Project Description

In Focus…
Barriers to effective treatment for women…
What’s inside:
Special report:
Beyond blame
Women’s voices…
Pushing the
envelope
Women’s
realities…
50 shades of
pleasure
News from the
‘margins’…
Not a luxury
Women’s
realities…
Women’s rights
post 2015
Women’s voices…
A united voice
In our opinion…
We need action!
The Women’s Networking Zone
(WNZ) is again a vibrant and vital
space at the International AIDS
Conference, providing a focussed
space for the voices, issues and
priorities of women to be brought
to the centre. Parallel programming
creates a platform for women to
identify and address the key issues
that affect them. Additionally, a
forum for international sharing and
exchange allows shared experiences
and priorities to emerge.
Facilitating this exchange,
the AIDS 2014 Women’s
Networking Zone features daily
Community Dialogue Sessions,
convened by ICW and featuring
panels of women living with HIV
representing the regional and
global chapters of ICW. Each day
the dialogue addresses a different
theme that resonates with the
priorities and experiences of
women living with HIV. The theme
is also reflected in the rest of the
day’s programming in the WNZ,
ensuring a continued conversation.
The first Community Dialogue
explored issues around access
to treatment. Speakers, all
representing ICW in their country
or region, shared their own
experiences of treatment access,
as well as exploring wider issues
affecting women living with HIV
in their communities. Cath Smith,
from Australia, described the
challenges of accessing treatment
in the context of centralised and
city-based treatment services,
necessitating long journeys for
women in rural communities. In
her own experience, she described
journeys of up to 800km to
access a clinician able to write a
prescription for HIV treatment,
and a pharmacy to dispense it.
This challenge is compounded by
partial state funding for health
services, which means the closest
clinic may be one that women are
unable to access, due
to state boundaries.
While a recently
announced policy
change will allow more
pharmacies to dispense
HIV treatment, the
requirement for the
costs to be paid up
front then reclaimed
from government
funds is likely,
Cath argued, to be
prohibitive to smaller
local pharmacies
participating in
the scheme.
All speakers
addressed advocacy
goals and activities.
Cath discussed her
lobbying efforts
towards HIV clinicians
being officially
designated as specialists, a
classification which would entitle
people living with HIV to some
financial support towards the cost
of travel to attend appointments.
Consolata Opiyo, junior
communications assistant
for ICW Global, shared her
experiences as a young woman
living with HIV in East Africa.
While treatment is available, it is
often inaccessible. Travel to clinics
is a barrier, in terms of both cost
and time availability. Further,
many clinics provide only 1-3
month treatment, so the journey
has to be made frequently.
Mujeres Adelante Wednesday • 23 July 2014
Daily newsletter on women’s rights and HIV – Melbourne 2014
Jacqui Stevenson
Community dialogues in the WNZ
2 Wednesday • 23 July 2014
Stigma and discrimination from
health workers, especially towards young
women living with HIV, presents a
further barrier to accessing treatment.
Access to additional services,
particularly viral load testing, is also
a challenge for women in East Africa.
This challenge was also highlighted by
Daisy David, speaking of the experiences
of women living with HIV in India.
This, along with drug stock outs, short
supplies being offered of sometimes as
little as seven days treatment, and lack
of provision of second and third line
regimens, were both challenges and
advocacy priorities for women in India.
Speaking of experiences in South
Africa, Sethembiso Mthembu
emphasised that treatment coverage
is not yet universal, with many
women unable to access treatment at
all. Further, lack of women-specific
treatment programmes and underrepresentation
of women in treatment
trials presents a barrier to effective
treatment meeting the needs of women
living with HIV.
Access to additional diagnostics,
treatment and care are also an issue.
Sethembiso highlighted the ‘secondary
pandemic’ of cervical cancer among
women living with HIV, and the gender
inequality inherent in failures to
adequately address it, concluding:
If you treat cervical cancer you are
treating a woman as herself, you’re
not saving any babies, so it is difficult
to get popular support.
Maura Elipe, from Papua New Guinea,
described the difficulty women face
in travelling to clinics, in respect of
distance, time, childcare and domestic
responsibilities, cost and a lack of
adequate transport facilities. TB is also
a growing issue for women living with
HIV in her country. Viral load testing
is not available, with only one machine
that is being ‘piloted’, and which women
cannot access.
Further, Maura described how
treatment and care are provided at
separate sites, compounding accessibility
issues. This was echoed by Cath Smith,
who described women being referred
back and forth between different health
services, and called for change, as:
We need to stop treating the virus and
start treating the person.
Sharing experiences in West Africa, Patricia Ukoli, expanded
the conversation to consider the challenge women who are
mothers face in accessing treatment for their babies and children.
Travel to clinics, family and community stigma, and lack of
provision of paediatric treatment all cause difficulties for women.
On the second day in the Women’s Networking Zone, the
focus turned to sexual and reproductive health and rights.
Speakers from ICW again explored the theme through their own
experiences and issues facing their communities. L’Orangelis
Thomas Negro from Puerto Rico described the barriers women
face to accessing SRHR services, both practical and caused by
stigma and discrimination by health providers. She shared an
experience of being told when seeking SRHR services, aged 15,
that as a woman living with HIV she ‘should not’ have children.
