Project Description

In Focus…
At the margins of an inequitable society…
Redefining the decriminalisation agenda
What’s inside:
Women’s Realities:
Asking and
answering the
What’s the story?
Young Women’s
On CSW and HLM
In Focus:
Ensure that
diversity is heard…
Women’s Voices:
Redefining the
Special Report:
The insufficiency of
any single one…
In our opinion:
Time to
bodies and making informed
decisions about their bodies; as is
their right. What is lacking is not
necessarily documents that reflect
injustices faced by the diversity
of women, but the willingness
of society to uphold the rights
and protections outlined in these
agendas. The social environment
in which we are living must be
understood to be a large contender
in the race for decriminalisation.
Redefining the decriminalisation
agenda for women in all their
diversity is not so much the
issue, as is the lack of agendas,
which result in immediate and
continuous action. This is not just
Despite global commitments and
progress on decriminalisation,
women and their bodies
remain criminalised, reflecting
limited evidence of significant
progress. Women continue to be
criminalised for being women, and
in their diversity as women. Their
experiences reflect a society which
does not encourage adherence to
rights, agency, and the capability
for one to choose how and when
they use their body. It instead
stresses containment of women’s
bodies, binaries on women’s
sexuality, and discrimination based
on, amongst other, class and sero
status. Their identity as women
becomes informed by these societal
misconstructions of what rights
and privileges are afforded to
which women.
The level of criminalisation
faced by women is
multifaceted and is underscored
by the stigma and discrimination
women experience for using their
a call for a renewed advocacy for
decriminalisation, it is a rightsbased
call to action. To act out
and claim back the rights that
society has violated. To make free
our bodies and our choices. To
take back our agency as diverse
women with diverse sets of
experiences and identities, which
should not deny us our rights and
our agency to use those rights in
our day-to-day interactions.
The larger question that needs
to be addressed is how do we
translate this redefined agenda
into ‘tangible’, ‘measurable’, and
‘sustainable’ actions that will
impact women in their diversity on
a daily basis.
The right of women to equal
treatment and non-discrimination
on the basis of sex is part of
the traditional canon of
human rights.1
Women are not to be controlled
or contained by an uninformed
society. The criminalisation of
Mujeres Adelante 14 – 24 March 2016
Newsletter on women’s rights and HIV • 60th CSW • New York
Samantha Manley
women directly impacts the
effectiveness of HIV responses
and the progress being made on
human rights and the protection
of those rights. Women in their
diversity are still marginalised.
Adapting frameworks to be
inclusive of not just women and
their bodies, but of their position
as equals in society – and in
advocating for those rights to be
upheld – requires further action
and advocacy. The violence and
violations made against women
and their bodies requires further
action and advocacy.
Decriminalisation needs to
address the diversity and the
inequality between and amongst
women, because women are
still living at the margins of an
inequitable society. Criminalising
women, and their diverse sets of
experiences, deepens stigma and
discrimination and inequality
within society, and by adding
other multiplying variables that
contribute to our identities, such
as HIV status, sexual orientation,
gender identity, gender expression,
drug use and sex work, our
marginality becomes exacerbated
and indeed criminalised.
Rights-based advocacy
responses address some of these
variables and identities, but many
of them fall short of addressing
women’s identities in their
multiplicity and intersectionality.
By doing so, there is a limited
impact on human rights
protections for women, and
potentially adverse effects of
well-intentioned HIV responses
for these identities. These
intersections reflect broader
societal cleavages that need to
be addressed before equitable
rights are not only realised, but
practiced within society.
Criminalisation takes a ‘law and
order’ approach to an exceeding
complex health and social issue.
The ‘law and order’ approach
does virtually nothing to stop
HIV and other STI transmission,
stigmatises people living with
and at risk of HIV, such as sex
workers, and is undermining
proven HIV prevention strategies
and programmes. Protection of
sexual and reproductive health for
persons living with HIV, and those
at risk of acquiring the virus is
predicated on the recognition of
individual sexual and reproductive
rights, and other human rights,
under the law.2
The integration of gender
equality and human rights into
global decriminalisation will
enable countries to meet the needs
and priorities of women, further
addressing gender-related barriers
to access to HIV prevention,
treatment, care and support and
allocate resources accordingly. We
need a roadmap for how to create
policy that not only incorporates
the voices of those who are most
impacted, but makes them central
to any decision-making processes;
but people want action.
The bottom line on
decriminalisation is that it is a
means of harm reduction. The law
is a frequently overlooked tool for
addressing these complex issues.
Some of the most contentious and
challenging public health issues
arising from the HIV pandemic
involve sexual and reproductive
health.3 The law intersects with
sexual and reproductive health
issues and HIV in many ways,
and to criminalise people,
who would choose to protect
themselves and others, is to
remove agency and consent.4
A transformative
rights-based approach both
through programming, service
delivery and advocacy needs
to be understood through the
decriminalisation of women in
all their diversity, fundamentally
based on the decriminalisation of
women and women’s bodies.
Samantha is a PhD Candidate at the
Department of Political Science at
York University.
For more information:
1. Charlesworth, H. & Chinkin,
C. 2000. The boundaries of
international law. Manchester,
UK: Manchester University Press.
2. Gable, L. et al. 2008. HIV/AIDS,
reproductive and sexual health,
and the law. In: American Journal
of Public Health, 98(10),
3. Cook, R.J. et al. 2003.
Reproductive Health and Human
Rights: Integrating Medicine,
Ethics, and Law: Integrating
Medicine, Ethics, and Law.
Clarendon Press.
4. Gable, L. et al. 2008. HIV/AIDS,
reproductive and sexual health,
and the law. In: American Journal
of Public Health, 98(10),
… societal
of what rights
and privileges are
afforded to which
…a large
contender in
the race for
…the lack of
agendas, which
result in immediate
and continuous
2 60th CSW Conference • New York • 14 March – 24 March 2016
Over the last five years global HIV and health
organisations have called for a dramatic increase in
early testing and treatment for people living with HIV,
but little attention has been given regarding what
this could mean for women. In the light of this gap,
ATHENA Network, AVAC, and Salamander Trust with
UN Women, undertook the first ever inter-continental
study of HIV care and treatment access issues for and
by women living with HIV. It is a multi-stage review,
exploring the experiences of women living with HIV
in relation to HIV treatment and care – including
retention in care. Preliminary findings were released
at the International AIDS Society Conference on HIV
Pathogenesis, Treatment and Prevention at Vancouver in
July 2015, and the full findings will soon be published.
This review is very timely – 2015 saw the launch of two
specific events that promote early testing and treatment for
people living with HIV.
• The UNAIDS ‘Fast-track’ strategy, setting new ambitious
targets for 95% of all individuals to be tested, 95% of
all those who test positive on treatment and 95% of all
those on treatment with high adherence (to achieve an
‘undetectable viral load’ making it nigh impossible to
pass on HIV to others) by 2030.
