Download Silenced and Forgotten

05
SILENCED and
FORGOTTEN
HIV and AIDS agenda setting paper for
women living with HIV, sex workers and
LGBT individuals in southern African
and Indian Ocean states
OPEN POLICY 05 Silenced and forgotten
Contents
03
Introduction
05
Context
08
Challenges and barriers to accessing HIV
and sexual and reproductive health services
and rights
10
Conclusion
11
Recommendations for key stakeholders
12
Endnotes
Acknowledgements
The Open Society Initiative for Southern Africa (OSISA) would
The Red Umbrella Namibia (TRU); SISONKE Botswana; and
like to thank the following activists, civil society organisations,
SISONKE South Africa.
other key stakeholders and individuals for their contribution to this
agenda setting paper:
African Men for Sexual Health and Rights (AMSHeR); Centre
for the Development of People (CEDEP); Coalition of African
Bomme Isago; Chrysalide; Circles of Hope (People living with HIV/
Lesbians (CAL); Friends of Rainka Zambia (FOR); Gays and
AIDS); Coalition of Women and Girls Living with HIV and AIDS
Lesbians of Zimbabwe (GALZ); Gender DynamiX; House
Malawi; Collectif Arc-en-ciel; Community of Women Living with
of Hope MARP; LAMBDA Mozambique; Lesbians Gays and
HIV/AIDS Lesotho; Family AIDS Caring Trust; Her Rights Initiative;
Bisexuals of Botswana (LEGABIBO); Matrix Support Group; Out
Rede de Mulheres Vivendo com VIH/Sida (Rede MWENHO);
Right Namibia (ORN); Trans Bantu Zambia (TBZ); True Identity;
International Community of Women Living with HIV in Zimbabwe
and Rainbow Identity Association.
(ICW-Zimbabwe); Namibian Women’s Health Network; Network
of Zambian People Living with HIV/AIDS (NZP+); Positive
Diane Cooper from the University of Cape Town’s Women’s
Women’s Network; Prevention Information Lutte Contre le SIDA
Health Research Unit, who as an OSISA consultant, co-facilitated
(PILS); SOLIDER; Stop SIDA Comoros (TAS); and Swaziland
the workshops and contributed towards the development of this
Positive Living (SWAPOL).
agenda; Dr Vicci Tallis, former OSISA HIV and AIDS Programme
Manager; Erin Stern, chief rapporteur at the meetings; and Caroline
African Sex Workers Alliance (ASWA) Regional; ASWA
Nenguke Phiri for the consolidation and finalisation of this paper.
Mozambique; ASWA Zimbabwe; Botswana Network on Ethics, Law
and HIV/AIDS (BONELA); CARE South Africa-Lesotho; Engender
We also thank UN Women, which generously provided funding to
Rights Zambia; Ministry of Health Swaziland; Sexual Rights Centre
enable the realisation of this document and possible action that will
(SRC); Sex Workers Education and Advocacy Taskforce (SWEAT);
actualise the recommendations agreed by the participants.
01
“The goal of the project was to build the
capacity of WLHIV, SW and LGBT groups
to develop a regional action plan to address
the specific and shared HIV and AIDS
challenges that continue to confront them ...”
02
The ution
Constit
Ch a r
Rights
H uman
Policies
Health
OPEN POLICY 05 Silenced and forgotten
ter
Introduction
The impact of the HIV and AIDS epidemic is felt hardest by the individuals
who are infected or affected by the disease, and in particular by individuals
who are especially vulnerable to HIV infection due to stigma and
discrimination, poverty, a lack of access to education, health and other
services that promote HIV awareness. However, the impact of HIV and AIDS
goes beyond the individual or household level – it affects nations as a whole.
In October 2010, UN Women issued a call for proposals to work with three
marginalised groups – namely women living with HIV (WLHIV), sex workers
(SW), and lesbian, gay, bisexual and transgender (LGBT) individuals – to
develop a regional advocacy strategy on HIV and AIDS. UN Women chose
the Open Society Initiative for Southern Africa (OSISA) to conduct the work.