Further, L’Orangelis detailed how barriers are compounded for
migrant women, a significant population in Puerto Rico, who
experience additional discrimination.
In the Philippines, according to Elsa Chia, women’s issues are
neglected, as women are only 1% of the population of people
living with HIV. This leads to government neglect and a failure to
provide services that are accessible to women, and which provide
for their specific needs, including reproductive health services,
Pap smears and SRHR services. Cervical cancer is neglected and
affecting an increasing number of women.
Women living with HIV also face discrimination in public
hospitals from healthcare staff. Elsa described how women
living with HIV entering hospital to give birth find their beds
labelled with signs saying ‘highly infectious’. Similar signs
are placed on the baby’s crib. Elsa has led lobbying efforts to
address this, and further to call for centralised and specific
services for women living with HIV to address their SRHR
needs in a non-discriminatory environment.
Daisy David, sharing experiences from India, detailed how
while at the global level policies, guidelines and best practices
exist, in the context of women’s lived experience there is no
implementation of these. Women experience discriminatory
treatment, and in her own experience struggle to access adequate
diagnostics and treatment for SRHR health issues. Services
providing VCT, HIV treatment, SRHR services, and maternal
healthcare are housed and delivered separately and work
differently, creating an additional burden and complexity for
women seeking to have their SRH needs and
rights met.
In the Australian context, Rebecca Matheson explained how
women living with HIV are a ‘minority within a minority’, with
services and information largely tailored to the needs of men
who have sex with men, who make up the larger part of the
population of people living with HIV in the country. While
Rebecca observed that there has been progress since the 1990s,
when women living with HIV were given instructions, rather than
choices, there is still much work to be done. Ensuring women are
engaged, participate and heard, and developing young women’s
capacity to challenge and advocate is essential to achieve the
change that is needed.
Throughout the dialogues, this need for women living with
HIV to advocate and to be heard was repeatedly emphasised.
The community dialogues, and the wider WNZ space and
programming, is a vital part of this essential process.
Jacqui is with the Athena Network.
…while
treatment
is available,
it is often
inaccessible…
…barrier
to effective
treatment
meeting the
needs of women
living with HIV…
…additional
burden and
complexity for
women seeking
to have their
SRH needs and
rights met…
Wednesday• 23 July 2014 3
Wednesday 23 July
07:00-08:30 Stepping up the pace for young women in
South Africa Room 203-204 [non-Commercial Satellite]
08:20-10:30 Plenary: No one left behind Plenary2
11:00-12:00 Community Dialogue: Discrimination
and violence
Women’s Networking Zone, Global Village
11:00-12:30 Living better, living longer, living stronger:
Women living with HIV
Plenary 3 [Oral Abstract Session]
Unpacking risk and HIV in transgender communities
Room 203-204 [Oral Abstract Session]
13:00-13:45 Bringing women out from the margins: Gender
equality in concentrated epidemics
Women’s Networking Zone, Global Village
13:45-14:15 Sex work is work: 20 Years of sex worker
activism in Asia and the Pacific
Clarendon Room C, Global Viallge
14:30-16:00 Addressing gender concerns: Violence and HIV
Melbourne Room 1 [Oral Abstract Session]
14:30-17:30 Engaging traditional leadership in accelerating
HIV and gender-based violence (GBV) prevention through
culture-transformative strategies: The “Rock” Integrated Model
Room 109-110 [Community Skills Development Workshop]
15:45-16:45 Town Hall Dialogue and Launch: Community
innovations in addressing gender-based violence
Women’s Networking Zone, Global Village
16:30-18:00 Andrew Hunter Memorial Session:
A rights-based approach to sex work
Melbourne Room 2 [Symposia Session]
16:30-18:30 Global injustices: The control, containment and
punishment of people living with HIV
Room 203-204 [Symposia Session]
Community Action for Global Female Condom Day: Get inspired,
join and create your own female condom campaign
Clarendon Room D&E, Global Village
18:30-20:00 Research shouldn’t sit on a shelf: Stories of
strengths, action and resilience from women living with HIV
Clarendon Auditorium
Upcoming
events
News from the ‘margins’…
Harm reduction services
for women…not a luxury!
A policy brief entitled ‘Women who inject drugs and HIV: Addressing
specific needs’ launched on Monday at AIDS 2014 calls for the
specific needs of women in the context of injecting drug use
and HIV to be addressed. The brief, authored by UNODC in
partnership with UN Women, WHO, and
the International Network of Women
who Use Drugs (INPUD), outlines the
specific needs and vulnerabilities of
women who use drugs.
The brief addresses the unique
challenges faced by women who use
drugs, including more and different
barriers to accessing services and
violence, as well as legal barriers. These
challenges were illuminated in the
launch event by presentations from
various panellists, including Elena
Strizhak who spoke of the experiences
of women who use drugs in Ukraine,
highlighting the marginalisation created
by national policy that removes official
registration (ensuring proof of ID and entitlement to government
services) from people who are in prison. This policy not only
creates barriers to accessing services, but also identifies women
as having been in prison; thus compounding the stigma and
discrimination women who use drugs experience.
