Promoting Gender Equality and Women's Empowerment in HIV and AIDS Responses

Photo of a mother holding her child.
Jon Hrusa/EPA

Gender refers to a culturally-defined set of economic, social, and political roles, responsibilities, rights, entitlements and obligations, associated with being female and male, as well as the power relations between and among women and men, boys and girls. The definition and expectations of what it means to be a woman or girl and a man or boy, and sanctions for not adhering to those expectations, vary across cultures and over time, and often intersect with other factors such as race, class, age and sexual orientation. Transgender individuals, whether they identify as men or women, are subject to the same set of expectations and sanctions.

GENDER INEQUALITY AND HIV AND AIDS

Gender influences an individuals’ status within society as well as the roles, norms, behavior that in turn shape opportunities to access and utilize health services – all of which influence dynamics of the HIV and AIDS epidemic and the success of programs to prevent and/or respond to HIV and AIDS. For example, gender norms may discourage women from asserting control over the timing and circumstances of sex, including negotiating protection against HIV and other sexually transmitted infections. At the same time, gender norms surrounding masculinity can discourage men’s use of HIV testing and other health services. Such norms may encourage male dominance in sexual decision-making and discrimination against male same-sex behavior. In some cases, expectations about exerting power and control over others can result in gender-based violence(GBV) and may be overlooked in health services and aggravated by justice and legal systems that do not adequately protect vulnerable groups.

HIV/AIDS Health Clinic
Diana Prieto/USAID

USAID’S RESPONSE

The U.S. Agency for International Development (USAID) is responding to the U.S. Government’s call of advancing gender equality and women’s empowerment in all of its development work. Addressing gender norms and inequities, preventing and responding to GBV, transforming power dynamics, and promoting gender equality are essential to addressing the HIV epidemic. USAID is a key implementing partner of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and provides leadership for the PEPFAR Gender Technical Working Group. Through its PEPFAR programming, USAID takes a two-prong approach; ensures gender interventions are integrated throughout HIV prevention, treatment, and care and support programs; and emphasizes five strategic areas of focus. These areas of focus, and illustrative examples of our work, include:

An essential aspect of USAID’s gender portfolio is monitoring and evaluation. Work in this area ranges from building the capacity of local organizations to incorporate gender into their monitoring and evaluation plans and implementing evaluations of gender- sensitive programs, to developing indicators and evaluation frameworks for global gender issues and initiatives, such as the Global Health Initiative (GHI).

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CURRENT PROGRAMMATIC HIGHLIGHTS

Gender Challenge Fund

USAID is a leader in the PEPFAR Gender Challenge Fund, which supports field-based initiatives to mainstream gender equality and prevention and response to GBV into existing HIV programs. The Gender Challenge Fund has made additional resources available to country programs on a matching basis, based on country-submitted proposals in line with the PEPFAR gender strategy. To date, 18 countries in generalized, mixed and concentrated epidemics in Africa, Asia and Latin America have received funding through the Gender Challenge Fund.

Gender-Based Violence Response Scale-Up

Photo of a health clinic
Diana Prieto/USAID

In addition to integrating gender throughout all programs, USAID and PEPFAR have invested significant resources and effort on preventing and responding to gender-based violence. USAID is a major partner in PEPFAR’s Gender-Based Violence Response Scale-Up in three countries: Mozambique, the United Republic of Tanzania, and the Democratic Republic of the Congo. The objectives are:

  1. Move beyond GBV pilots to demonstrate that GBV programs can be brought to scale at the national or regional level
  2. Offer screening, counseling and post-rape care services for GBV survivors within HIV and AIDS programs
  3. Support comprehensive and integrated GBV care for victims of violence at health facilities
  4. Support GBV prevention to address the underlying causes of violence and work across sectors (education, police, judiciary, social services)
  5. Address policy and structural barriers for women and children
  6. Advance the knowledge base through support for program and intervention evaluation and improved monitoring of community and clinic-based activities

Gender-Based Violence Impact Evaluation – Tathmini GBV

Tathmini GBV, under Project SEARCH, is a 3-year rigorous evaluation of the combined effects of the comprehensive GBV program delivered through health facilities and the community, in the Mbeya Region in Tanzania. The evaluation focuses on two types of GBV highly prevalent in Tanzania: intimate partner violence and sexual violence against adults and children. Primary outcomes of the study are the decline in GBV and increased care of GBV survivors; secondary outcomes include a shift in community norms toward greater gender equality, increased utilization of HIV services and reduction in HIV risk behaviors. The evaluation is implemented by Futures Group in partnership with Muhimbili University, Pangaea Global AIDS Foundation and Population Council. Findings will be used for policymaking and programming in Tanzania and globally.

What’s New

Resources for the Clinical Management of Children and Adolescents Who Have Experienced Sexual Violence

These technical considerations and accompanying job aids serve as a guide for medical providers to address and respond to the unique needs and rights of children and adolescents who have experienced sexual violence and exploitation. These resources focus on the delivery of clinical post-rape care services and include information on establishing services tailored to the unique needs of children and adolescents, preparing for and performing a head-to-toe physical examination, conducting forensics evidence collection and ensuring follow-up care and referrals for psychosocial and community support services.

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Last updated: September 10, 2013

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