03
T
he goal of the project was to build the capacity of WLHIV, SW and LGBT groups
to develop a regional action plan to address the specific and shared HIV
and AIDS challenges that continue to confront them in ten southern African
countries – Angola, Botswana, Lesotho, Malawi, Mozambique, Namibia,
South Africa, Swaziland, Zambia and Zimbabwe – and three Indian Ocean
states – Comoros, Mauritius and Seychelles.
Women living with HIV, sex workers, and LGBT activists and their allies
first convened in Johannesburg in 2011 to develop a joint regional advocacy
strategy. Three individual sector meetings were held in the first phase,
while a larger platform meeting bringing together all three sectors was
held in 2012.
At these meetings women living with HIV, sex workers, and LGBT
individuals identified HIV specific issues affecting them and drafted
agendas highlighting specific and shared issues that increase their
vulnerability to HIV and how they wanted these issues to be addressed by
both state and non-state actors. Delegates engaged in contextual analysis
of the issues affecting them in the environments where they live and work.
There was also a problem identification and defining process highlighting
the social-cultural and political challenges that affect them and increase
their vulnerability to HIV. In the build-up to the agenda setting, delegates
also embarked on the identification of supporters and detractors in relation
to issues and challenges affecting them. Key areas for action were then
identified and defined. It was agreed that any agenda on HIV and AIDS
for women living with HIV, sex workers and LGBT individuals needs to
address both the broader structural issues as well as the specific and more
localised challenges.
At the end of the community consultation process, OSISA analysed all the
inputs and all the issues raised and produced a list of recommendations for
three of the key role players – governments, civil society organisations, and
international donors and partners. The full list of recommendations can be
found at the end of this paper.
04
OPEN POLICY 05 Silenced and forgotten
Context
In 2010, an estimated 68 percent of all people
living with HIV resided in sub-Saharan Africa
– a region with only 12 percent of the global
population. AIDS has claimed at least one
million lives annually in sub-Saharan Africa
since 1998. Nearly half of all AIDS-related
deaths in 2010 occurred in southern Africa.
The region also continued to account for 70
percent of all new HIV infections globally.1
Despite these statistics, women living with
HIV, sex workers and LGBT individuals
remain marginalised and excluded from HIV
information, education and communication
(IEC). They are also often left out of treatment,
care and support programmes.
Most countries in Africa criminalise sex work
activities and same sex practices in one form
or another, either explicitly or latently. This
consistently leads to discrimination against
individuals who belong to these groups through
poor access to justice, inappropriate health care
services and stigmatisation – characterised by
their being blamed for driving diseases such as
HIV and other sexually transmitted infections
(STIs). Furthermore, the unwillingness of
state actors and stakeholders to engage in
meaningful dialogue and research regarding
sex work, gender roles and same sex practices
erects barriers towards appropriate and
effective policy formulation.
The lack of recognition, representation,
participation and engagement of these groups
further excludes them from important
national health programming and campaigns.
It also denies them their right to be accepted
as part of the community for which policies or
laws are formulated.
Women living with HIV and HIV & AIDS
Women living with HIV in southern Africa and
the Indian Ocean states continue to suffer grave
violations of their human rights. Women living
with HIV have had their right to reproductive
choice taken away, by denying them the right
to conceive and give birth. 2 Authorities in
many countries in the region continue to pay
lip service to cases of women living with HIV
being coercively and, in some cases, forcibly
sterilised. In Namibia and Swaziland, cases
of women living with HIV being subjected to
coerced sterilization have been documented
and litigated. In a recent landmark judgment,
the High Court in Windhoek found that the
Namibian government had coercively sterilised
three women living with HIV in violation of
their basic rights. 3
At the end of 2010, it was estimated that out of
the 34 million adults worldwide living with HIV
and AIDS, half of them were women.4 The AIDS
epidemic has had a unique impact on women,
which has been exacerbated by their role
within society and their biological vulnerability
to HIV infection. Generally, women are at a
greater risk of heterosexual transmission of
HIV. Biologically, women are twice as likely to
become infected with HIV through unprotected
heterosexual intercourse as men. In many
countries, women are less likely to be able to
negotiate condom use and are more likely to be
subjected to non-consensual sex. Additionally,
millions of women have been indirectly affected
by the HIV and AIDS epidemic. Women’s
childbearing role means that they have to
contend with issues such as mother-to-child
transmission of HIV. The responsibility of caring
for AIDS patients and orphans is also an issue
that has a greater effect on women in southern
Africa and the Indian Ocean states.
