The 2004 World AIDS Campaign's theme is women, girls and HIV/AIDS. Lisa Vettori discusses the impact of HIV/AIDS on women and girls and Oxfam Community Aid Abroad's response.

Each year, the World AIDS campaign, which is commemorated on 1 December, explores an issue related to HIV/AIDS. This year, the campaign's theme is women, girls and HIV/AIDS and how gender inequality fuels the epidemic. The name of the campaign is "Have you heard me today?"

Oxfam Community Aid Abroad is participating in this campaign by promoting understanding of the impact of HIV/AIDS on women and girls. We are calling on the government to support programs which empower women to control their lives and have a greater role in decision making, especially with regard to sexual activity and reproductive health rights. This includes asking the government to provide funding for research and development into female HIV prevention methods and for greater access to female condoms.

Oxfam Community Aid Abroad has gained significant experience in reducing gender inequality in relation to HIV/AIDS in our programs in southern Africa and the Pacific. We work with women and men, recognising that both need to be involved for real changes to take place.

HIV/AIDS is the primary cause of death at Port Moresby Hospital in Papua New Guinea (PNG). The World Health Organisation predicts that the number of HIV cases in the country could reach one million people (or one in five) in ten to 15 years unless decisive action is taken now. However, PNG is ill-equipped to deal with the epidemic, even at its current level.

Working with our partner organisation 'Hope For Living', we have set up a home-based care program for people living with HIV/AIDS. Traditionally, care of ill family members has been the responsibility of mothers, sisters and wives.

Hope For Living is actively recruiting young men to be part of the program.

We have also supported a Positive Living workshop in Port Moresby to provide support for people living with HIV/AIDS. The workshop covered self-care, gender roles and emotional health. Importantly, both men and women attended the workshop. This enabled participants to explore the need for both men and women to be involved in caring for family members.

In sub-Saharan Africa, young women aged 15-24 are more than three times as likely to be infected with HIV as young men. Despite this trend, women know less than men about how HIV/AIDS is transmitted and how it can be prevented, and what they may know can be rendered useless by discrimination and violence.

Getting young men actively involved in HIV education and prevention helps reduce the spread of HIV and violence against women. Our partner organisation Targeted AIDS Inventions, or TAI, works with young men to influence their attitudes and behaviour in relation to sexual practices and the treatment of women. TAI works with soccer programs to train young men as 'peer educators' to educate their friends about a whole range of HIV issues. Andile Sithole, who is a soccer player and peer educator with the TAI program, says, "As men, we want to make a difference to our country."

Violence against women is difficult to resolve through the legal system in southern Africa, as many cultural and social factors legitimise its use in relationships. In Mozambique, we are supporting the Women and Law in Southern Africa Research and Education Trust (WLSA), which aims to improve the legal status of women. The Trust lobbies for legal reform and changes in the policy and practices that disadvantage women.

Women and girls infected at a faster rate
Globally, women and girls are becoming infected with HIV at a faster rate than men and boys. In 1997, women made up 41 per cent of all people living with HIV/AIDS. Today, they make up nearly 50 per cent, and in sub-Saharan Africa, women and girls make up 60 per cent of those infected.¹

Why ABC is not enough
Marriage and long-term relationships do not always protect women from HIV/AIDS, as women may be infected by their long-term partner. The 'ABC' strategy to prevent sexual transmission of HIV - Abstinence, Being safer (by being faithful or reducing the number of partners), and correct and consistent Condom use - is an unrealistic option for many women and girls. A lack of social and economic power in relationships means many women are unable to negotiate relationships based on abstinence, faithfulness or condom use². They may be forced or coerced into sex, their husbands or boyfriends may have several partners outside the relationship and condoms require the cooperation of men.

Who looks after the sick?
Women are vulnerable to HIV due to inadequate knowledge about AIDS and a lack of prevention methods that women can control³. At the same time, women all over the world are expected to take on the burden of care for family members living with HIV/AIDS. In many instances, when the male of the household falls ill, it is the women who provide care. However, when the women fall sick, older or younger women step in to provide care.

¹ and ² Source: UNAIDS, 'Women and AIDS - A Growing Challenge'
³ This includes female condoms and microbicides. The latter refers to a range of different products, such as gels, creams, and suppositories which aim to prevent the sexual transmission of HIV. However, no safe and effective microbicide is currently available - testing is underway, though it may be more than five years before a product is available.