Speaking from her experiences in Indonesia, Ester Vinanti
Nigraheni of ODHA described the range of challenges facing
women who use drugs and are living with HIV. In order to
effectively address these challenges; she called for alternatives to
imprisonment, access to safe and effective healthcare services,
and the participation of people who use drugs. Improved
healthcare, information and opportunities
for women who use drugs are essential to
achieve progress.
Monica Beg, Chief of the HIV Section
at UNODC, described how the gaps
identified by the panelists in their
presentations contributed to the impetus
for the policy brief, which is intended to
provide a comprehensive harm reduction
package and key interventions with a
gender responsive approach.
Summarising, Ruth Birgin (INWUD)
highlighted that while a lack of harm
reduction programming is a problem
across the board, the additional paucity
of gender responsive harm reduction
programming ensures a double barrier for women.
Aldo Lalf-Demos of UNODC concluded:
…harm reduction services for women is not a luxury, it’ is not
a privilege, it is a basic human right.
4 Wednesday • 23 July 2014
Recognising the difference between
rule by law and rule of law, based on
equality before the law, Kate argued
for people to be the heart of the
development agenda, with human
rights as the heartbeat,
in a framework that ensures
non-discrimination.
As post-2015 negotiations proceed,
gender and SRHR advocates must
continue to raise their voices and
push governments to address gender, HIV and SRHR in the
new development framework, to ensure no one is left behind,
and to ensure sexual rights, sexual orientation and gender
identity, and human rights (more than ‘empowerment’)
are part of the eventual framework. Kate made a further
call, to recognise and overcome not only the discomfort of
governments in addressing sexual and reproductive health
and rights, but also the growing conservative calls to focus
on family and reproduction:
…The idea of sex troubles governments greatly. I’m yet
to understand how you do reproduction without sex [even
infertility can only be identified by having sex] … we have
to put the sex back into reproduction.
Jacqui is with the Athena Network.
The post-2015 development
framework provides an
opportunity to underscore and
enhance the call for women’s
rights. At the same time, there
is however also a real risk that
hard-won ground will be lost.
In a session convened by
IPPF on Sunday exploring
‘gender and sexual rights in the
post 2015 framework’, a diverse
panel outlined the essential
demand for gender and sexual
and reproductive health and
rights to be fully included in the
development framework to replace
the MDGs.
Opening the discussion,
Nhey Shiel Grace Salaila, a young
woman SRHR activist from the
Philippines, described her desire to
know about her body, her sexual
and reproductive health, and family
planning and to access services,
without parental accompaniment
or consent. However, restrictive
policies and a conservative social
context in the Philippines mean
that it will be civil society, rather
than government, who is to address
this demand.
This speaks to the gaps and
challenges in a development
framework that does not
explicitly mandate that the needs
of diverse and key affected
populations are addressed.
Leigh Ann van der Merwe of
S.H.E., a Feminist Collective
of Transgender and Intersex
Women of Africa, addressed this
issue, highlighting the gender
normativity in the MDGs and
the resulting failure to address
the issues and needs of sexual
and gender minorities. Leigh
Ann voiced her disappointment
with the trading of the needs
of different groups in evidence
at the most recent Commission
on the Status of Women, and
the resulting failure to adequately
recognise and address the rights
and needs of sexual and gender
minorities. Her call was clear:
…We have to be talking about
all groups of women, all classes
of women, all races of women,
women in all our diversity.
A truly effective and progressive
development framework must
involve and meet the needs of
everyone, especially people who face
marginalisation and discrimination.
The barriers to accessing HIV
prevention services experienced by
sex workers in Eastern Europe and
Central Asia were addressed by
Lena Luyckfasseel from IPPF. HIV
prevention report cards developed
by IPPF, SWAN, and UNFPA
provide a baseline illustrating the
distance still to be travelled to
achieve HIV prevention for sex
workers in the region, including
the need for change in terms
of the legal and social context,
sex workers’ participation, and
realisation of rights. Lena called
for Universal Health Coverage
in the post-2015 framework to
specifically and explicitly include
full coverage for all people,
regardless of any status, identity
or profession.
This call was echoed by
Christine Stegling (ITPC), who
observed that in the move to
country ownership there is an
additional risk, as governments
choose the populations they
recognise and accept responsibility
for. As priorities shift – in a
context of ever-decreasing
resources being contested and
the call for country ownership
increasing – there is a real danger
that progress on achieving
women’s sexual and reproductive
health and rights will be lost.
Kate Gilmore (UNFPA)
underscored the need for activism
to ensure that governments
negotiating the new development
framework adequately address
sexual and reproductive health and
rights, placing people, especially
young people, women and
marginalised populations, at the
centre of the development agenda.
…a real risk that
hard-won ground
will be lost…
Women’s Realities…
Women’s rights and the post-2015
development agenda…
Jacqui Stevenson
Wednesday • 23 July 2014 5
Women’s Voices…
Pushing the envelope…
The recent Global Fund transitions,
including its New Funding Model
and its Gender Equality Strategy Action
Plan, provide unique opportunities for
working together and ensuring that the
Global Fund is truly responsive to the
realities, rights and needs of women
and girls in all their diversity. Exploring
the progress made was the focus of
the ‘pushing the envelope: Gender,
equality and rights – getting it right for
key affected populations’ session at the
Women’s Networking Zone on Monday;
collaboratively hosted by the Athena
Network, Women4GF, and ICW.