• The release of the START research trial results, which
indicate that it may be best for people with HIV to begin
treatment as soon as they test positive rather than
waiting until their ‘CD4 count’ drops to 350, as currently
recommended by the British HIV Association.
But is anyone asking how will women experience new
treatment initiatives, and how will they impact on women’s
lives? Our global review shows that women living with HIV,
with the support of agencies, such as UN Women, are asking
and answering these questions.
Our methodology was led and governed by women
living with HIV and took as its starting point the major
gaps regarding information on women’s access to HIV care
and treatment across the lifecycle. We formed a Global
Reference Group (GRG) of 14 women living with HIV from
11 different countries and from many different backgrounds
and experiences, to guide, inform and shape this review.
GRG members felt strongly that the global review had to
highlight the social and behavioural contexts that women
experience when making decisions about treatment and
care so that any approach to increase testing and treatment
could be informed by their realities and views. In pre-review
discussions the GRG highlighted the multiple dimensions of
…holistic-wellbeing that should inform any questions
regarding women’s experiences of treatment and care.
Multiple dimensions of holistic-wellbeing, pre-consultation
exercise by GRG members and their peers
Women’s realities…
Asking and answering the questions…
Women living with HIV on treatment and care
Emma Bell
60th CSW Conference • New York • 14 March – 24 March 2016 3
4 60th CSW Conference • New York • 14 March – 24 March 2016
The participatory methodology is an exercise of
empowerment at individual and community level. There
are no experts, saviours or victims when we use this
methodology, we learn and help one another. In all areas of
life, women are the experts. [Violeta Ross]
The three phases of the review included:
1) A literature review of research related to women’s
access to treatment and care focusing on how women’s
experiences are influenced by gender-related factors
at the household, community, health care and national
level. The review also included an analysis of all available
sex-disaggregated data from PEPFAR (United States
President’s Emergency Plan for AIDS Relief), Global
Fund for AIDS, Tuberculosis and Malaria, UNAIDS and
other sources;
2) Community dialogues via focus group discussions
(FGDs) in Bolivia, Cameroon, Nepal and Tunisia with
175 women, one-to-one interviews (13) and an online
discussion group involving 15 women living with HIV;
3) Country case studies undertaken in Kenya, Uganda
and Zimbabwe with in-depth focus groups, one-to-one
interview and country-level policy scans to provide a fuller
picture of women’s access in specific contexts.
What did we find …?
Women face multiple discrimination and rights violations
at an individual, household and community (micro level),
healthcare setting (meso level), and at national levels
(macro level), which were frequently cited as barriers to ART
initiation. This is particularly true for sex workers, transgender
people, adolescent girls and young women and migrants.
Such violations also affect treatment adherence, and act as
a brake on the potential of treatment and care advice and
options to improve the health and well-being of women over
the long-term.
For example,
• Micro level – having to ask permission from husbands or
other family members to seek services, violence and the
fear of violence on or after disclosure
• Meso level – disclosure of HIV status by health service staff
in front of family members and other staff and clients;
refusal of treatment and care for themselves and their
children; human rights violations during and after labour,
as well as forced and coerced sterilisation
• Macro level – punitive laws, including criminalisation
that exacerbate structural, partner and community
violence against women living with HIV, and key
affected populations
Community dialogues – a unique approach
As research fatigue is a reality we set out to have
discussions that were relevant, meaningful and useful for
women living with HIV in each selected country, as well
as feeding into the global review. We realised that we
needed to approach this in a way that enables women
to describe their realities and not just to ask the same
narrowly focused ‘barriers to treatment’ questions that
‘outside’ researchers have asked for many years, which
would elicit limited answers. Through peer outreach, every
effort was also made to ensure that women across their
diversities were meaningfully involved in the discussions:
young women, women with experience of sex work, drug
use, transgender women, widows of migrant workers, and
with other potentially marginalising factors, such as living
in poverty were involved.
60th CSW Conference • New York • 14 March – 24 March 2016 5
As a result, women describe experiencing internalised
stigma resulting in depression, low self-esteem and
self-worth, and other mental health problems. These can
also impact on their health-seeking behaviours, including
treatment access and adherence.
Negative impacts of treatment on women’s emotional and
physical health serves to exacerbate women’s feelings of
discomfort and even shame. Many women who participated
in the community dialogues raised the issue of side effects
of HIV treatment as a barrier to long-term adherence. Some
side effects – especially changes in body shape – were also
described as having impacts on their mental health or
emotional repercussions, particularly around gender norms
and expectations for women’s bodies and sexuality.
Yet, many health services do not appear to institutionalise an
approach that recognises the links between discrimination,
respect, support, disempowerment and health outcomes.
Women highlighted a lack of respectful treatment by
healthcare staff. Further, healthcare providers spent limited
time with them which discouraged their ability to ask
questions about the benefits of treatment, understand side
effects and drug interactions and what to take and when.
Rather women felt pressurised to make quick decisions
without adequate information.
The importance of a supportive and understanding health
environment is underscored by women’s testimonies of
services that work well for them. Women consistently cited
the benefits of contact with other women living with HIV
as a means to improving their own treatment literacy and
preparedness, with peer support directly linked to accessing
and remaining on ART over time. Women also cited building
trusting relationships with healthcare providers as important
to staying on treatment. Family roles as mothers, partners
and caregivers, as well as community leadership came out
strongly as factors that made women feel valued, and also
motivated treatment uptake and adherence.
What this means for the HIV treatment agenda
ART can only be effectively delivered in a rights-based
context, hand in hand with a specific agenda implemented
by and for women living with HIV in all their diversities, to
identify ways of promoting their right to health, as well as
their choice and agency in all decision-making that affects
their lives – including decisions to start and remain on
An intentional, nationally-endorsed, community-led,
demand-driven and sustainably funded service delivery
model that addresses gender equality and women’s rights
at household, family, community and national/institutional
levels, will be essential to ensure that women who wish
to initiate ART are supported to make an informed choice
about whether and when to do so and, critically, to be able
to remain on ART, if desired, over time.
1. Preliminary findings – including quotes included in this article, can
be found at [
Emma is a gender and women’s rights researcher and advocate,
currently working for Social Development Direct. For more
Young Women’s Voices…
It is extremely important for women and girls to engage
actively in the CSW and HLM, as it then makes them actors
in the solution as opposed to being mere subjects of the
solution. I think the key priority for women, girls and gender
equality in this context is engagement in all processes
and at all levels in all interventions directed towards our
These comments are from young women in Uganda who are are participating in an ATHENA Young Women
Leadership Initiative Working Group on CSW and HLM.
Young Women’s Voices…
The HIV epidemic is disproportionately affecting young women and
such a demographic is really facing issues, like include gender-based
violence (including sexual abuse) and lack of access to education,
health services, like family planning services, social protection and
information about how they cope with these inequities and injustices. It
is therefore paramount for us young girls and adolescents to engage in
the CSW and HLM to break such barriers that impede us from making
informed decisions and choices.