Incidents of violence against women (VAW)
– regarded as any ‘act of gender-based
violence that results in, or is likely to result
in, physical, sexual or psychological harm
or suffering to women, including threats of
such acts, coercion or arbitrary deprivation
of liberty, whether occurring in public or
05
in private life’ 5 – continue to escalate in
southern Africa and the Indian Ocean states.
In Zambia, Demographic Health Survey
(DHS) data indicates that 27 percent of evermarried women reported being beaten by
their spouse/partner in the past year – a rate
that rose to 33 percent for 15-19 year-olds
and 35 percent for 20-24 year-olds. Fiftynine percent of Zambian women reported
having experienced violence after the age of
15 (Kishor & Johnson, 2004). In South Africa,
7 percent of 15-19 year-olds reported having
been assaulted in the past year by a current or
ex-partner, while 10 percent reported being
forced or persuaded to have sex against their
will (South Africa DHS, 1998). 6
Violence against women increases their
vulnerability to HIV by limiting their ability
to negotiate safer sex practices. Women
may also be infected with HIV and other
sexually transmitted infections through
direct means of violence like rape. In South
Africa and other neighbouring countries in
the region, there has been a growing trend
of violence towards lesbian and bisexual
women by men who claim to be ‘curing’ the
women of their homosexual tendencies. The
attacks also extend to transgender people
and other gender non-conforming women.
These attacks are very violent and many of
them end up in death or permanent injury.
This form of violence has continued to make
lesbian and bisexual women and transgender
people more vulnerable to HIV and has been
a major barrier to them accessing sexual and
reproductive health services.
Cervical cancer is one of the leading causes
of cancer-related deaths among women in
developing countries, including southern
African and Indian Ocean states. Zambia, for
example, has the world’s second highest rate of
cervical cancer and deaths each year. Women
who are HIV-infected are 4-5 times more likely
to develop cervical cancer than women who are
not HIV-infected.7
06
Sex Workers and HIV & AIDS
Recent studies continue to confirm that in
many southern African and Indian Ocean states
sex workers experience higher rates of HIV
infection than most other population groups.8
For example, female sex workers have the
highest prevalence of HIV in Malawi at 70.7
percent.9 The Swaziland HIV Bio-Behavioural
Surveillance Study and a Qualitative Study
among Most At-Risk Populations, which was
conducted by Population Services International
in conjunction with Johns Hopkins University in
the United States, showed that HIV prevalence
among sex workers stood at 70.3 percent.10
Violence and discrimination against sex
workers, police raids, incarceration, and a
lack of accessible and relevant information,
evidence-based prevention tools and
treatment services compromise the ability of
sex workers living with HIV to protect their
health and receive adequate care, treatment,
and support. Migrant sex workers who are
living with HIV are particularly excluded
from access to treatment and care due to
xenophobia and other barriers. Transgender
sex workers seeking transgender-specific
health care and gay male sex workers seeking
non-judgmental health care are similarly
neglected in most of the region. 11
In cases where interventions targeted at sex
workers do exist, these are often confined
solely to female sex workers who have sex
with male clients with none targeting male or
transgender sex workers.
LGBT individuals and HIV & AIDS
For same sex practising people in southern
Africa and the Indian Ocean states, like
in other parts of the globe, HIV and AIDS
research and programming has focused on
men who have sex with men rendering other
same sex practising individuals invisible in the
HIV and AIDS picture.
