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This shift in HIV infection did not go unnoticed and was addressed in part by strategies aiming at empowering women in all section of the society. Overall, women’s empowerment was a central policy goal of both the International Conference on Population and Development (ICPD) in Cairo in 1994 and the Fourth World Conference on Women (FWCW) in Beijing in 1995. Empowering women was also emphasised in agreements reached at the World Summit for Children in 1990, the World Conference on Human Rights in 1993, the World Summit for Social Development in 1995, the World Food Summit in 1996, Habitat II in 1996, and the fifth-year review of ICPD implementation (ICPD+5) in 1999.
Ten years later, women empowerment is still on the front line in the fight against HIV/AIDS suggesting that it has somehow failed to fulfil its objectives.
Gender and its role in HIV/AIDS Gender refers to the social attributes and opportunities associated with being male and female and the relationships between women and men and girls and boys, as well as the relations between women and those between men. These attributes, opportunities and relationships are socially constructed and are learned through socialization processes. They are context/ time-specific and changeable.
Gender determines what is expected, allowed and valued in a woman or a man in a given context. In most societies there are differences and inequalities between women and men in responsibilities assigned, activities undertaken, access to and control over resources, as well as decision-making opportunities.
Office of the Special Adviser on Gender Issues and Advancement of Women (OSAGI) |
Gender refers to the socially constructed roles, behaviors, activities, and attributes that a given society considers appropriate for men and women (see inset). Gender issues are often wrongly perceived as “women issues” when actually, gender issues are about understanding and addressing the needs of both women and men to promote equality.
The relative achievements of empowerment strategies may be the result of misunderstood gender and gender issues and the failure of policy makers and strategists to recognize that empowering women without disempowering men is akin to giving a moneybox to the poor hopping they will get rich.
However, let’s not underestimate the importance and the success of strategies and policies aiming at empowering women during the last 10 years. An Actionaid report shows that in Africa empowering young women through education has contributed to lowering the risk of HIV infection and increased safer sex practice[4].
Nowadays, adolescent girls appear to be the target group for prevention strategies aiming at giving them access to education and providing them with life skills. However, Mohammad Khairul Alam, Executive Director of the Rainbow Nari O Shishu Kallyan Foundation in Bangladesh[5] observed that,
“[…] health education programmes which aim to empower women and girls to use condoms often fail adequately to tackle the actual problems because of imbalanced power relations. The desired changes in the behaviour of adolescent girls and boys cannot happen without programmes addressing such issues like how a girl can say no, but also why boys, teachers and other adults should respect the human rights of girls.”
In a paper that examines the context of women’s risk for HIV in the city of Chiang Mai[6], Lynn Morrison documented women’s acknowledgment of their husband’s need to visit sex workers:
“A 26 year-old woman said, ‘Sometimes we have a quarrel, then it makes me think that if I refuse him, then he will go out to a prostitute because if he needs sex he cannot control himself. For women, mostly we can control ourselves’. She justified her husband’s ventures in several ways by viewing them as less serious than having a mia noi [‘second wife’] and by making the analogy that sex, like food, is a necessity.”
When investigating how the women she interviewed responded to the threat of AIDS, “a 27 year-old woman stated, ‘There’s only one way. If he asks for sex, don’t refuse him’. In contrast, when a 36 year-old woman refused her husband sex, he became ‘very, very angry’ and had sex with her regardless.”
Other researchers have also found that condoms were unlikely to be used within the marriage, and wives could not control their husband’s extra-marital sexual behaviour in Thailand[7],[8].
This clearly demonstrates how the challenge to redress imbalances between genders does not refer to women and men in isolation, but to the relationships between them and how these relationships are socio-culturally constructed. Incidentally, the role of Buddhism as a rational for women’s inferiority has been explored by Klunklin and Greenwood hailand is primarily a function of the inferior status of women, which, in turn, is a function of Buddhism and Thai cultural beliefs[9] who argued that the current spread of HIV/AIDS in
These observations are not limited or specific to Thailand or any Asian country. Similar cultural or religious beliefs about women’s position in society and men’s pre-eminent status are universal. Therefore, empowering women will require disempowering men; it will need changing what gender is determining, what is expected from one gender, and what is allowed and valued in a woman or a man in a given context.