These comments are from young women in Uganda who are are participating in an ATHENA Young Women
Leadership Initiative Working Group on CSW and HLM.
6 60th CSW Conference • New York • 14 March – 24 March 2016
The global movement for gender
equality is a transformational
social justice movement,
comprised of feminists, women’s
rights and intersectional
advocates, networks, groups
and organisations. Achieving
gender justice is a uniting goal
bringing together diverse groups
and individuals, who share the
understanding that overturning
harmful, limiting and violent
gender norms offers benefits
to everyone, across the gender
spectrum. There is a space within
this movement for men and boys,
as partners and allies and as
beneficiaries. And there is space
in the movement for the activity
of engaging men and boys, to
achieve shifts in gender attitudes
and practices.
What role should men have
in the gender equality
As feminists and gender
equality activists, the
question of the right role for
men is a difficult one. There are
spaces and conversations that are
harder to open up,
while others benefit
from the involvement
of everyone. Too
often, however,
the ‘men and boys’
question dominates –
risking the question
of who is involved
overshadowing the
vital work we are all
committed to doing.
In a challenging political moment,
as funding dries up and donor
focus moves on, how can we work
effectively together, ensuring space
for involvement of people of
all genders in the movement for
gender equality, including men,
without losing women’s vital voice,
leadership and vision?
Part of this involves engaging
with what it means for people
who are not women to be
accountable, meaningful partners
and allies in the movement for the
advancement of women’s rights,
agency and autonomy. The role of an ally is necessarily a
challenging one; and ensuring that you are a thoughtful,
committed, and respectful ally is a challenge many of
us face as we work and advocate across movements and
issues. Building on our own experiences, and our expertise
as gender equality advocates, we suggest the following
key elements to promote what meaningful partnership
and accountability looks like (or
would be) to us.
Committing to meaningful
Partnership rests on listening
and engaging from a position of
equality and respect. For men
engaging in the struggle for gender
equality, this means recognising
…space in
the movement
… to achieve
shifts in gender
attitudes and
In Focus…
Ensure that diversity is heard…
Engendering accountability1
Jacqui Stevenson
60th CSW Conference • New York • 14 March – 24 March 2016 7
women as equals, with expertise
both from lived experience and
from academic, professional and
vocational practice. Men working
for gender equality should listen
to and engage with women, not
just as the ‘right thing to do’,
but from a position of respect
and learning. It should not be
utilitarian, or transactional.
Women have the intrinsic right
to be at any table as equals, and
to create the table and define
the conversation, not just to be
heard. As a woman, a feminist
and an activist, I expect to be
heard, because I have knowledge,
experience and expectations that
are legitimate and have value.
Let everyone have an equal
seat at the table. This includes
engaging purposively in ensuring
the right people are part of the
conversation – through seeking
diverse partners in gender
identity, race, age, community
and geographic location, and
investing in promoting and
widening participation.
Recognising privilege
It is important to recognise that
privilege does not have to be
exercised in order to function.
We have all been socialised into
gender roles, and it is an ongoing,
conscious process to overcome
them, including through choosing
and accepting a loss of power
where the status quo confers this.
For men in the gender justice
movement, this means consistently
being conscious of the power
and privilege their gender has
conferred. It means thinking
about who is speaking and
whether this is easier for men than
women (through social norms,
education, or confidence). Who
speaks first? Who speaks longest?
Who interrupts? Who is doing
the meeting ‘housework’ – getting
coffee, handing out papers? We all
carry ‘gender baggage’, and being
mindful of fulfilling or enacting –
or subverting – socialised gender
roles is critical.
In addition to gender privilege,
intersecting factors including
race, ethnicity and North/South
hierarchies influence who is
heard. As activists, we all must be
committed to opening up spaces and
access to resources and platforms, to
ensure that diverse voices are heard.
Accountable practice is intersectional
practice – recognising multiple layers
of exclusion and marginalisation and
how this intersects with gender to
prevent or enable a voice being heard.
Overcoming the gender
Accountability for all gender
justice advocates also includes
overcoming or opposing
heteronormativity and a rigid
gender binary. One danger of the
‘engaging men and boys’ approach
is reinforcing an understanding
of gender equality as being about
men and women, constructed in
a heterosexual dynamic with men as ‘victors’ and women
as ‘victims’. As feminists, we recognise that gender identity
and sexual orientation are not binary, and that we need
to recognise and respect diversity across the spectrums of
gender and sexuality, and that there is no ‘them and us’
approach that will lead to transformation – gender justice
is not about men versus women, but people of all genders
achieving equality.
…for people
who are not
women to be
partners and
8 60th CSW Conference • New York • 14 March – 24 March 2016
Parallel spaces
Creating safe parallel spaces can
be an effective means to engage
everyone in gender dialogue,
including different age groups,
gender identities and other
diversities. Certain spaces and
discussions are legitimately
limited to a particular group:
there are settings where male
involvement is not appropriate
or welcome, and being an ally
means recognising this. Of course,
this applies for men too – there
are discussions and spaces on
masculinity and the impact
on men of gender norms that
women should not join. It is vital
that opportunities and resources
are channelled towards creating
spaces for everyone to engage.
Women-only and
women-led spaces
Within this need for diverse safe
spaces, women-only or women-led
spaces are critically valuable and
important. It is hard to articulate
the power and potential of these
spaces. In some cases, men can
be very welcome in them, such
as in the Women’s Networking
Zone at International AIDS
Conferences, but it is vital that
men come into these spaces as
allies, listening not leading. There
is a valid role for allies in any
social justice movement, but this
does not extend to leadership,
parallel organising and in
separate, exclusive movements
and organisations.
Naming the perpetrators
Engaging men as partners cannot
negate the space and ability to
name men as perpetrators.
When we discuss, for example,
gender-based violence, there are
roles for men as partners to address
and re-define gender norms, to take
action to achieve social change, and
to foster transformation. And we
also need to recognise and articulate
that violence against women is
overwhelmingly – though by no
means exclusively – committed
by men.
Recognising what is already
being done
We also need to acknowledge
that feminist and women’s
organisations are not only working
with women – we have been
engaging with men and boys, and
challenging the gender binary,
since the beginning. Work to
achieve transformational gender
change has always recognised that
shifting gender norms means, in part, changing gendered
ideas and practices, and subverting and changing social
constructs around gender. Achieving gender justice means
everyone changing their gender norms and behaviour, and
everyone has to be engaged in that process. Change
requires everyone.
Leadership is vital. Commitment to
gender equality is key, but so too is
knowledge and experience. Women
have defined, shaped, and led the
movement for gender justice for
generations; defined the intellectual
and conceptual frameworks and
done the leg work for centuries. This
leadership and deep knowledge is
a vital asset for the movement, and
accountable practice respects this
and ensures that this legacy continues
ideas and
practices, and
subverting and
changing social
60th CSW Conference • New York • 14 March – 24 March 2016 9
to be supported and begins to be
properly financed.