OPEN POLICY 05 Silenced and forgotten
The belief that women who have sex with
women are at no or low risk of HIV infection
has led to the exclusion of women who
have sex with women from HIV prevention
efforts, access to health care services,
education, treatment and research (Gomez,
1995; Stevens, 1993 as cited in Montcalm
and Myer, 2000; Hughes and Evans, 2003;
Teti et al., 2007; Gay Men’s Health Crisis,
2009). Specific groups of women are more
affected by this exclusion than others, such
as women who have sex with women and are
living with HIV, including those who do not
identify themselves as lesbian or bisexual
(Young et al., 1992; Marazzo, 2000; Arend,
2003; Shisana and Louw, 2007; Lenke and
Piehl, 2009). This social exclusion is in many
respects informed by gender inequities
inherent in almost every country of the
world. For this reason, any HIV prevention,
treatment and care programme for women
who have sex with women must work from
the premise that access to knowledge and
services on health is disproportionate
for women and men in a context where
gender inequities persist (Doyal, 1995;
Lorberm, 1997). 12
There is also a widespread misconception,
characterised by exclusion from research or
focus, by both women who engage in same
sex relations and other stakeholders that
women who have sex with women are not
at risk of HIV and AIDS. In a 2002 study
conducted by the Human Science Research
Council (HSRC) in South Africa, 13 percent
of lesbian women (aged 15–49) self-reported
a positive HIV test result. While this rate
is lower than seroprevalence rates for
heterosexual South African women, it still
represents a substantial number of people for
whom no targeted HIV prevention, treatment
or care services currently exist. 13
Same sex practising women in southern
Africa and the Indian Ocean states – and
in South Africa in particular – continue to
experience sexual violence in the form of
rape, and this form of violence increases
their vulnerability to HIV and AIDS and
is an infringement of their sexual and
human rights.
In southern Africa and the Indian Ocean
states today, transgender people continue
to remain at the margins of HIV and AIDS
programming, their needs and issues are
under researched and health programing
for transgender people is usually integrated
into programming for men who have sex
with men. The marginalised position of
transgender people can have serious effects
on their quality of life. Overall, high HIV
infection rates, inaccessibility of health
services, high incidence of sexual violence
and murder, and vulnerability to societal ills,
such as substance abuse, can all potentially
reduce the life expectancy of transgender
people in Africa. 14
In the context of the global AIDS epidemic,
sex between men is significant and
throughout the course of the global epidemic,
consistently high levels of HIV infection
have been found among men who have
sex with men. However, in many southern
African and Indian Ocean states, men who
have sex with men are – like other same sex
practicing people – less visible. Same sex
relations are stigmatised, officially denied
and criminalised in most of these states.
Most governments and societies in the
region continue to refuse to acknowledge
the existence of same sex practising people
in their countries, although research done in
southern Africa, the Indian Ocean states and
other parts of Africa proves otherwise. As a
result, HIV prevention campaigns often only
talk about the risks of heterosexual sex and
there is little or no appropriate information
available for LGBT individuals. This gives a
false impression that they are not at risk and
serves to justify their exclusion from HIV and
sexual and reproductive health services.
07
Challenges and barriers to accessing HIV and sexual and
reproductive health services and rights
During the workshops and consultative
meetings conducted by OSISA, representatives
from the women living with HIV, sex worker
and LGBT sectors came up with a list of
barriers to accessing services and challenges
to attaining a holistic and human rights based
approach to HIV and AIDS programming in the
region. The challenges below are a collective
summation of the issues presented by the three
groups. However, in some instances, where
indicated, a particular group faces a specific
challenge or set of challenges that may not
necessarily affect members of the other groups.
Research and knowledge
•Lack of evidence based and targeted
research outlining the situational needs of
women living with HIV, sex workers and
LGBT individuals.
•Research ethics boards not wanting to
approve research on sex work and LGBT
individuals citing laws, culture, religion and
morals for their rejection.
•Lack of recognition of lesbian women and
transgender people as groups that are
vulnerable to HIV and AIDS.
•National research is neither inclusive nor
specific as evident in national demographic
health surveys that exclude sex workers and
LGBT individuals.
•Exclusion of women living with HIV,
sex workers and lesbian, bisexual and
transgender individuals from vital research
around microbicides, reproductive cancers,
HPV vaccines and contraceptives.
