Fighting AIDS Demands Changing Tradition and Culture


The HIV/AIDS epidemic has put the spotlight on deep-rooted constraints that hold women back in many areas of life, said WHO Director-General Margaret Chan in a keynote address at the inaugural International Women's Summit themed "Women's Leadership on HIV and AIDS" in Nairobi, Kenya.

Tradition and culture help to give individuals in a society a sense of meaning, belonging and identity, as well as define behavior.

But, in sub-Saharan Africa, traditional and cultural practices are increasingly being identified as the bane that puts women and girls at risk for diseases and death.

"Traditional attitudes and behaviors change gradually, sometimes over several generations. This epidemic gives us no luxury of time," said Chan.

The boundaries of tradition and culture are holding women back from much-needed progress, leaving them vulnerable to the vicious cycle of HIV infection, poverty, stigma, violence and death.

"In sub-Saharan Africa, 60 percent of the people living with HIV/AIDS are women," said Kenyan Preside Mwai Kibaki in opening remarks at the Summit. "Much more work needs be done in empowering women and girls."

A key imperative is strengthening the overall health systems in the worst AIDS affected regions. Currently, many of the women have little to no access to appropriate health care services, and, most importantly, they cannot access sexual and reproductive health services.

While in affluent countries mother-to-child transmission of HIV has been virtually eliminated, 80 percent of the estimated 500,000 children born with HIV annually are in sub-Saharan Africa (PDF).

In Kenya, as in many other countries, fewer than one in ten of eligible women is benefiting from anti-retroviral prophylaxis to prevent transmission to their babies.

The biggest challenge is that to make an impact on AIDS requires focusing on a host of other disease that worsen women's situation.

"We know that containing AIDS is not about responding to a single disease," said Chan," We have to deal with multiple infections, sexually transmitted diseases, tuberculosis, malaria, reproductive health, mental health, and psychosocial support."

The current situation is that health care services are not responsive to the health care needs of women.

Making matters worse, marriage—traditionally and culturally seen as a safe have for women—has become a death trap for women.

"We must seize every opportunity for women to learn their infection status. Being married is not a safe haven," said Chan.

Chan urged women to keep up the pressure for new sexual reproductive health tools such as microbicides because they hold great promise for giving women greater control to protect themselves from infection.

However,in spite of the progress that has been made in making communities aware of HIV and AIDS, stigma, fear and discrimination continue to be three stumbling blocks in reversing the epidemic.

According to Chan, community interventions can influence the process of changing retrogressive traditional and cultural practices at the grassroots level, and in the process, help to break the chains that hold women back.

Economic interventions targeted at women, particularly micro-finance mechanisms, can release the power of impoverished women.

To ensure effectiveness, women themselves have to be in the driving seat to change their lives and their communities.

"When women control household income, they gain decision making power. When women make decisions they invest in health promoting activities that benefit family and communities," said Chan.

"Women power goes up, also in intimate relationships, and domestic violence goes down."

Given the fact that women are the bedrock of family and communities, they can help to influence the social change required to stem the AIDS epidemic.

"If the empowerment of women is one result of this epidemic, then all of society, and all of public health will benefit," said Chan.

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