Partnership in an arid
funding landscape
Feminist and women’s
organisations are in a difficult
political moment. Donor funds
are drying up, political interest
is vanishing and momentum is
fading. ATHENA has previously
developed a 3-part blog series
on funding for women’s rights.2
In this we outlined the perilous
financial position feminist and
women-led organisations are in
as a result of the lack of funding.
The partnership between menand
boys-focused organisations
and the wider feminist movement
has been challenged by this
financial reality. While there is
great focus on ‘women and girls’
at the present moment, this is too
often constructed with women
and girls as beneficiaries rather
than actors. There is a shared
struggle between all gender justice
advocates to resource political,
feminist advocacy – we should be
partners in this, not competitors.
It is not as simple as ‘funding for
women’ or indeed, ‘funding for
men’, but sustained and significant
resourcing to support advocacy
to realise political change. That
means increasing and opening up
funding, and moving beyond a
beneficiary model.
More, these changes are emerging
alongside global drives for
austerity and cuts in funding
and delivery of services and
programmes, including legal aid,
shelters, care services and women’s
organising. In this climate, there
is a responsibility for multi- and
bi-lateral agencies to prioritise
delivering services to women
including survivor-centric services,
and to invest in women’s work to
address gender equity.
‘Engaging men and boys’ is a
tool, not a solution
Now more than ever, it is vital
that attention and investment
continues to be paid to all aspects
of gender justice, including
delivery of services and women’s
advocacy. Engaging men and boys
is one strand of gender justice,
but not the only priority. Having
a male speaker as the keynote at
a gender justice panel might seem
innovative, but how many women’s
voices are being shut out as this
becomes the innovative thing
to do?
Looking forward
This is not the gender justice
movement we have struggled and
fought to create. Men should be
our allies, our partners, and should
ensure that we feel respected and
treated as equals and ready to
accept their partnership. In our
shared movement, we must be
accountable to each other and
our shared values, and ensure that
our work supports and upholds
our shared principles, towards our
shared goals.
1. A version of this contribution first appeared as part of a
MenEngage blog series on Partnerships and Accountability.
Contributors were Susana T. Fried (Fellow, Yale Global Health
Justice Partnership), Neelanjana Mukhia (Independent consultant),
Alice Welbourn (Salamander Trust), Tyler Crone, Ebony Johnson,
Alex Murphy & Luisa Orza (ATHENA Network).
2. See for part one [
Jacqui is with the Athena Network. For more information:
men and boys
is one strand of
gender justice,
but not the
only priority…
Young Women’s Voices…
Engaging women and girls in the CSW is
important, because It leads to better decisions
and better outcomes; it also strengthens women’s
understanding of human rights and democracy.
Engaging women and girls also promotes social
integration and cohesion in society while it is
an integral part of a democratic society which
helps to encourage more women to participate in
programmes that are designed for them.
These comments are from young women in Uganda who are are participating in an ATHENA
Young Women Leadership Initiative Working Group on CSW and HLM.
10 60th CSW Conference • New York • 14 March – 24 March 2016
Women health advocates all
over the world were jumping up
and down with excitement last
month. Why? For the first time,
two large-scale studies have
confirmed statistically significant
efficacy for a microbicide to
prevent HIV, something that
many people said would
take decades. Although the
effectiveness of vaginally applied
tenofovir gel was proven in 2010,
it has not yet been confirmed by
a second large-scale trial, which is essential for licensure.
About the Ring studies
Research into the vaginal ring as an innovative prevention
tool designed specifically to meet the needs of women in
settings where HIV is endemic began in 2002. The broader
field of microbicides research dates back however to the
early 1990s. The long-awaited results
of two Phase III trials were released at
the Conference on Retroviruses and
Opportunistic Infections (CROI) in Boston
on 23rd February.
ASPIRE (MTN 020) was launched by
the Microbicide Trials Network (MTN)
and enrolled 2,629 women in Malawi,
South Africa, Uganda and Zimbabwe; and The Ring Study
(IPM 027) was sponsored by the International Partnership
for Microbicides (IPM) and enrolled 1,950 women at sites in
Uganda and South Africa.
In ASPIRE, the vaginal ring reduced
women’s risk by 27% overall, while The
Ring Study did so by 31%. These figures,
however, reflect the average when
including the experience of women
who did not use the ring consistently.
The level of protection was much
higher among women with consistent
use, also called adherence to the study
protocol. Rates of adherence differed
substantially in various age groups.
ASPIRE showed that the ring reduced
HIV risk by 61% for women older than
25 years, and in a post-hoc analysis
by 56% in women older than 21, who
also appeared to use the ring more consistently. The Ring
Study which also showed higher efficacy (37%) for women
over 21. However, little to no protection was seen in women
ages 18-21 across both studies – 15% in The Ring Study and
no protection in ASPIRE. Although additional exploration of
this is needed, it is likely that this lack of effectiveness is due
to low rates of use among younger women.
Three reasons why it is
exciting news
There are many reasons why we should
all share in the jubilation of the trial
participants and sponsors without
hesitation, but here are three:
Firstly, we finally have a long-acting (as
opposed to daily) and non-systemic option that women
can use discretely, without the active participation of their
male partner. The analysis of the data is promising, showing
that this is a product, when used consistently, provides a
Women’s realities…
The Dapivirine Ring: What’s the Story?
Anna Forbes, Georgina Caswell, Rebekah Webb
…no single biomedical tool
will prevent all HIV infections
among women…
See footnote 1
60th CSW Conference • New York • 14 March – 24 March 2016 11
significant level of
protection against HIV
for women over 21.
While researchers are
working to improve
the efficacy of the
dapivirine vaginal ring, they will also be trying to better
understand challenges to adherence and why the youngest
women had low levels of protection, which could be due to
ring use, or biological and other factors.
Secondly, we know from the experience of PrEP studies that
adherence to HIV prevention products increases when they
are offered outside the context of trials. Within the trial,
participants are constantly told that the effectiveness of the
method is unknown. In addition, they do not know if they
are on a placebo or the actual product. PrEP demonstration
studies have shown that adherence increases as the evidence
for effectiveness has grown. Just as with oral PrEP, discussions
are underway for an Open Label Extension (OLE) follow-on
study, which will make the dapivirine ring available to all
ASPIRE and Ring Study participants. This is vitally important
so we can gain further insights into how women would use
the ring once they are aware it can help offer protection.
Thirdly, we have something to build on. No single biomedical
tool will prevent all HIV infections among women. The
dapivirine vaginal ring however will be a significant
contribution to the HIV prevention toolbox and our
understanding of HIV acquisition in women. It also provides
us with a platform to explore multipurpose technologies,
options that could enable women to both prevent HIV and
unplanned pregnancies. The potential for this emerging
technology is huge.
Looking ahead
Thirty years into the pandemic, HIV remains the leading
cause of death worldwide for women of reproductive age.