Legal frameworks and access to justice
Most countries in the region have laws that
criminalise same sex conduct and sex work
activities. Even if such activities are not explicitly
outlawed, penal codes based on so-called
08
‘morality’, criminalise sexual relations that
are regarded as ‘immoral’, ‘indecent’ or ‘crimes
against the laws of nature’ and so forth.
•Criminalisation of HIV transmission, sex
work and same sex relations also occur in
some countries – these laws are usually
structured to target women living with
HIV, sex workers and LGBT individuals
who are wrongfully labelled as ‘drivers’ of
the epidemic.
•Poor access to justice – reports of violations
of the rights of women living with HIV, sex
workers and LGBT individuals are often not
investigated or taken seriously by both state
and non-state parties.
•Lack of protective policies and their
implementation – where policies exist to
mitigate and address the HIV and AIDS
epidemic, they often exclude women living
with HIV, sex workers and LGBT individuals.
•Lack of freedom of association and expression
– some groups, such as sex workers and
LGBT groups, are often unable to register as
legal entities and are therefore denied legal
status, which deprives them of the liberty
to collectively demand both their rights and
tailor-made sexual and reproductive health
and HIV and AIDS services.
•Lack of legal recognition of gender identity
– transgender people cannot access identity
documents in their chosen name and
identity, which negatively impacts on their
access to services and justice.
Access to health
Health service delivery systems do not recognise
the diverse rights of women living with HIV, sex
workers and LGBT individuals. Health service
providers also lack training and sensitivity to
the specific HIV care, treatment and support,
and sexual reproductive health needs and rights
OPEN POLICY 05 Silenced and forgotten
of women living with HIV, sex workers and
LGBT individuals – thereby making health care
centres potential sites of exclusion, physical and
emotional violence.
•Health service delivery systems
discriminate against women living with
HIV, sex workers and LGBT individuals
and lack a human rights based approach to
service provision.
•Post Exposure Prophylaxis (PEP) is not
always accessible to women living with
HIV, sex workers and LGBT individuals
who have survived rape and other violence
against women.
•Emergency contraceptives are not always
accessible. Women living with HIV, female
sex workers, lesbian and bisexual women,
and transgender men who seek them are
often blamed instead of being assisted by
health professionals.
•Health care services do not often cater to the
specific needs of women living with HIV, sex
workers and LGBT individuals.
Access to information and education
•Lack of tailored Information, Education and
Communication (IEC) material for women
living with HIV, sex workers and LGBT
individuals.
•Lack of inclusive campaigns on sexual and
reproductive health and rights affecting
women living with HIV, sex workers and
LGBT individuals.
•Sex workers, LGBT individuals and
women living with HIV lack the space,
representation and participation within the
information and education arenas to give
legitimate voice to their communities.
•The media is often discriminatory, nonobjective and biased, evidenced in its lack
of – or negative – coverage of issues related
to women living with HIV, sex workers
and LGBT individuals, which further fuels
stigma, discrimination and prejudice against
them; increases their vulnerability to HIV;
and makes it even harder for them to access
HIV and AIDS services.
•The media lacks the knowledge, sensitivity
and skills needed for objective reporting
on the sexual and reproductive health
and rights of women living with HIV, sex
workers and LGBT individuals, which leads
to these groups being denied access to the
media as a critical tool for advocacy.
•The education system does not embrace
a culture of diversity and is therefore not
cognisant of the specific issues affecting
women living with HIV, sex workers and
LGBT individuals and has been used to
perpetuate intolerance.
Movement building and strengthening
The prevailing legal, cultural, social and religious
contexts are major obstacles to movement
building and strengthening for women living with
HIV, sex workers and LGBT individuals.
•Lack of recognition, representation and
meaningful participation of women living
with HIV, sex workers and LGBT individuals
and groups leads to exclusion from national
health programming and campaigns.
•The marginalisation of women living with
HIV, sex workers and LGBT individuals
and organisations by the broader human
rights, health and social movements impedes
movement building and strengthening.
•Lack of effective capacity building and
organisational strengthening strategies leads
to unsustainability and may lead to perpetual
dependency on external support.
