Gender

  • Why adolescents?

    In 2012, young people ages 15 to 24 accounted for an estimated 40 percent of new nonpediatric HIV infections worldwide [UNAIDS World AIDS Day Report 2012]. Furthermore, perinatal HIV transmission is a major cause for HIV infection, and given the success of pediatric antiretroviral therapy (ART), many more infants born with HIV are growing up into adolescents and young adults living with HIV.

    While care and treatment programs for people living with HIV (PLHIV) can be found in every country, there is a gap in provision of ongoing, supportive counseling for adolescents living with HIV (ALHIV). Adolescence is often when young people begin having sex, which increases chances that adolescents living with HIV might pass the infection to partners who are HIV negative. Another concern is that girls living with HIV may become pregnant; if they do not know about or have access to services for preventing mother-to-child transmission, they can pass the infection to their babies. Given that adolescents are a large sub-group of those living with HIV, there is a need for tailored interventions and support systems that address adolescents’ unique vulnerabilities.

    Positive Connections

    To shed light on the specific health and social support needs of ALHIV, FHI 360 — on behalf of USAID’s Interagency Youth Working Group — developed a resource called Positive Connections: Leading Information and Support Groups for Adolescents Living with HIV. This unique guide provides facilitators with background information about the needs of ALHIV, tips for starting an adult-led information and support group, 14 sessions to follow in a group setting and guidance on tracking a program’s progress.

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  • Gender, economics, and ART adherence: What’s the connection?

    In a rural village in central Africa, my colleagues and I stood over a registration book for antenatal care clients with the goal of identifying clinic-level data that could be extracted for a project evaluation. As we made our way through the book, the left sides of the pages were filled with names of women, dates and HIV test results — it was clear that almost all of the women who tested HIV positive received some form of antiretroviral therapy (ART). As my eyes ran to the right across spaces for follow-up records, however, the fields became increasingly emptier, and our team began to discuss the various barriers to services, even a highly effective service like prevention of mother-to-child transmission (PMTCT).

    Access and adherence to the greater continuum of HIV care is influenced by several factors, including community-level gender norms and related behaviors. For example, HIV-positive men may avoid HIV testing and may spend a significant amount of their income attempting to address symptoms of their illness rather than confirming their HIV status. Often, these behaviors are driven by fear that knowledge of a positive HIV test result could compromise their leadership at home and cause family instability. Research has also identified instances when men undermine their wives’ access and adherence to ART, even taking their wives’ medication for themselves. Interestingly, despite such challenges, women are more likely to access and adhere to HIV-related treatment and care than men.

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  • “I will not let you hit your wife!” I yelled. “I work for an organization that is empowering women to end violence in their lives.” Moments earlier, my older brother had joined his wife (my sister-in-law), daughter and me on the balcony of his house. As he ate, he complained that his wife was using the charger for his mobile phone. He grew so angry that he threw his plate of food on the floor and stood up to confront her. He tried to punch her, but I pushed him away.

    This was not the first time I had experienced violence. My former partner and the father of my two children threatened to kill me when I was 24 years old. He physically abused me, treating me like I was his punching bag. He often struck my face so people would know he “owned” me. With all of the bruises, I always felt ashamed to walk in public. My past experience with my former partner made me more sensitive to what was happening in my family.

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  • positive-connections-coverWhy adolescents?

    In 2012, young people ages 15 to 24 accounted for an estimated 40 percent of new nonpediatric HIV infections worldwide [UNAIDS World AIDS Day Report 2012]. Furthermore, perinatal HIV transmission is a major cause for HIV infection, and given the success of pediatric antiretroviral therapy (ART), many more infants born with HIV are growing up into adolescents and young adults living with HIV.

    While care and treatment programs for people living with HIV (PLHIV) can be found in every country, there is a gap in provision of ongoing, supportive counseling for adolescents living with HIV (ALHIV). Adolescence is often when young people begin having sex, which increases chances that adolescents living with HIV might pass the infection to partners who are HIV negative. Another concern is that girls living with HIV may become pregnant; if they do not know about or have access to services for preventing mother-to-child transmission, they can pass the infection to their babies. Given that adolescents are a large sub-group of those living with HIV, there is a need for tailored interventions and support systems that address adolescents’ unique vulnerabilities.

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  • Reducing violence against women and girls in Papua New Guinea

    Yesterday was the International Day for the Elimination of Violence Against Women. In Papua New Guinea, where I work for FHI 360, violence is a serious, widespread problem that affects many women and girls on a daily basis. While exact figures are difficult to obtain, recent estimates show that violence occurs in more than two-thirds of families living in the country.

    FHI 360 is tackling this pervasive problem through a new project. The Komuniti Lukautim Ol Meri Project (KLOM), funded by Australian Aid, supports women and girls who are survivors of violence in Papua New Guinea by providing community services focused on prevention, response and empowerment. The project, which is managed by FHI 360, is being implemented in ten communities in the Sandaun and Western Highlands provinces. Each community has two “mobilizers” who play a pivotal role in helping women and girls who survive violence. For example, when two primary school girls were gang-raped coming home from school in April, the girls’ families reported the incident to the two community mobilizers, who then accompanied the girls to town for medical and legal assistance. FHI 360 works closely with these mobilizers, as well as two provincial hospitals, a faith-based organization and a community-based organization.

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  • Promoting male involvement in Uganda

    Since August 2012, the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) has partnered with FHI 360 to engage men in the prevention of mother-to-child transmission (PMTCT) of HIV and other family planning services in Uganda. The project, titled, “Promoting Constructive Male Engagement to Increase Use of PMTCT Services,” encouraged clients to seek HIV/AIDS care and treatment services at eight health facilities in the Kabale District of Uganda.