The results of the ring studies represent a giant leap for
women’s sexual and reproductive health and rights. In the
words of Lori Heise, the founder of the Global Campaign
for Microbicides
…we now face what we all knew from the start – a
technology alone would never be enough to help women
to protect themselves. We are now where the contraceptive
field was in the beginning – with a first generation product
that we can work with to learn how to support women in
its use – with a long, under-attended social justice agenda
to address the social, relational, and structural barriers that
women and girls still face in their lives.
More research is critically important to understand the data
better and to take forward the development of the vaginal
ring. A lower-than-hoped-for efficacy may mean donors are
discouraged. We have a collective responsibility to ensure
that the momentum is sustained and not threatened by a
lack of enthusiasm about women’s health, a preference for
one product against another or shrinking health budgets and
donor support. Women want and need more HIV prevention
tools. We have a new tool in the mix. Let’s build on it.
1. Jacquelyne Alesi, of the Ugandan Network of Young People Living
with HIV, during a civil society workshop about the dapivirine ring
results, March 2016, Kampala
Anna is a writer, policy analyst, organizer, and women’s health
activist; Georgina is with the International HIV/AIDS Alliance;
and Rebekah is a freelance consultant specialising in advocacy
and resource mobilisation in the areas of HIV and sexual and
reproductive health and rights.
For more information:
…the potential for this
emerging technology is huge…
12 60th CSW Conference • New York • 14 March – 24 March 2016
Women’s Voices…
Redefining the Agenda…
Call to action from Harare1
If you want to go fast, go alone (it’s fine, you go) but if you want to go far, go together.
On 28th November 2015, on
the eve of ICASA in Harare,
Zimbabwe, AIDS Legal Network
(ALN), Access Chapter 2 (AC2),
and Katswe Sistahood, with
support from the
Ford Foundation, convened
a special session to explore:
What needs to change in the
agenda on women, violence
and HIV?
The creation of safe spaces for
dialogue and sharing experiences
among women is a fundamental
aspect of a transformative feminist
approach. The meeting organisers
established a safe space, and
encouraged participants to feel free
to open up and contribute to the
discussion so that women can be
driving the agenda. We began by
introducing ourselves, as women
(and men) from Africa, Asia, Europe
and the Americas who are: dancers,
singers, home-based carers, soccer
players, gardeners, writers, travellers,
runners, students, teachers, feminists,
and ‘volunteers at large’; who are
humble, passionate, people-centred,
shy, impatient, beautiful, confident,
forgetful, different people in different
spaces, proud to be a woman, always
getting into trouble, scared; who
wanted to have a penis and made a
real mess in the toilet; who is doing
research into women’s masturbation;
who works for a soccer company
but has two left feet; who doesn’t
apologise about what she wants or
where she is going; who danced so
hard last night that she had to go to
bed early with a headache.
…before we speak about inclusion
we first have to recognise difference
– because without recognising
difference, you’re not going to
meaningfully include anyone…2
This conversation was rooted in
women’s organising in relation to
the HIV response that has been
going on for a number of years.
This includes – among others – the
Women’s Networking Zone3, which
historically provides a democratic
community space parallel to the
international and regional AIDS
conferences; an on-going series of
women’s conversations on the theme
of ‘From Criminalisation to Agency’;
and, through on-going in-person
and virtual organising within and
among networks of women in all of
our diversity, to make policies and
programmes that affect women and
girls the strongest they can be to
bring about positive change.
Johanna Kehler, Steve Mmapaseka Letsike,
Talent Jumo, Luisa Orza
60th CSW Conference • New York • 14 March – 24 March 2016 13
…women have a tendency to
underestimate the value of our
experiences; we need to build each
other up, so that when we go into
those spaces we have the confidence
to voice out the issues, and make
ourselves heard…
We are at a pivotal point in the
HIV response, with the introduction
of the new global development
framework in the shape of the
sustainable development goals (SDGs).
As an increasingly narrow, bio-medical,
‘targeted’ approach to ‘ending AIDS’
comes into play, there is an urgent
need to ensure that structural drivers
underlying the HIV epidemics are
addressed. A broader women’s rights
agenda, necessary for bringing about
transformative change that goes beyond
the HIV response, is imperative.
…whether women are car mechanics,
health workers, sex workers … how
do we re-organise ourselves; how
do we claim back the space and
work together?…
1. This is an excerpt of the full report about
the event, which will be available shortly.
2. Quotes included here are from
participants in the event.
3. More information, including a history of
the Women’s Networking Zone can be
accessed at [
Johanna is with the AIDS Legal Network,
Steve is with Access Chapter 2, Talent
is with Katswe Sistahood, and Luisa
is with the Athena Network. For more
A 10-point call to action:
Women, including young women living with HIV, and
representing women in all of our diversity, and men
championing gender equality, who attended the Harare
meeting identified a 10-point call to action for building
and strengthening an inclusive movement to prevent and
address HIV and gender violence.*
1. Claiming our space and organising as women in all of our
diversity: looking to the women who are most vulnerable, and
create a fully inclusive agenda
2. Setting our own agenda: involving affected communities in
processes and initiatives, including research, from Day One.
3. Strengthening our capacity: mentoring young women to create a
‘multiplier effect’
4. Challenging social constructions which limit us: working at
a formal legal and human rights level, intervening at the level of
culture, and to break down those ‘informal’ laws
5. Ensuring safety, dignity and respect for women in all areas of
work: challenging the assumption that women will volunteer their
time and resources
…women must be given the respect and knowledge to make their
own choices. If the space is safe for you to disclose, it doesn’t mean
it’s safe for me…
6. Developing a fully integrated, rights-based agenda: recognising
and addressing the complex and iterative links between HIV, sexual
and reproductive health and rights, and violence against women
7. Building our movement and amplifying our voices: working with
allies at different levels
8. Measuring the cost of violence: stratifying our approaches
among a diverse range of stakeholders
9. Connecting ‘grassroots’ to the decision makers: coordinating
between people working on women’s rights issues at grassroots
level and those working at national policy level
10. Working across generations to change mindsets: starting at an
early age to talk about issues of gender, sexuality, violence, and HIV
…we need to engage our families, our husbands. That’s where
violence is growing. We need to carry these discussions into the
bedroom – and the kitchen…
* Our thanks to the Ford Foundation for supporting the meeting, and to all the women
and men who participated, to make this happen.
14 60th CSW Conference • New York • 14 March – 24 March 2016
In 1993, the United
Nations Declaration
on the Elimination
of Violence Against
Women defined
violence against
women as
…any act of
violence that results
in, or is likely to result
in, physical sexual
or psychological
harm or suffering to
women, including
threats of such acts,
coercion or arbitrary
deprivations of
liberty, whether
occurring in public
or private life.1
This was, coincidentally, the
same year South Africa
moved to be among one of the
first African countries to make
marital rape illegal; stating in the
Prevention of Family Violence Act
that a relationship of husband and
wife may no longer be a mitigating
factor, and therefore marital
rape must be treated like any
other rape.2
The above comparison is
aimed towards illustrating
the importance of definitions
and the potential capacity for
change different definitions
have in different contexts.