Empowering women or mainstreaming gender?
Initiatives, interventions and training manual aiming at empowering women, in particular regarding their reproductive right[10], are numerous (UNFPA[11], UNESCO, UNIFEM, FAO, PHDRE). But few[12], if any, actually involve men in their approach. This is overlooking the obvious, that in a relation, marital or not, with a power imbalance, it is the man who dictate when to have sex and how.
Strategies and policies that bring together men and women, give both of them knowledge about HIV/AIDS, life skills, leadership skills (because power does not mean leadership), lead men and women to view each other differently and share power and role in a different way would be more appropriate.
A prerequisite to this approach is to acknowledge that women and men have different needs, concerns and aspirations and that this is particularly true in situation of emergency. This was recently put forward in the Gender Handbook in Humanitarian Action[13] produced by the Inter-agency Standing Committee. Gender specificities do not suggest or confirm inequality between men and women, on the contrary,
“Understanding the gender dynamics or putting on a ‘gender lens’ quite simply means, recognizing the different needs and capacities of women and men, girls and boys. Being blind to or ignoring them can have serious implications for the protection and survival of people caught up in humanitarian crises.”
The HIV/AIDS epidemic is a situation of emergencies and as such we should put on a “gender lens”. In this regard, gender mainstreaming[14], an organisational approach putting gender issues at the centre of organisational processes and programmes, might prove a successful approach to empowering women. Gender mainstreaming undertakes to include gender-related issues within and during the process of strategy planning and policy making. Women are not seen or treated as a special group but as one of the several groups whose concerns, needs and aspirations must be heard and taken into account.
This approach has several advantages. It does not consider women as being powerless as “women empowerment” would let think. It does not oppose women to men, limiting confrontational dialogue that lead to gender discriminated workshops[15] and training. And it provides an opportunity to reflect and transform the attributes, prospects and relationships previously imposed by gender perception.
Mainstreaming is a relatively new concept, not restricted[16] to gender-related issues. For instance, the benefits of HIV/Aids mainstreaming were recently evaluated[17] in a report by UNAIDS, UNDP and the World Bank. Overall, it has had mixed results but in Thailand, the benefits of mainstreaming HIV/Aids in the National Development Plan were evident in terms of improved participation, commitment, coordination, and planning between various ministries and civil society, locally and nationally. The experience and skills acquired through mainstreaming produced faster, more effective responses to the challenges in hand. Where mainstreaming has failed, the report faults not the approach itself, but a lack of understanding, commitment, prioritisation, funding and skills among participants.
Gender mainstreaming is a globally accepted strategy for promoting gender equality in several areas including HIV/AIDS. Training manuals[18] and strategic plans[19] have been developed and are being evaluated to mainstream gender in HIV/AIDS organizations, programmes and policies.
To “think” about women and their position and role in society is already empowering them. It is the first step leading to power sharing between men and women, and as such should be at the heart of responsible and hopefully successful strategies much needed in the fight against HIV and AIDS. Undoubtedly Mainstreaming gender needs political will and commitment, often in the hands of men. But lest we forget, in France married women were given the right to dispose of their own wage ninety-nine years ago, on 13 July 1907, with the support of men like Tommy Fallot and Léon Richer who saw in women's control of their personal income a protective measure against debauchery and prostitution. Their paternalist logic may be at odds with today's empowerment, but it nevertheless raises hope for modern strategies involving men and women working together.
© 2008 Roger TATOUD. All rights reserved.
[1] The Gates Foundation
[2] Avert.org
[3] Eldis
[4] ActionAid
[5] GNP+
[6] Morrison L. Culture, Health & Sexuality 8:145–159, 2006.
[7] Aheto D and Gbesemete K. Health Policy 72: 25-40, 2005.
[8] Tharawan K. Contraception 68:47-53, 2003.
[9] Klunklin A, Greenwood J. Health Care Women Int 26:46-61, 2005.
[10] UNFPA
[11] Development Gateway
[12] Eldis
[13] WHO
[14] Bridges
[15] The Centre for Conflict Resolution
[16] Government of Scotland
[17] Eldis
[18] The South African AIDS trust
[19] The Policy Project
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