Recognising the progress made in terms
of the new funding model and the ‘new’
commitments to advancing gender
equality and human rights, presenters
and participants were ‘pushing the
envelope’ raising questions as to the real
progress made thus far in translating
the very same into actions beneficial
for women in all their diversity at a
community and country level.
Enhanced country ownership and the
meaningful involvement of key affected
populations, particularly women, are
two of the important pillars of the new
funding model. Lillian Mworeko from
ICW Eastern Africa underscored the need
for resources to go directly to women
and their organisations, and cautioned
that resourcing country ownership may
adversely impact (and divert) funding
available for networks of women living
with and affected by HIV. Highlighting
the failure of the national AIDS response
to understand the multiplicity of
women’s realities and needs, she asked:
…how can this be translated
into gender-sensitive or
gender-transformative
programmes benefitting women
in all their diversity?…
Further elaborating on the various
challenges at a country level,
Lydia Munghere from Uganda (Mama’s
Club) emphasised that national
institutions, such as the
national AIDS councils
and country coordinating
mechanisms (CCMs) are
male dominated and with
little understanding of
the meaning of ‘gender’
and/or ‘gender equality’;
thus affording limited
space for engagements
on the advancement and
protection of women’s
rights within the national
AIDS response or for the
successful implementation
of the new funding model.
As such, ‘where are the
women’ in the national
AIDS response advancing
gender equality remains
to be a constant question (and area of
contestation) when advocating for key
affected women in all their diversity
to meaningfully participate and be
at the core of programme design,
implementation and evaluation at a
country level. Summarising, she asked:
…how many women’s voices are really
heard at the national level?…
Prudence Mabele from the Positive
Women’s Network (South Arica)
echoed the need to find effective
ways to not only translate these
commitments into actions, but also
to ensure that women
– especially women at a
community level – are
more than ‘beneficiaries’
of programmes. Sharing
experiences from South
Africa, she cautioned
that women’s meaningful
participation in and
engagement with country
level processes cannot be
measured ‘by policies and
numbers alone’ – for which
South Africa with all its
‘gender affirming’ laws
and policies (whilst
dissolving the Department
of Women after the recent
national election) is an
exemplary case.
In her response to women’s concerns,
Marike Wijnroks from the Global Fund
reaffirmed that given the patriarchal
and male dominated societies,
institutional capacity building
addressing the deep rooted and
discriminatory values about women
in all their diversity has to be a crucial
aspect of making the new funding
model work for key affected women at
a country level.
Johanna is with the AIDS Legal Network,
South Africa.
Johanna Kehler
… addressing the
deep rooted and
discriminatory
values about
women in all
their diversity…
6 Wednesday • 23 July 2014
Working to end the overly
broad criminalisation of HIV
non-disclosure, exposure and
transmission was the focus of
the ‘Beyond Blame: Challenging HIV
criminalisation’ pre-conference on
Sunday, 20 July 2014.1
The meeting was opened
by Hon David Davis ,the
Minister of Health of Victoria,
Australia, who, in a surprise
announcement, shared that the
Victorian government would
…amend Section 19 A of
the Crimes Act, a 21 year
old provision, criminalising
intentional transmission of a
serious disease, including HIV.
At a follow-up session in the
Human Rights Networking Zone
on Monday, 21 July, Paul Kidd of
Living Positive Victoria, a member
of the Legal Working Group,
welcomed the announcement,
recognising it as a success of their
advocacy efforts. However, he
cautioned that there is not much
clarity on what the Minister meant
in terms of the amendment.
We welcome the announcement,
which has been a long time
coming. However, we would not
like for the amendment of the
law to result in a broadening
of the law to other medical
condistions.
Globally, more than 50
countries have HIV-specific
laws, but only about 25 of these
have used criminal statutes to
prosecute people living with HIV
for transmission, exposure or
non-disclosure. Some countries,
and in particular some states in
the US have even used general
endangerment and terrorist laws to
prosecute people living with HIV.
In terms of prosecutions, the US
have had the most prosecutions,
followed by Canada. The Nordic
countries, including Sweden,
Norway, Finland and Denmark,
as well as Australia and New
Zealand, are not far
behind in regards to the number of
people prosecuted.
There was consensus during
the pre-conference that
the criminalisation of HIV
transmission, exposure and
non-disclosure affects women
disproportionally. According
to Jessica Whitbread of
ICW, criminalisation of HIV
transmission, exposure and nondisclosure
interacts with women’s
sexual and reproductive rights, as
the majority of people living with
HIV are women who continue
to be at disproportionate risk
of sexual transmission of HIV,
and have been prosecuted for
vertical transmission of HIV. She
explained that these laws are often
enacted to keep women ‘safe’
from HIV, but have proven to
exacerbate women’s vulnerability
to HIV, stigma and violence. Thus,
advocacy related to criminalisation
of HIV transmission, exposure
and non-disclosure should not be seen as a peripheral
issue, but should be embraced as an essential HIV
prevention intervention.