Discussions about violence and
what constitutes violence are not
simply theoretical arguments
for the academic, but carry
implications for legislation, policy
and intervention. Definitions
are strategic, and narrowing
or broadening their scope has
political significance. What follows
below is a discussion around some
widely respected interpretations of
violence, with the aim of drawing
attention to the insufficiency of
any single one.
Global definitions
The 2014 definition of violence
against women offered by
UNAIDS follows word for word
that given in 1993 by CEDAW.3
This is problematic in that despite
the reality that social forces and
state laws affecting gendered
violence are constantly shifting,
UNAIDS has failed to adjust their definition accordingly. It
could be argued however, that the 1993 definition still applies
today and remains relevant, this in turn calling into question
the practicality of such a broad-scoped interpretation. Too
wide a scope risks failure in addressing or illuminating the
oftentimes complex and multifaceted nature of an issue.
While UNAIDS’s description of violence against women
is unsuited for concrete, practical use, it does give those
researchers analysing on a global scale a framework within
which to work. UNAIDS’s broad conceptualisation of
violence allows for the inclusion of a large number of
different acts, thus creating the impression of a widespread,
Special report:
The insufficiency of any single one…
Defining violence
Robin Kilshaw
60th CSW Conference • New York • 14 March – 24 March 2016 15
compelling problem. Researchers
investigating the issue of violence
against women globally could
use UNAIDS’s definition in
order to underline how extensive
the issue is and hopefully draw
greater resources. It must be
noted however, that analytical
categories are especially important
for those embarking on research
concentrated on gendered violence,
and precise, specific definitions
are more likely to enable clear
identification of what factors
directly increase or decrease one’s
risk of experiencing violence.
Despite adhering to a definition
produced 23 years ago, UNAIDS
has supplemented their typology
of violence with the addition of
‘gender based violence’. Gender
based violence
…describes violence that
establishes, maintains or
attempts to reassert unequal
power relations based on gender.
It encompasses acts that inflict
physical, mental or sexual harm
or suffering, threat of such acts,
coercion and other deprivations
of liberty.4
The category ‘gendered violence’
provides a tool for researchers
and policy makers interested in
the gendered nature of violence
against gay and transgendered
men, but also remains inclusive
enough that it could be used to
address violence against women
as well. An element in UNAIDS’s
definition of ‘gendered violence’
missing in their interpretation
of violence against women is
the acknowledgement of gender
inequality as a driving force
behind gendered violence.
Another globally recognised
definition of violence is that of
the World Health Organization
(WHO). WHO characterises
violence as
…the intentional use of physical
force or power, threatened
or actual, against oneself,
another person, or against
a group or community that
either results in or has a high
likelihood of resulting in injury,
death, psychological harm,
maldevelopment or deprivation.5
While WHO’s interpretation of violence offers an
appropriate framework for their own organisation, and
others interested in the public health outcomes of violence,
it’s limitations must be acknowledged.
The language used in WHO’s interpretation reflects their
commitment to public health by addressing specific physical
outcomes of violence as the only results. It ignores the social
context of the act, and in doing so discounts various acts
of violence or abuse that are violent, due to social forces
rather than individual impetus. For example, abandonment
by itself is not necessarily abuse; however considering the
social and economic inequality between men and women in
countries, such as South Africa, it oftentimes has the same
results as physical abuse.6
A Comprehensive Definition
Fiona Hale and Marijo Vazquez offer a well-rounded
definition that acknowledges social contexts, while
remaining broad enough to encompass a multitude of acts.
The authors begin by conceptualising violence in a nonspecific
way: as
…one of the elements that sustains and perpetuates an
unequal society in which some people have control over
others in a hierarchical scale of power which is based on
exploiting differences between people.7
They follow with:
…the violence which keeps this system in place becomes
…a social
of silence
allows abuse to
gendered violence as
being personal, cultural
and structural…
16 60th CSW Conference • New York • 14 March – 24 March 2016
part of the system and
condoned by society.8
This interpretation of violence
is especially salient for South
Africa, where gendered violence
has become normative and for
the most part accepted, rather
than rejected or challenged.9 The
remainder of the definition reads:
…violence is used to achieve
and assert power and control
over others, and becomes
accepted (to greater or lesser
degrees) as part of normal
social structures. Peace studies
distinguish between ‘structural’,
‘personal’…and ‘cultural’
What is useful in this definition
is that rather than limiting the
description of violence to women,
the authors describe the social
contexts in which gendered
violence is most often perpetrated
and perpetuated. Therefore, it
could just as easily apply to gay
men or transgendered men as
it could to women, while still
specifically addressing the multiple
layers in which gendered violence
most often happens.
Hale and Vazquez depart
from UNAIDS and WHO by
addressing the social elements
at play in gendered violence,
as well as the social outcomes
of such violence, rather than
listing personal or public
health outcomes. The definition
acknowledges that violence can be
personal, cultural and structural –
something that UNAIDS alludes
to and WHO ignores. Their
definition provides a lens through
which to examine the multifaceted
nature of violence against women
– an approach that arguably
would offer the most efficient ways
to respond to violence against
women. Too broad a definition
(such as those offered by CEDAW
and UNAIDS) collapses levels of
violence onto one another and
gives an understanding of violence
that limits it to the personal
level. This means that addressing
issues of violence against women
would be limited to intercepting
and intervening with individuals,
rather than responding to
systematic or cultural ideologies
perpetuating violence against
women. Narrow definitions are
useful tools for researchers who
wish to examine specific cases of
gendered violence, but their use is
limited to those specific contexts.
To this end Hale and Vazquez’s
definition is the most suitable,
as it has room for a macro comprehension of violence, but
also narrows the scope to reveal the social and economic
conditions in which violence functions.
While Hale and Vazquez’s interpretation of violence
provides a useful tool for researching and addressing
violence against women, it does not offer insight into the
concrete ramifications for individual acts. For this, one must
look to the South African legal definitions of violence.
Legal Definitions
‘Violence’ as a criminal offence is not defined by South
African legislation, however two very common acts of
…systematic or
cultural ideologies
violence against
…they are not enough
and they fail to
address the source of
the issue…
60th CSW Conference • New York • 14 March – 24 March 2016 17
gendered violence – domestic
violence and rape – are.
Rape is defined in the Criminal
Code as
…any person (‘A’) who
unlawfully and intentionally
commits an act of sexual
penetration with complainant
(‘B’) without the consent of B,
is guilty of the offence of rape.11
Important to note is that
‘consent’ in cases such as
rape means voluntary or
uncoerced agreement.12
The Domestic Violence Act
(No 116 of 1998) denotes domestic
violence to include: physical abuse,
sexual abuse, emotional, verbal
and psychological abuse, economic
abuse, intimidation, harassment,
stalking, damage to property,
entry into the complainant’s
residence without consent, where
the parties do not share the same
residence, or any other controlling
or abusive behaviour towards a
complainant – where such conduct
harms or may cause imminent
harm to, the safety and well-being
of the complainant.13
What the definitions above
offer are very specific, literal
understandings of the issue at
hand that aim at facilitating
straightforward court cases. What
they fail to acknowledge
or address is that oftentimes
women’s perception of ‘rape’,
‘domestic violence’ and ‘consent’
do not match up with
legal understandings.
