness against bias. Take action for equality.