Gender inequities and labour migration in Southern Africa have been pinpointed as factors contributing to the spread of HIV/Aids in the region by an epidemiologist at the International Aids Conference in Toronto, Canada, on Monday.
Chris Beyrer told the opening plenary session that migrant men were 26,3 times more likely to be infected by ”outside concurrent” partners.
Assessing risk and transmission factors, Beyrer said South Africa has over 2,5-million legal migrants working in the country, which, along with relationships with more than one person at a time, contribute to the spread of HIV/Aids in the region.
Marriage and intimate partner violence were factors that increased the likelihood of women contracting HIV.
He said that while individual risk factors were key targets for HIV prevention, structural realities remain powerful drivers of the epidemic.
An example of this was the ”condom gap” in sub-Saharan Africa.
”Current funding supports three condoms a year per man in sub-Saharan Africa,” said Beyrer.
The region has a shortage of 1,9-billion condoms a year, a gap which would cost $57-million a year to fill.
Beyrer highlighted the urgent need to provide ”evidence-based prevention services” to injecting drug users, men who have sex with men and girls and young women in order to improve their social context and reduce individual-level risks of HIV infection.
”Where HIV spread is driven by lack of prevention services, we risk failing, again, to respond to Aids,” he said.
Meanwhile, Louise Binder of the Canadian Treatment Action Council showed how in some cases, women were making strides in turning the tide against HIV/Aids, despite ”staring in the face of massive devastation and injustice”.
In rural Limpopo a learning programme called Sisters for Life has been implemented to help minimise conflict within households and to advance women’s self empowerment.
”After two years, the risk of intimate partner violence was reduced by 55%.
”Participants were able to challenge the acceptability of the virus, to expect and receive better treatment from their partners, to leave abusive relationships and to raise public awareness about intimate partner violence,” said Binder.
This and other initiatives, such as the growing investment in microbicide development, show that the problems faced by women are not insurmountable.
Binder said empowerment strategies will be more successful if they are integrated within macroeconomic and cultural strategies aimed at creating improved equity.
”They teach us that the oft-repeated myth that culture and religion are insuperable barriers to successful HIV programmes is nonsense.”
She lashed out at the Abstain, Be faithful, Condomise (ABC) approach to prevention, saying it was the ”most blatant example of policymaking by men who know nothing of the context and reality of the lived experience of women and girls”.
She also said compulsory testing of women, including those who were pregnant, was a betrayal, while millions of men could avoid being tested. — Sapa