Theory vs Reality: The social
Differences between popular
and legal conceptions of rape have
critical implications for women
who have experienced particular
sexual encounters, not just for how
they personally interpret the events
but also for attempts to gain an
understanding of the magnitude
of the problem.14 This discrepancy
often hinges on women’s
understanding of ‘coercion’, as
sexual coercion can take many
forms and does not always
involve force.15
A 1998 study found that women
did not define their experiences of
sexual violence as falling neatly
into categories of ‘marital rape’
and ‘not marital rape’.16 Rather,
they defined their experiences in
various ways, such as ‘survival’
or ‘forced’ sex, sexual assault/
abuse, ‘like rape’ and ‘pressurised
sex’17. Defining an experience
strictly as ‘rape’ or not was based
on a number of variables, such as
consent, force, relationship to the perpetrator, degree of
violence used, social pressures, and a perceived ‘duty’ to
provide sex in return for food and shelter.18
A major factor contributing to the discrepancy between
legal definitions and individual perceptions of rape are the
popular discourses that rape is a crime of violence between
strangers.19Similarly, gender norms dictating how men and
women should act in relationships silence many survivors
of domestic violence, who may perceive their experiences
as such, but are unable to take legal action, due to social
repercussions as well as inadequate access to services
resulting from stigma and discrimination of providers.20
Social stigma and fear of further abuse provoked by
speaking out combined with women’s overall lack of social
agency in South Africa decreases their access to services
and justice.
In South Africa, violence is systematic and functions
on the societal level, as is seen in health clinics where
women’s human rights are often violated.21 This systematic
gendered violence is also seen in the justice system, where a
common theme in many sexual assault cases is that women
survivors of sexual abuse or attacks are met with hostile and
unsympathetic treatment from the police and sometimes
even judicial officers.22
…social forces and
state laws affecting
gendered violence
are constantly
18 60th CSW Conference • New York • 14 March – 24 March 2016
Yet, despite all their
shortcomings, legal definitions,
such as the ones offered above are
necessary and most often needed
in their concise, literal format.
And just as necessary are the
more complex, socially centered
definitions, such as that offered
by Hale and Vazquez. If both
are equally as essential, then the
question must be asked why only
the legal definitions are considered
legitimate and enforced? Dealing
with violence after it has occurred
does nothing to address the
root causes, nor does it dissuade
individuals from committing
acts of violence. In countries
such as South Africa, the legal
framework is in place yet the rigid
gender norms enforced by cultural
ideologies prevent many survivors
of violence from coming forward,
while simultaneously legitimising
acts of violence. What is needed is
a shared understanding of violence
– not one in line with UNAIDS
or WHO’s blanket definitions that
address the individual level – but a
shared understanding of violence
similar to that offered by Hale
and Vazquez. Legal definitions
will always be necessary, but they
are not enough and they fail to
address the source of the issue.
Calling for a shared
understanding in
South Africa
In South Africa, the
epidemic of violence against
women is converging with
the human immunodeficiency
virus (HIV) resulting in deadly
consequences, as it is women who
are disproportionately affected
by both violence and HIV.23 In
fact, heterosexual women are the
section of society with the
most rapid rates of new
HIV transmission.24 The power
of diminished social agency to
increase HIV vulnerability is
evident among young women
(aged 15-24), who are twice as
likely to be living with HIV than
young men of the same age
and account for 22% of all new
infections.25 Violence against
women in South Africa is both
a cause and consequence of
HIV and many women report
experiencing a range of abuses
after disclosing their positive
HIV status.26 Laws exist in South
Africa that specifically address
acts of violence, such as rape and
domestic abuse, yet male power,
economic constraints, and a social
environment of silence allows
abuse to continue.27
It could be suggested that the
legal definitions be rewritten to be more comprehensive,
however their specificity is their strength. A broad definition,
such as that given by Hale and Vazquez would leave too
many loopholes for perpetrators to jump through and offer
too many avenues for debating and lengthening legal trials.
In the case of the law it could certainly be argued that the
more specific the better. Yet, as is evident in South Africa,
legal definitions are not enough. Their shortcoming is not
something to be debated by researchers or academics in
search of the ‘best’ definition, but rather a crucial public
health matter to be discussed on community, regional and
national levels immediately. The effects of South Africa’s
failure to define and address violence against women as a
social, economic and public health issue can be seem among
the many women disproportionately affected by violence
and HIV, and internationally is reflected by Sub-Saharan
Africa holding the highest rate of new infections (70%) in
the world.28
What is needed is a more comprehensive definition
of violence, not to replace the legal ones, but rather
complement and enhance them. Addressing violence against
women is not just a criminal matter, but also a social and
public one. A definition is therefore needed that addresses
both of these issues, and while WHO and UNAIDS both
engage each topic separately, it is Hale and Vazquez’s
interpretation of violence against women that understands
gendered violence as being personal, cultural and structural.
If adopted by policy and law makers this
multidimensional understanding of violence would result
in policies and laws that address violence at all levels.
Undoubtedly, narrower and more specific definitions of
…it ignores the social
context of the act …
due to social forces
rather than individual
60th CSW Conference • New York • 14 March – 24 March 2016 19
violence would be necessary for
each separate issue, however
without the shared understanding
of violence at the high levels there
would be no guarantee that all
contexts would be addressed.
While this approach would
undoubtedly be useful in most
countries across the world, it is
not just ‘useful’ in South Africa
but necessary.
There is no hope of ending
HIV without first addressing
and ending violence against
women, something that must be
acknowledged by policymakers
before progress will be seen.
1. United Nations. 1993. Declaration
on the Elimination of Violence
Against Women, 85th Plenary
Meeting, n4.
2. Prevention of Family Violence
Act. 1993. Government Gazette
15161, para1-4.
Guidance: UNAIDS Terminology
Guidelines, Guidance.
4. Ibid, p21.
5. WHO. 2002. World report on
violence and health, p4.
6. Vetten, L. & Bhana, K. 2001.
Violence, vengeance and gender:
A preliminary investigation into
the links between violence against
women and HIV/AIDS in south
Africa. Research report written
for the Centre for the Study of
Violence and Reconciliation.
7. Hale, F. & Vazquez, M. 2011.
Violence against women living with
HIV/AIDS: A background paper.
Development Connections, p8.
8. Ibid.
9. Outwater, A. et al. 2005. ‘Women
in South Africa: Intentional
Violence and HIV/AIDS:
Intersections and Prevention’. In:
Journal of Black Studies, 35, No. 4,
10. Hale, F. & Vazquez, M. 2011.
Violence against women living with
HIV/AIDS: A background paper.
