This article is co-authored by Julia Smith and Alan Whiteside.
The recent publication of a series of articles in the New York Times magazine
focused on women and development, at a time when several books on the
subject have also been published, has sparked debate in the women’s
rights community internationally and domestically. These debates come
at a time when US Foreign Aid programs are under review and during the
15th anniversary of the International Conference on Population and
Development. RH Reality Check is featuring commentary on these issues from a diverse set of voices in the US and abroad.
A compilation of the pieces posted on RH Reailty Check and on other blogs will be published on the week of September 14th.
The lead story in New York Times magazine special issue on women
(23 August 2009), “The Women’s Crusade,” by Nicholas Kristof and Sheryl WuDunn
has generated much discussion. In the HIV and AIDS field we hear a lot about
the subjugation of women, how sexual and reproductive rights are routinely
denied, and how gender-based violence is fueling the epidemic. We see much less
action on these issues, and even less critical discussion of the underlying
political and culture factors that put women at increased risk. The article
reiterates a well-known situation that is indeed in need of urgent action.
However, the lack of perspective reduces its impact. Luckily, a number of
commentators have since added more analytical voices to the discussion. We
would contribute our perspectives as HIV and AIDS researchers and activists.
Edwin Okong’o rightly argues that “Placing a blanket
misogynist label on men from the Third World” is condescending and ill informed.
The numerous examples of strong male-led organizations tackling the AIDS
epidemic and gender inequality are numerous. One such example is Men for Gender Equality Now in Kenya.
Instead of painting men as the perpetrators of violence,
research and journalism needs to critically engage with the diversity of gender
issues that fuel the AIDS epidemic. In much of the world, homophobia prevents
programs identifying men who have sex with men as an at-risk group in need of
targeted prevention methods and treatment programs. Similarly, the rape of boys
goes largely un-discussed, while funding programs target the girl child.
us spent years working with street boys in Kenya, the majority of whom had been
raped while living on the streets. A number of them had contracted HIV because of it. Yet even professional councilors were unable to hold healing conversations with the boys about this, the stigma and homophobia being so great that neither party knew how to talk about it. We sometimes forget that providers themselves are part of the culture in which they live and can be both deeply affected by and a part of the problem of discrimination against marginalized populations. Working with providers to address these issues in their own lives is an important part of the challenge we face on HIV and AIDS and other issues.
But men also have to take responsibility where it is due.
For example, the spread of HIV has been linked to the fact that men in
sub-Sahara Africa often have more than one wife, or multiple girlfriends, which
creates numerous paths for HIV to spread. In her book the Invisible Cure, Helen Epstein suggests that there has been
silence on this issue because of unwillingness of male decision-makers to
change their own behavior. Culture is often used as an excuse for such silences;
in the context of the AIDS epidemic excuses are not justifiable.
One of us wrote in 2008:
Globally, HIV disproportionately
infects and affects women. Not only are they more likely to be HIV positive,
but they [also] bear the burden of care and support. Prevention must empower
women; give them choice over whom they have sex with, when, and how. Men must
be empowered to accept this.
And went on to warn,
The final concerns around
prevention messages are what they are and who is targeted. A narrow focus on
abstinence and fidelity is unrealistic, hypocritical, and stigmatizing. The
emphasis should be on responsible sexual behaviour rather than scare tactics.
The discourse needs to move from sex to relationships, teaching people how to
negotiate and develop responsible and loving interactions. Young people need to
be inculcated with the behaviours and values that allow them to protect
themselves from HIV and lead fulfilling lives. There is little point in
targeting people whose sexual behaviours are set and unlikely to change.
Single-component interventions do not work anywhere, and no general approach
will work everywhere (Alan Whiteside, HIV/AIDS A Very Short Introduction’ OUP,
Men must be engaged if the response to the AIDS epidemic is
to be affective. South Africa recently launched a Brothers for Life
campaign to do just
that. Time will tell how effective this effort will be, but the spirit is
right. Instead of tarring men with the brush of beast that spread the virus, we
need to mobilize them as partners in the response.
Finally, as Carol Jenkins points out, the developing world
does not have the monopoly on gender inequality, something HIV infection rates
illustrate all too clearly. African American women are up to 20 times more
likely to contract HIV than white women. In Canada, there is a new epidemic
amongst young aboriginal women. In Russia, where the AIDS epidemic was once
located amongst young male injection drug users, women now make up 44% of those
living with HIV and AIDS.
HIV infection rates clearly depict who is disadvantaged,
abused, misused and abandon. Often, we ignore those men who are victims of
abuse themselves, and stigma and discrimination prevents them from demanding
their rights. Often, we are much better at seeing the injustice in someone else
backyard than in our own. But the AIDS epidemic tells us we are all living with
inequality in our communities: it might be the young women begging on the
corner of a first world city, the baby born to an HIV positive mother in an
under resourced hospital in Eastern Europe, or the street boy in Kenya, but it
is here and it requires action not simple platitudes that label women as
victims and men as monsters.