Jessica also explained that women are
disproportionately exposed to violence before they
become infected, and this is related to women becoming
infected, however, they are also disproportionately
affected by violence after becoming being diagnosed.
The prosecution of women under laws that criminalise
HIV exposure, transmission or non-disclosure is a
structural form of violence.
Laurel Sprague of the Sero Project (US) shared some
of the research findings and explained that they have
found that HIV criminalisation creates a ‘disabling’ legal
environment for HIV prevention, instead of an ‘enabling’
environment.
People living with HIV experienced a strong sense
of vulnerability, as they could not anticipate what
behaviour would land them in court, due to the arbitrary
application of the law and the overly broad nature of
the provisions … The law does not make people feel
protected as it is intended to do. People living with
HIV fear false accusation and feel that they would not
get a fair trial. Instead of creating an enabling legal
environment, individuals feel
they should hide from law as
it would single them out. This
leaves individuals who already
need human rights protection
due to the stigma still attached
to HIV, feeling and being
incredibly vulnerable.
In developing advocacy
strategies and messages, a process
of critical reflection by advocates
on their own journeys to identify
what convinced them to become
opponents of criminalisation
is crucial; as advocates should
challenge their personal biases so
to avoid reinforcing ideas of who
…should be
embraced as
an essential
HIV prevention
intervention…
Special report:
Beyond Blame: Challenging HIV Criminalisation
Felicita Hikuam
The best role the law can play is in creating a supportive environment for people in private to govern their
own conduct. [Hon. Michael Kirby, former Justice of High Court of Australia]
Wednesday • 23 July 2014 7
in January, a nurse living with HIV
was arrested and sentenced to 3 years
imprisonment for exposing a 2-year old
child to HIV, while trying to inject the
child with a syringe as a part of
her duties.
Following this case, the Ugandan
parliament passed the HIV/AIDS
Prevention and Control Act in
May 2014. This Act criminalises
‘attempted’ and ‘wilful’ transmission
of HIV with a five year imprisonment
term, provides for the mandatory
testing of pregnant women, and
permits healthcare workers to forgo
confidentiality and to unilaterally disclose a patient’s positive
status to an ‘at-risk’ partner or household member. Dora
concludes:
If the President assents to this law, it will be a tragedy
for those of us responding to HIV in this environment
as people who are already vulnerable to HIV may be
prosecuted disproportionately. In our context, so many
people are already living with HIV. This law creates room
for mothers to be prosecuted for transmitting HIV to their
children. People who may still be getting to terms with
their status and not ready to disclose may be arrested for
not disclosing or healthcare workers may disclose their
status before they are ready to do so.
The participants also learned about how lawmakers can
make a difference in reforming problematic laws by engaging
with US Senator Matt MacCoy of Iowa, who was instrumental
in the reform of Iowa’s criminal statute, which provided that
people living with HIV have to mandatorily disclose to a
is worthy of prosecution and who
is a victim. As messaging around
criminalisation and gender puts
pressure on women to play the role
of ‘victims’ and ‘advocates’, there
is also a need to dispel the image
of women as ‘victims’, as it
is disempowering.
Re-emphasising that the
responsibility of HIV prevention
should not only be placed on
the diagnosed person, work still
needs to done with people living
with HIV and gay communities
to ensure they are better
informed about the dangers of
criminalisation, and speak about
shared roles and responsibilities
for HIV prevention.
Participants emphasised that
work on HIV criminalisation is
not peripheral to other HIV work,
rather it is integral HIV prevention
work as criminalisation of HIV
transmission, exposure and
non-disclosure increase stigma
and make it difficult to access
HIV-related services.
During the pre-conference,
alternatives to using a punitive
criminal justice system to address
transmission, exposure and nondisclosure
explored included the
Australian and Swedish use of
the public health system as an
‘alternative to criminalisation’,
which has received divergent
support from activists.
Several countries in Europe
and Canada have also taken
measures to consider advances
in science, such as evidence that
the consistent and correct use
of condoms and uninterrupted
treatment adherence resulting in
an undetectable viral load lowers
risk of transmitting HIV in the
application of laws that criminalise
HIV transmission, exposure and
non-disclosure.
In Sweden, a statement by
scientists and medical experts
to present the science of HIV
and how criminalisation does
not take into consideration
recent scientific evidence, such
as how the use of condoms
and uninterrupted adherence
to treatment lower the risk of
transmission. Prosecutorial
guidelines in England and Wales
also recognise advancements
in science and recommend that
the judiciary take this into
consideration when dealing with
similar cases.
While there has also been
some progress with the complete
suspension or modernisation of
laws in the global north, countries
in the south, mostly in Africa,
have increasingly been including
problematic provisions in existing
laws or enacting HIV-specific laws
over the past decade. Uganda is the
most recent country in Africa to pass
an HIV-specific law. Dora Kiconco,
of the Uganda Network on law,
Ethics and HIV/AIDS (UGANET)
shared their harrowing experience in
Uganda over the past 6 months since
the Speaker of Parliament delivered
on her promise to give the Ugandan
people a Christmas present by
passing the Anti-homosexuality Act
in December 2013. Shortly thereafter,
…HIV
criminalisation
creates a
‘disabling’ legal
environment
for HIV
prevention…
8 Wednesday • 23 July 2014
In light of both successes and
remaining gaps, Paul Kidd concludes:
It is a complicated, long, slow
process, but I think we will
ultimately get to turn the tide
around. We are on the verge of
making progress and I am proud to
be part of this movement.