Resource allocation and mobilization
•There is a lack of national government
funding for women living with HIV, sex
worker and LGBT organisations with most
of them not being included in country health
programme budget allocations. In cases
where funding does exist, the allocations
are very minimal and insignificant.
09
•Limited availability of and access to funds for women living with HIV,
sex worker and LGBT groups and organisations.
•There is a lack of core support for women living with HIV, sex
worker and LGBT individuals and organisations, which leads to
organisations being understaffed and inadequately resourced with
key staffing skills and this negatively impacts on the execution of
programmatic interventions.
•Limitations are imposed on activities by having to fit in with a funding
driven programmatic and strategic approach that may not respond to the
needs of women living with HIV, sex workers and LGBT individuals.
Conclusion:
Development programmes work best when
they reflect local realities and respond to both
rights violations and lack of access to services.
Basic and ‘beyond basic’ needs programming
should be planned together from intervention
design, with a clear step-by-step process to
move from one to the other. A rights-based
approach to programming is crucial for the
achievement of long term and sustainable
empowerment of marginalised groups.
While the vulnerability of marginalised groups
is widely acknowledged, the mechanisms that
drive this vulnerability and the measures that
will address them are not coherent. Most laws
that increase their vulnerability are ‘morality’
based and not evidence or human rights based.
In this regard, policies need to be all-inclusive
and laws – rather than being punitive, abusive
or enabling of abuse and discrimination –
should be protective of vulnerable people.
Formulated laws and policies must also be
complementary rather than contradictory.
There are a number of actions that can be
undertaken in order to reduce the burden of
the epidemic among women. These include
promoting and protecting women’s human
rights, increasing education and awareness
among women, and increasing access to
preventative technologies such as post-exposure
prophylaxis and microbicides. Evidence
10
and experience show that providing AIDS
programmes and services to those who are most
at risk can be hugely beneficial to a country’s
fight against HIV and AIDS. Yet key affected
groups in the global AIDS epidemic such as
women living with HIV, sex workers and
LGBT individuals are all too often neglected
by governments, broader civil society and
international donors. Stigma and cultural
intolerance of same-sex relations and sex work
are largely to blame and until these issues are
addressed it will be difficult to make headway
in reducing HIV infection levels among these
vulnerable groups. In turn, this will hinder
the wider global fight against AIDS. Attacking
stigma and discriminatory practices, whether
based in law or not, will serve to empower
marginalised groups to more effectively inform
themselves about HIV and facilitate access to
testing, prevention, treatment, care and support.
To ensure the response to the HIV epidemic
among marginalised groups is appropriate,
it should be based on a wide range of quality
evidence concerning, among other things,
behavioural and epidemiological trends, human
and legal rights, and programme monitoring and
evaluation. Furthermore, such activities should
involve a wide variety of people, including
affected communities, governments, the private
sector, nongovernmental organisations, and
international partners and organisations.
OPEN POLICY 05 Silenced and forgotten
“policies need to be all-inclusive and laws
– rather than being punitive, abusive or
enabling of abuse and discrimination – should
be protective of vulnerable people.”
Recommendations for key stakeholders:
Governments should:
•Review and repeal all laws that implicitly or explicitly criminalise
HIV transmission and sex work, and where applicable enforce
protective laws that already exist to end the marginalisation
and exclusion of women living with HIV, sex workers and LGBT
individuals.
•Enact and implement laws and policies that create an enabling
environment and ensure equal access to health and justice services.
•Invest in restructuring and capacity strengthening of health care
delivery systems to respond to the specific health care needs of
women living with HIV, sex workers and LGBT individuals.
•Hold perpetrators of violence against women living with HIV, sex
workers and LGBT individuals accountable for their crimes and
enforce stiffer punishments.
Civil Society should:
•Advocate for laws/clauses in constitutions and other legislation that
prohibit discrimination of any kind based on an individual’s sex, gender,
sexual orientation, HIV status, choice of profession or any other status.
•Advocate for evidence based health programing that reduces HIV
transmission and protects the sexual and reproductive health and
rights of women living with HIV, sex workers and LGBT individuals.
