Globally, the 1st of December is observed as World AIDS Day. It’s an opportunity for people to unite globally in the fight against HIV, show support for people living with HIV, and commemorate the lives of those who have passed away from an AIDS-related illness.
Adolescent girls, young women (AGYW) and young gender-diverse people in Eastern and Southern Africa are among the key populations most affected by and vulnerable to HIV transmissions. According to UNAIDS, in 2020, women and girls accounted for 50% of new infections; in sub-Saharan Africa, six in seven new HIV infections were among adolescents aged 15–19 years among girls; and around 4200 AGYW and young gender-diverse people aged 15–24 years became infected with HIV every week. Young women aged 15–24 years are twice as likely to be living with HIV as men. As a result, global strategies and commitments must acknowledge AGYW and young gender-diverse people’s experiences and vulnerabilities.
UNAIDS has declared the theme for 2022 World AIDS Day “Equalize”. The slogan is a call to action aimed at prompting collective efforts to work for the proven practical actions needed to address inequalities and end AIDS as a global health threat.
Gender inequalities are one cause of the spread of HIV. It increases transmission rates and reduces the ability of women, girls and gender-diverse people to cope with the pandemic and access prevention, treatment and care services. Girls, women and gender-diverse people often have less information about HIV prevention and treatment options and access to other sexual reproductive health and rights services and information. They face barriers to protecting themselves from unsafe sex, because of unequal power dynamics with men.
Bahati Thomas Haule, a feminist activist who is passionate about raising awareness about the vulnerabilities and experiences of girls and women living with HIV, shared her reflections for World AIDS Day.
“HIV disproportionately affects AGYW and young gender-diverse people in Eastern and Southern Africa. They account for six out of seven new infections.
If we are to successfully ‘equalize’ to end HIV as a global health threat, leaders and stakeholders need to think about where and how they have failed AGYW and young gender-diverse people and why they are still disproportionately affected and vulnerable to HIV transmissions. Equalizing means ending gender and other inequalities; ending gender-based violence; protecting AGYW and young gender-diverse people’s human rights and bodily autonomy; ensuring that girls have equal access to education; eliminating barriers to healthcare and basic services; increasing access to information; and ensuring that AGYW and young gender-diverse people have access to prevention, treatment, care and other sexual reproductive health services.
Leaders and stakeholders are not just obligated to solve the problem, they also have the capacity and power to create sustainable changes. They need to think about what has worked, and what hasn’t and create the interventions from there. Leaders need to look at policies and laws and ask themselves how they might contribute to the problem or undermine the issues that perpetuate the growing health pandemic. They also need to look at what resources are available and ask how they can use and direct them in the best ways to double up on meeting targets and protecting AGYW and young gender-diverse people.
I strongly believe that intersectional feminist approaches are important if we are to have a fighting chance at meeting targets to end the HIV crisis and protect AGYW and young gender-diverse people. It is important that as feminists; we continue to highlight the gendered consequences of the HIV crisis and fight for gender-transformative interventions, programs, policies, and laws. A lot of HIV interventions and programmes do not prioritise or even acknowledge that the pandemic thrives in the face of gendered and other inequalities. This does not mean that feminists or AGYW and young gender-diverse people should carry the burden of ending the crisis.
If we think of our problems, goals and inequalities in isolation, then we can’t achieve sustainable changes. We also can’t leave it to specific organisations like UNAIDS, WHO or The Global Fund to end the HIV pandemic. Governments, communities, leaders, civil society organisations, institutions in the private sector and individuals need to form partnerships and work in collaboration. If we work together, then we can collectively create local, regional and global strategies and sustainable changes. We can reach more people. We will have more resources, skills and knowledge to draw from. Partnerships and collaborations should involve people at every level. It’s been three decades since the pandemic began spreading across the world. However, it does not look like the end is in sight.
It is important to remember that everything starts from the ground and that all interventions and programming should be led from a community and grassroots level. Civil society is important because they are government and stakeholders’ connection to the people. So, civil society must be constantly evaluating what is happening, what needs to be done, who is not getting the support they need and whose needs are not being met. They can’t do that if they are not deeply connected to the communities, they intend to serve. As a result, civil societies should not just be community-based, they also need to be community-led.
Partnerships, collaborations, interventions, and programming won’t be successful if we do not bring it to an individual level by thinking about how each of us contributes to sustaining inequalities, stigma, and discrimination. Everyone needs to take a step back, recognise and address their hypocrisies, and think about if and how they have contributed to creating or maintaining barriers to accessing services or making progress.
The importance of partnering and collaborating with AGYW and young gender-diverse people is often overlooked. They are the people most affected, vulnerable and already mobilising at a grassroots level. They have lived experience and are connected to those who are most affected.
Partnering and collaborating with AGYW and young gender-diverse people means ensuring that they are meaningfully engaged. They need to be involved and consulted in designing interventions, programmes, laws and policies from the beginning; distributing resources; implementing interventions and programs; making decisions locally, regionally and globally; and monitoring and evaluating programmes, interventions, policies, laws, and outcomes. They need to be supported by those who are in power by creating opportunities for them to lead; participate; share their experiences and knowledge, and be put in leadership positions that are conducive to their participation.”
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Bahati Thomas Haule is a Tanzanian feminist activist who is passionate about raising awareness about the vulnerabilities and experiences of women living with HIV. She is the programme officer at Dignity and Wellbeing of Women living with HIV Tanzania, a member of the International Community of Women Living with HIV Eastern Africa and a community representative at the African Community Advisory Board. She is also on ATHENA’s Young Women’s Governance Board