Footnote:
1. The pre-conference was hosted by the HIV
Justice Network, AIDS and Rights Alliance
for Southern Africa (ARASA), Canadian
HIV/AIDS Legal Network, Global Network
of People living with HIV, International
Community of Women living with HIV,
Sero project, UNAIDS and members of the
HIV Legal Working Group of Australia
(Living Positive Victoria, the Victorian AIDS
Council, the National Association of People
Living with HIV Australia (NAPWHA), and
the Australian Federation of AIDS Service
Organisations (AFAO) with financial support
from the Victorian Department of Health. A
video of the pre-conference will be posted on
www.hivjustice.net after the conference.
Felicita is with ARASA.
sexual partner or be held criminally
responsible and risk imprisonment
for 25 years. A campaign to educate
lawmakers and the media, as
well as convening of community
forums, contributed to the success
and convincing the public and
lawmakers to support the effort.
The session at the Human Rights
Zone ended with an outline of what
the panellists plan to do beyond the
pre-conference to make the situation
better. There was commitment to
continue advocating for the repeal
of Section 19A in Australia; to
use what was learned during the
conference to enhance advocacy
efforts; to continue to convene
opportunities for activists to meet
and share on this subject; facilitate
dialogue between and education
of people living with HIV to know
their rights and risks, as well as to
take the lead in reform efforts.
In Uganda, activists will continue
to lobby the President not to
assent the Act to law, and to raise
awareness of the implication of the
law, especially for women.
I want to continue the process
with positive women to ensure
that women understand issues of
power dimension in the context of
criminalisation.
[Lillian Mworeko, ICW EA]
Senator MacCoy committed
to continuing work on getting
more people prosecuted under
the statues out of prison and
getting them off the sex offender
registry. He will also look at
how prosecutorial guidance can
support efforts in Iowa.
We will also work on cultivating
solidarity, inclusion and support
for repeal of criminalisation
statutes by the gay community.
…advocates
should
challenge their
personal biases
so to avoid
reinforcing
ideas of who
is worthy of
prosecution
and who is a
victim…
Seen out and about
Wednesday • 23 July 2014 9
Women’s Voices…
Women living with HIV speak out…
The need for a united women’s voice!
UNAIDS hosted a session in
anticipation of its report ‘The Women
Speak Out’ on Tuesday, which sheds
light on the experiences of women
living with HIV in overcoming,
as well as addressing violence
against women.
The report highlights the views of
women in all their diversity – women
living with HIV, female sex workers,
women who inject drugs, transgender
women, mothers and children – who all
personally experienced violence, can
(and should) inform the debate on how
to end violence against women, and the
spread of HIV amongst women.
Participants of the session strongly
expressed the need for a united women’s
voice. As expressed by a Malaysian
feminist
The voices of women keep getting
forgotten as soon as we stop speaking,
so the only solution is that we never
stop speaking.
Women coming together and expressing
their needs will result in action, which is
best suited for them.
The lack of data has proved to be a
barrier to effective action. Svetlana
Moroz form Union of Women affected
by HIV in Ukraine, Positive Women,
highlighted that there was an increasing
need for data that organisations could
rely on and trust. More data and analysis
of the epidemic in women is crucial and
must be communicated in the right way.
A transgender woman from Malaysia
shared how transgender women
continue to be registered as male, based
on the Sharia law; distorting the figures
of the number of women living with HIV.
It is also important to understand the
conditions in which gender-based
violence festers. Annie Banda, of the
Coalition for Women living with HIV/AIDS
(COWLHA) in Malawi
shared how evidence
had shown that there
was widespread
violence against women
within the community,
and in the home, and
this had a significant
impact on access to
treatment and services
for women. One of the
main issues was that
males in the community
were unaware of
women’s rights.
There was also a high
prevalence of alcohol
consumption amongst
men and this would
result in the abuse of
women. The use of the
Stepping Stones training
programme on gender,
HIV, communication
and relationship skills,
and other innovative
approaches, such as
increased dialogue with
men about issues of
women’s rights, has to an extent reduced
incidents of violence in the community,
although violence against women still
widely exists.
Legal frameworks continue to act as
a barrier to effective responses to HIV
and gender-based violence. Even where
sound legal frameworks exist, there are
very few policies that protect women
from gender-based violence. In Eastern
Europe for example, some jurisdictions
have low penalties for men who commit
these crimes. Stigma and discrimination
against women who use drugs and sex
workers also fuel violent treatment from
law enforcement. There is also little or no
access to redress or justice for women
who experience violence and abuse.
In Malaysia, Section 66 of Sharia law
prohibits men from wearing women’s
garments or posing as a woman, which
violates the sexual orientation and
gender identity rights. The problem
is compounded by the fact that
transgender women do not know or are
unaware of their rights.