    Studies have shown that male involvement in PMTCT and other family planning activities can reduce the risks of vertical HIV transmission (mother-to-child) and infant mortality by more than 40 percent. Educating male partners about HIV in general and how it is transmitted is essential to successful, long-term approaches to eliminating HIV/AIDS. A 2008 study by the University of North Carolina at Chapel Hill and South Africa’s University of KwaZulu Natal found that male involvement in PMTCT was linked to more people taking advantage of HIV testing, antiretroviral treatment, condoms, and support for infant feeding choices. What’s more, some women say they need their partner’s support in order to access HIV prevention, care, and treatment services, including PMTCT.

    To encourage male involvement, team members from EGPAF and FHI 360 consulted with leaders in the Kabale district, including district health officials, civic leaders, religious leaders, politicians, and community groups to discuss matters related to gender and HIV and family planning. The community leaders then nominated well-respected men from their community to serve as champions (called “Emanzi” in the local language) and role models for their peers and lead discussions on gender and health issues in their communities.

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  • Focus on Education: To improve education globally we must end child marriage

    It seems remarkable that 11 October 2013 marks only the second time that the global community has come together to celebrate the International Day of the Girl Child. Has it really taken us this long to recognise that adolescent girls hold the key to building a healthier, safer, more prosperous world?

    The theme for Day of the Girl 2013 – ‘Innovating for girls’ education’ – highlights this link, and recognises that we are unlikely to address global poverty if we don’t enable girls to complete their education. The case is clear. Girls who complete secondary school earn significantly more as adults. They are more likely to know about and use reproductive health services. And the benefits spill over to the next generation as well: mortality rates of children whose mothers have at least seven years of education are up to 58% lower than those among children whose mothers have no education.

    Despite all we know about the benefits of education for girls, millions of girls miss out. Indeed, only 30 per cent of girls around the world are enrolled in secondary school. That is why on Day of the Girl 2013, we cannot ignore the practices that keep girls out of the classroom.

    Child marriage is a major barrier to progress on girls’ education. When girls marry as children, they usually drop out of school, forced to abandon schoolbooks for household chores. They are denied the opportunity to learn the skills that could help them earn a safe, dependable income as adults and which are necessary to build a sustainable and prosperous future for their communities. Every year approximately 14 million girls a year marry before they turn 18. While not all of them will drop out of school, most do. How can we get all girls in school, when child marriage keeps pulling them out?

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  • Women and girls: Beyond 2015

    We know what we can achieve.

    And we know what needs to be done.

    We know that improving access to family planning can reduce maternal and child mortality. Moreover, as long as women are unable to negotiate the number and spacing of their children, gains will be limited. We know that exclusive breastfeeding provides an infant the best start in life. Yet, evidence shows that a child born to a mother who has had access to quality education, especially secondary education, has a greater chance of surviving to see her fifth birthday than a child whose mother has no education. In countries around the world, we have reduced dramatically the incidence of HIV. Yet, gender violence and sexual exploitation will need to be addressed as part of the solution if we are to halt the spread of the disease.

    Last week, the United Nations General Assembly debated the post-2015 agenda, and it has never been more clear that women and girls must be top of mind in the global development discussion. Only when we transform unequal gender norms will we be able to tackle the world’s most pressing challenges. This means taking a broader approach than what we have done in the past by integrating gender concerns and putting women and girls front and center in every post-2015 priority.

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  • Efforts to prevent HIV must focus on gender equity

    The latest figures on HIV infections, as reported this week by the Joint United Nations Programme on HIV/AIDS (UNAIDS), revealed an impressive 33 percent reduction in new infections among adults and children since 2001. To continue down the road to success, future efforts must address the gender inequities that contribute to the disproportionate impact of HIV and AIDS on women and girls.

    More than half of the 35 million people living with HIV are women. In sub-Saharan Africa, almost 60 percent of people living with HIV are women. Young women between ages 15 to 24 are at highest risk of and most vulnerable to HIV infection. Closer to home, black women in the United States remain at high risk for HIV infection, and HIV-related illness is now one of the leading causes of death among black women between ages 25 to 34.

    Gender inequity is a key driver of the epidemic, making women more vulnerable to HIV in many ways.

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  • Gender integration: Making it a reality

    Why has there been so much emphasis on gender integration? What does gender integration really mean, and how is it done?

    Equal gender norms, roles and relations are key determinants of well-being across every aspect of human development. Gender inequality limits access to information, education, decision-making power, economic assets and health care. Women and girls are put at a great disadvantage because of unequal gender norms.

    Research, especially in the health and education fields, shows that when efforts are made to address gender inequalities, individuals, communities and societies benefit.

    At FHI 360, we use a Gender Integration Framework to provide practical guidance on how to analyze issues from a gender perspective and devise research and programs that identify and challenge gender-based inequalities that pose barriers to development.

    FHI 360 conducts trainings at our U.S., regional and country offices to give our staff and leadership the capacity to put the framework into practice. Gender specialists throughout the organization help ensure that our research or programs integrate gender considerations at all stages of the project cycle — from planning and design to implementation and measurement.

    This week in Tanzania, 28 technical staff from 17 FHI 360 country offices in sub-Saharan Africa and the Middle East will participate in our three-day gender integration workshop. The workshop will train these technical experts on how to use the framework and other tools and approaches in their day-to-day work. Participants will become Gender Focal Points, ensuring that gender remains front and center in our country and project offices.

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