Addressing gender norms and inequities is essential to reducing HIV risk and increasing access to services for everyone. Gender-related disparities are the result of biological, structural, and cultural factors. Stigma and discrimination can also impede access to HIV services and hamper efforts to effectively control the epidemic. (See Box 1: Key Affected Populations)
This fact sheet describes the newly updated PEPFAR gender strategy, describes PEPFAR’s central gender initiatives, and highlights key results from PEPFAR activities to address gender and HIV/AIDS. .
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PEPFAR’s Gender Strategy focuses on five key areas:
To respond to emerging evidence and programmatic needs, PEPFAR released an updated Gender Strategy in December 2013. The strategy is designed to help programs recognize the critical role gender norms and inequality play in the HIV epidemic, ensure equity in access to HIV programs and services, and take concrete steps to respond to the unique needs of different populations. It emphasizes the importance of understanding the needs of populations whose sex (women and girls), gender identity (transgender persons), sexual orientation (lesbian, gay and bi-sexual populations—LGBT), and/or sexual behavior (men who have sex with men, sex workers) make them vulnerable to HIV.
S/GWI-PEPFAR GBV Small Grants: In order to support small, grass-roots civil society organizations that respond to GBV, PEPFAR and S/GWI have partnered to provide over $4.6 million in new small grants for countries with a PEPFAR presence. These grants address a range of GBV issues, such as strengthening legal and judicial systems, reducing stigma, and enhancing prevention efforts—all of which work to address the drivers of both GBV and HIV.
Saving Mothers, Giving Life (SMGL): A five-year public-private partnership to rapidly reduce maternal mortality in Sub-Saharan Africa, where many of these deaths occur. In its first year, SMGL districts in Uganda and Zambia reported significant decreases in the number of maternal deaths through the implementation of life-saving interventions that make high quality, safe childbirth services available and accessible to women and their newborns. In the first year of this initiative, the report found that maternal deaths dropped by 30 percent in the districts in Uganda and by 35 percent in the facilities in Zambia where the partnership has been implemented.
Together for Girls (TfG): A global public-private partnership dedicated to ending violence against children, with a focus on sexual violence against girls. TfG generates comprehensive national-level data, led by CDC, on the magnitude and consequences of emotional, physical and sexual abuse against children, which provides the foundation for action, mobilizing countries to lead a response and inform solutions that are evidence-based and supported by Together for Girls’ global partners.
Visit our page on Public Private Partnerships for more information about PEPFAR partnerships.
In Tanzania, 27% of girls and 12% of boys experience sexual violence during childhood. PEPFAR is working closely with the government to integrate comprehensive GBV programming into existing HIV platforms. For example, the community home-based care program Tutunzane (“Let’s take care of each other”) works to sensitize communities about GBV and assist GBV survivors and people living with HIV with medical care and psychosocial support through regular home visitations. As of February 2012, Tutunzane was providing home-based care to nearly 30,000 people living with HIV/AIDSvii. Also, close to 2,000 people received post-exposure prophylaxis through PEPFAR supported programs in 2013, up from 187 the previous year.
In addition to addressing the negative health consequences of GBV, significant efforts are being made to move the GBV response beyond the health sector. With the support of Together for Girls, a PEPFAR-supported global public-private partnership, Tanzania has made impressive strides in developing a national child protection system. Following the completion of a Violence Against Children Survey, led by CDC, the government has launched a multi-sector national action plan and implementation is underway. To date an estimated 4,000 social welfare officers, community development officers, primary school teachers, health workers, police and district justice officials have been trained on child protection.
The impacts of these programs are being felt broadly. At a workshop in February 2014, Tanzanian Deputy Minister for Justice and Constitutional Affairs, Ms. Angela Kairuki, applauded PEPFAR for supporting the government efforts to address GBV. The Deputy Minister cited GBV’s impact on health outcomes for women and children and called upon the media to assist the public in understanding the laws and policies in place to protect people against GBVviii
In collaboration with United Nations partners, the Global Fund to Fight AIDS, Tuberculosis and Malaria, civil society, government representatives, service providers, and USG implementing partners, PEPFAR is working to ensure that gender issues are addressed and integrated throughout all HIV programs. You can view a number of newly developed resources online, including a Compendium of Gender Equality and HIV Indicators.
i World Health Organization. 2013. “Gender inequalities and HIV.” http://www.who.int/gender/hiv_aids/en/.
ii The Global Coalition on Women and AIDS, WHO. “Violence against women and HIV/AIDS: Critical intersections, intimate partner violence and HIV/AIDS,” 2004.
iii Baral S, Sifakis F, Cleghorn F, et al. “Elevated risk for HIV infection among men who have sex with men in low- and middle-income countries 2000-2006: A systematic review.” PLoS Med. 2007 December 1;4(12):e339.
iv Baral S, Poteat T, Strömdahl S, Wirtz A, Guadamuz, T, Beyrer, C. “Worldwide burden of HIV in transgender women: a systematic review and meta-analysis.” The Lancet Infectious Diseases. 2013 March (Vol. 13, Issue 3, Pages 214-222) DOI: 10.1016/S1473-3099(12)70315-8.
v UNFPA. “Ending widespread violence against women.” http://www.unfpa.org/gender/violence.html.
vi WHO and UNAIDS. 2013. “16 Ideas for addressing violence against women in the context of the HIV epidemic: A programming tool.” http://apps.who.int/iris/bitstream/10665/95156/1/9789241506533_eng.pdf.
vii Fleischman, Janet. 2012 July. “Gender-Based Violence and HIV: Emerging Lessons From the PEPFAR Initiative in Tanzania”. http://csis.org/files/publication/120709_Fleischman_GenderBasedViolence_Web.pdf.
viii Athumani, R. 2014 February 12. Tanzania: 'Enlighten people on gender violence'. Retrieved from Tanzania Daily News website: http://allafrica.com/stories/201402120053.html
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