Stigma and discrimination affect how
women living with HIV are treated, for
example, when giving birth. A lack of
enforcement of sexual and reproductive
rights frequently results in coerced
C-Sections, which then make it easier
for forced sterilisation to take place.
The violation of such rights can be
counteracted by training maternal
healthcare workers around women’s
rights and HIV.
Women’s rights and women
empowerment should therefore form the
basis of action – for both policy
and practice.
Nelago is with ARASA.
Nelago Amadhila
10 Wednesday • 23 July 2014
News from the Global Village…
Queer Resistance…
The session on Tuesday in the Human Rights Networking
Zone in the Global Village on ‘Queer Resistance’ focused on
the challenges associated with defending lesbian, gay,
bisexual, transgender and intersex rights, specifically in
hostile environments around the world.
The panel included Maurice Tomlinson from LGBTI Aware
Caribbean, Gennady Roshchupkin from Eurasian Coalition
on Male Health, Mauro Cabral from Global Action for Trans*
Equality, and Geoffrey Ogwaro from Civil Society Coalition
on Human Rights and Constitutional Law.
The most apparent challenge to the realisation of LGBTI
rights is repressive legal and policy environments. The
passing of the Anti-Homosexuality Act in Uganda, for
example, has created confusion, fear and panic. There
has been a mass exodus of gay men that have ended
up in refugee camps in Kenya, where they are further
stigmatised. Citizens also fear prosecution, which has
resulted in gay men being evicted from their homes, or
healthcare workers refusing to treat LGBTI people. In light
of the new legislation, LGBTI programmes are also under
threat of closure.
Some of these issues were echoed by Maurice, who
highlighted the effects of sodomy laws which criminalise
same-sex intimacy and carry harsh sentences, such as life in
prisons. Engaging with policy makers and parliamentarians
has proven to be difficult, because of the crusade led by
Evangelists who are succeeding in portraying the LGBTI
community as ‘foreigners’. The law has not only been used
to stigmatise LGBTI people, but also as a way of extorting
people. Police, for example, bribe people found to be
engaging in same-sex activities by threatening to disclose
their names to the media.
In Russia, there is no legislation that criminalises lesbian,
gay, bisexual, transgender and intersex people. The
environment, however, makes justice impossible, because
LGBTI organisations are treated as ‘foreign agents’, which
are equated to being ‘enemies of the state’. This creates
an environment where people fear to speak out on
LGBTI issues.
Mauro also highlighted the ignorance with regards to
intersex people. There is a perception that the medical
surgeries performed on intersex babies to make them
‘normal’ is body mutilation and is a human rights violation.
It was also highlighted that the issues faced by intersex
people vary from issues faced by LGBT people. Intersex
people, therefore get lost in the dialogue of LGBTI people.
Moving forward, Maurice
highlighted that hate
can be eradicated by
educating policy makers,
the media and other
stakeholders on the true
realities of lesbian, gay,
bisexual, transgender
and intersex people.
Mauro urged for support
of intersex people with
regards to gaining
employment so as to
be in the position to
continue their activism,
while Gennady called for
independent thought
and holding government accountable because it is ‘the
employee of the community’.
Wednesday • 23 July 2014 11
is also problematic. Jessica highlighted the inherent problem
in public health messaging that promotes condoms in sex
where a penis is involved, and gloves and dental dams
otherwise, as Jessica said:
…as if all genders don’t use mouths and hands.
The final panellist, Sethembiso Mhtembu of ICW
Southern Africa, discussed issues including gender
inequality, condom negotiation and microbicides
development. Her presentation, as highlighted by a
question from the floor, spoke less to issues of pleasure,
which perhaps highlights the challenges women can face
in achieving sexual pleasure in the face of barriers to
individual choice and securing prevention.
When opened to audience questioning, the focus of the
discussion quickly turned to PrEP, which dominated the
larger part of the session. Interestingly, both questions
and responses from panellists fixed on issues, such as
affordability, accessibility, side effects and its potential for
women. Whilst an important discussion, the issue of pleasure
was largely lost in the debate, as prevention tools and risk
once again dominated. In this ’50 shades’, pleasure played
the submissive role.
Jacqui is with the Athena Network.
There’s a lot of talk about
sex at the International AIDS
Conference. Almost all of it;
talking about prevention, about
risk, safety and interventions.
Very little conversation focuses
on sexual pleasure. Indeed, the
introduction of pleasure to a
discussion can fluster the most
experienced of HIV activists,
scientists or researchers. The
disconnect between sex and
sexual health, and consequently
on why people choose to have
sex, and where, when, how and
who they have sex with, was
explored in this provocatively
titled session on Tuesday
afternoon.
Speaking to the science
perspective, Udi Davidovich
of the Amsterdam Public Health
Service in association with the
University of Amsterdam, argued
that prevention science has not
done a good job of incorporating
pleasure – of understanding it and
the influence it has on behaviour.
In the early days of HIV, the only
prevention tool available, condoms,
were widely used, and uptake
especially among MSM was very
high. However, consistent condom
use has though steadily declined
since the 1990s. Prevention
scientists, Udi suggested, have
dichotomised sex into ‘good’ –
protected, and ‘bad’ – condomless.