Development Connections, p8.
11. Criminal Law (Sexual Offences
and Related Matters) Amendment
Act, No 32 of 2007. ss 3:10.
12. Ibid, ss2.
13. Domestic Violence Act. Act 116 of
1998. (ss(a) – ss(j)):2.
14. Jewkes, R. & Abrahams N. 2002.
‘The epidemiology of rape and sexual coercion in South Africa:
An overview’. In: Social Science & Medicine, 55, No7,
15. Ibid.
16. Kottler, S. 1998. ‘Wives’ subjective definitions of and attitudes
towards wife rape’. Master’s thesis, Pretoria, University of South
17. Ibid.
18. Ibid.
19. Jewkes, R. & Abrahams N. 2002. ‘The epidemiology of rape
and sexual coercion in South Africa: An overview’. In: Social
Science & Medicine, 55, No7, pp1231-1244.
20. Outwater, A. et al. 2005. ‘Women in South Africa: Intentional
Violence and HIV/AIDS: Intersections and Prevention’. In:
Journal of Black Studies, 35, No. 4, pp135-154.
21. Kehler, J. et al. 2012. ‘If I knew what would have happened, I
would have kept it to myself’: Gender Violence & HIV. ALN:
Cape Town, South Africa.
22. People Opposing Women Abuse & AIDS Legal Network. 2010.
Criminal injustice: Violence against women in Aouth Africa,
23. Outwater, A. et al. 2005. ‘Women in South Africa: Intentional
Violence and HIV/AIDS: Intersections and Prevention’. In:
Journal of Black Studies, 35, No. 4, pp135-154.
24. Ibid.
25. UNAIDS. 2011. How to get to zero: Faster, smarter, better.
World Aids Day Report, p10.
26. Vetten, L. & Bhana, K. 2001. Violence, vengeance and gender: A
preliminary investigation into the links between violence against
women and HIV/AIDS in south Africa. Research report written
for the Centre for the Study of Violence and Reconciliation.
27. Fox et al. 2007. ‘In their own voices’ In: Violence against women,
13, No6, pp583-602.
28. UNAIDS. 2014. Getting to Zero, p.1
Robin is an intern with the AIDS Legal Network (ALN).
For more information:
Young Women’s Voices…
I would like to be a part of a strong movement that sees
that policies and conditions favour the well-being of a girl
child through freedom of expression; confidence building
to ensure that girls are assertive with their choices and
are able to stick to them; and that girls are economically
empowered to limit us from subduing to demands that risk
our sexual and reproductive health.
Girls are not only the most affected by HIV, but also have a
social disadvantage of being girls. They suffer violence in all
its forms, as well as other social injustices like
choosing boys to go to school and girls to
stay home.
Young women should be given good space to
work in their diversities without captivating them
into one identification.
These comments are from young women in Uganda who are are participating in an
ATHENA Young Women Leadership Initiative Working Group on CSW and HLM.
Young Women’s Voices…
It is through the young women and girls that voices of others who can
not speak are represented, and this empowers young women with
confidence and an in-depth understanding of sexual reproductive
health and rights.
[Young women’s engagement at CSW is essential] to redress power
imbalances between all genders in the community, building more
positive relationship to develop social, psychological and financial
effects of young women.
The key issue that women are facing is stigma and discrimination in
communities, schools, work places and health facilities; hence hindering
them from access and adherence to medication.
These comments are from young women in Uganda who are are participating in an ATHENA Young Women
Leadership Initiative Working Group on CSW and HLM.
Young Women’s Voices…
Women’s engagement [in CSW and HLM] creates a room for women’s voices to be
heard, their needs are put in action and it creates awareness on SR; hence breaking
the gap for inadequate information through which women/girls learn their rights
and responsibilities.
These comments are from young women in Uganda who are are participating in an ATHENA Young Women Leadership
Initiative Working Group on CSW and HLM.
20 60th CSW Conference • New York • 14 March – 24 March 2016
Editor: Johanna Kehler
Photography: Johanna Kehler
Design: Melissa Smith
Printing: www.
Supported by Oxfam
In our opinion…
Time to humanise…
Zena A. Stein, Erica L. Gollub
sophisticated communication facilities, a basis for stability of our
partnerships, or is it the other way round? – or does the stability
promote communication??
We could speculate on all this, but, more usefully for our
purposes, if we could ‘capitalise on coupling’, and enhance
inter-partner communication, we could achieve a far wider
range of choices (beyond condoms, male and female), to permit
wanted conceptions, and prevent transmission of infections.
For some of these, technology could help, but if we could
proactively promote and strengthen partner communication as a
distinct intervention, we could expand and enrich the protection
and intimacy it promises. So, let the logo inspire:
Talk it over, speak your mind, decide to do something about it.
1. Lyric from Talking Union by Millard Lampell, Lee Hays and
Pete Seeger, 1941.
2. Illustration: Jane Shepherd.
Zena is an epidemiologist and Professor (Emerita) of Public
Health and Psychiatry and Co-Director at the HIV Centre at
Columbia University, and Erica is a public health specialist
at the Department of Epidemiology and Biostatistics,
Robert Stempel College of Public Health and Social Work,
at the Florida International University.
For more information:
In our opinion, on World
AIDS Day, we celebrated
two technological triumphs
and two challenges. We
can, technically, prevent
all new cases of unwanted
pregnancies and
HIV infections: but we
can still not cure current
cases of HIV infection,
and we cannot ensure
communication between
partners. This second
challenge is embodied in
our logo: time to humanise!
Couples need
to communicate!
The extraordinarily varied and
extensive world literature
informs us that use of male
and female condoms, in fact
contraceptives and HIV preventives
in general, are influenced more by
partner communication than by
anything else. Now we find that
partner handholding even provides
comfort, similar to that caused by
pain-relieving drugs! So our
image reflects our task for 2016
and beyond.
As senior epidemiologists, both
with decades of experience in
women’s issues, reproduction and
HIV, we are trying here to stand back
somewhat from the technology,
impressive though it is, and draw
some lessons from the behavioural
field of inter-partner communication.
What encourages it, and what are
the effects?
A biological background may be
helpful. Let’s start with reproduction.
It has long puzzled primatologists
that, distinct from almost all our
fellows in this category, homo
sapiens couples partake in sexual
relationships in all the days of their
adult lives together, well beyond the
relatively brief fertile period of each
cycle and beyond women’s fertile
years. Also, most couples do not
even know when the cyclical fertile
period is: males are stimulated and
both sexes enjoy sexual congress at
any time. Causes and consequences
of this phenomenon are many, but
at least one consequence may be
that partners find pleasure in sharing
many days and years together,
not necessarily lifetime mutual
monogamy, but at least some stability
of partnership. Is this good for dual
parenting of offspring? or division
of labour?? Are our seemingly more
See footnote 2