In so doing, they have taken sex
in its natural form and made it
problematic, something to be
studied to understand why people
do it. This approach leads to
people unwilling or unable to use
condoms being labelled ‘risktakers’
and a failure to explore or
understand the reasons underlying
their choices. The role of science,
Udi argued, is to study the choices
people can make between different
prevention options, and enable
them to make the best choice of
what they can use, what they want
to use and what provides them
with the best pleasure.
Cecilia Chung, president of the
US caucus of people living with
HIV organisations, outlined the
additional disconnect between
sexual pleasure and prevention for
transgender people. The conflation
between the needs of transgender
people and MSM is a barrier to
transgender women in particular
accessing services including testing
and treatment.
Under-representation in
research, due in particular to
binary gender categories used
for participants, means that
transgender people are not
engaged in studies, and therefore
there is insufficient evidence that
new prevention technologies will
be effective.
Cecilia described how in seeking
a partner, affirmation of gender
is first priority, with safety ‘hard
to come by’, and pleasure a much
lower priority.
Jessica Whitbread, of ICW,
described how science has
supported women to access greater
pleasure, but has not done nearly
enough, particularly to address
gender disparities. Giving the
example of condom negotiation,
Jessica suggested that while
female condoms exist, they are
problematic and under-utilised,
arguing that activists can be
disingenuous around their use:
…sometimes what we advocate
for is not actually what we use.
Prevention messaging which
assumes particular sexual practices
Women’s Realities…
When science meets the bedroom…
50 shades of pleasure and prevention
Jacqui Stevenson
Editors: Johanna Kehler jkehler@icon.co.za
E. Tyler Crone tyler.crone@gmail.com
Photography: Johanna Kehler jkehler@icon.co.za
DTP Design: Melissa Smith melissas1@telkomsa.net
Printing: Minuteman Press Melbourne minuteman@spencerprint.com.au
12 Wednesday • 23 July 2014
In my opinion…
We need action…!
Interview with Janelle Fawkes, Scarlet Alliance
to respond to the realities, risks and
needs of sex workers.
Biomedical approaches are
placed upon sex workers, without
consultation. And so, they are
doomed to fail, because they don’t
take into account discriminatory
legal frameworks that create
barriers for sex workers.
The Sex Worker Consensus Statement
from the AIDS 2014 sex worker preconference
held in Melbourne in July
20141 further underscores that for
instance an emphasis on HIV testing
without acknowledging legal barriers,
and the impact of stigma, discrimination
and other rights abuses on levels of access to services will only
perpetuate limited access to non-judgemental, quality and
voluntary services for sex workers.
Recognising that ‘decriminalisation’ in and of itself will not
transform societal prejudices and stigma against sex workers,
Janelle underscored that there is also a need to ensure that antidiscrimination
laws are enacted or amended to guarantee sex
workers’ inclusion.
Decriminalisation is only the first step…what needs to follow
are anti-discrimination laws giving a clear message that
sex workers cannot be discriminated against. Sex workers
need to know that they can expect to be treated equally
and equally protected by the law. Rights available to other
people should be rightfully available to us.
At the core of achieving sex workers’ equality, justice and
agency lies the decriminalisation of sex work and sex workers
– without, ‘there will be no end to HIV’.
Footnote:
1. The Sex Worker Pre-conference AIDS 2014 Consensus Statement
is available on www.scarletalliance.org.au/events/AIDS2014/
consensus2014/.
** The article is based on an interview conducted by
Johanna Kehler, AIDS Legal Network, South Africa.
While sex workers’ risks and
vulnerabilities to HIV, violence
and other rights abuses, including
barriers to access to services, are
well-recognised in many reports
and presentations throughout the
conference, there seems to be a
general ‘inability to move forward;
to move beyond these statements.
What we need is action that results
in law reform!’ – was the sentiment
expressed by Janelle Fawkes of Scarlet
Alliance, the Australian Sex Workers
Association, in a conversation on
Tuesday, 22 July 2014.
The decriminalisation of sex
workers and all aspects of sex work
has long been recognised amongst
advocates as both a pre-requisite to
effective and rights-based responses
to HIV and sex work, and a key to
achieving equality and justice for
past and present workers in the sex
industry. Yet, sex workers continue
to be violated, stigmatised and
discriminated against in policy and
practice, whilst at the same time
being ‘silenced’ and ‘kept voiceless’ in
the discourse of and the response to
HIV – even within the HIV sector.
There is a need for a paradigm shift!
There is a need to stop speaking
over and about us. It is us, who are
the experts and leaders in and for
our communities. We speak from
lived experiences.
With many references made
during the conference thus far
about the much needed ‘enabling
legal environment’ for key affected
populations, including sex workers,
Janelle continues to challenge that
these statements are rather ‘vague’,
and calls for clear statements on
the ‘decriminalisation of sex work
and sex workers’.
The persistence of prejudices,
stigma and violence against sex
workers is also evident in the
response to sex workers and HIV,
with biomedical approaches failing
…biomedical
approaches
failing to
respond to the
realities, risks
and needs of
sex workers…
www.aln.org.za www.arasa.info www.athenanetwork.org
Supported by Oxfam