•Work with the media to respect and uphold the sexual and reproductive
health and rights of sex workers, women living with HIV and LGBT
individuals by objectively reporting on issues
•The media should uphold ethics and strictly adhere to codes
of conduct as prescribed in various national, regional and
international instruments.
•Ensure mutual and meaningful partnerships exist between all social
movements, particularly with women living with HIV, sex worker and
LGBT movements.
11
UN Women should:
•Urge governments to repeal punitive laws, like the criminalisation of
HIV transmission, sex work and adult consensual same sex relations.
•Ensure that programming on violence against women includes
women living with HIV, sex workers and LGBT individuals.
Donors and International Partners should:
•Fund and support the transformation of the public health service
so that it responds to the specific HIV treatment, care and support
needs of women living with HIV, sex workers and LGBT individuals
•Ensure that funding for vital research around microbicides,
reproductive cancers, HPV vaccines and contraceptives includes
women living with HIV, sex workers, lesbian and bisexual women,
and transgender people.
•Provide core support to women living with HIV, sex worker and
LGBT organisations in order to enhance their development and
strengthen movement building, and to ensure their equal and
meaningful participations in programming policy formulation.
Endnotes
1. UNAIDS world AIDS day report 2011
2.http://www.osisa.org/hiv-and-aids/namibia/they-took-my-choice-away
3.http://www.osisa.org/hiv-and-aids/namibia/namibia-coercively-sterilised-hiv-women
4.http://www.unaids.org
5. Declaration on the Elimination of Violence against Women, Article 1, 1993
6. As cited in sexual and gender based violence in Africa (2008), a literature review by Population Council
7. Zambia leads in early cervical cancer detection, treatment; Kristie Mikus (PEPFAR) Country Coordinator, Zambia.
8. The UNAIDS 2008 Report on the Global AIDS Epidemic.
9. UNGASS Country Progress Report (2010) ‘Malawi HIV and AIDS Monitoring and Evaluation Report: 2008-2009’
10.http://www.osisa.org/hiv-and-aids/swaziland/shocking-hiv-rate-among-swazi-sex-workers
11.http://www.soros.org/reports/rights-not-rescue
12. Cloete, A., Sanger, N. & Simbayi, L.C. (2010) Are HIV positive women who have sex with women (WSW) an unrecognized and neglected
HIV risk group in South Africa?. Journal of AIDS and HIV Research. 2(8):Online.
13.http://www.iglhrc.org/cgi-bin/iowa/article/publications/reportsandpublications/4.html
14. HIV & Transgender Identity – Towards Inclusion and Autonomy, A position paper developed by 19 Transgender activists from an African
Exchange Program: Online (http://www.genderdynamix.co.za/content/view/519/199/)
12
www.unwomen.org
In July 2010, the United Nations General Assembly created
UN Women, the United Nations Entity for Gender Equality and
the Empowerment of Women.In doing so, UN Member States
took an historic step in accelerating the Organization’s goals
on gender equality and the empowerment of women. The
main roles of UN Women are to support inter-governmental
bodies in their formulation of policies, global standards and
norms; help Member States to implement these standards
and to forge effective partnerships with civil society; and
hold the UN system accountable for its own commitments
on gender equality. For many years, the UN faced serious
challenges in its efforts to promote gender equality globally,
including inadequate funding and no single recognized driver
to direct UN activities on gender equality issues. UN Women
was created to address such challenges. It will be a dynamic
and strong champion for women and girls, providing them
with a powerful voice at the global, regional and local levels.
Grounded in the vision of equality enshrined in the UN Charter,
UN Women, among other issues, works for the elimination
of discrimination against women and girls; empowerment of
women; and achievement of equality between women and men
as partners and beneficiaries of development, human rights,
humanitarian action and peace and security.
www.osisa.org
The Open Society Initiative for Southern Africa (OSISA) is a
growing African institution committed to deepening democracy,
protecting human rights and enhancing good governance in
southern Africa. OSISA’s vision is to promote and sustain the
ideals, values, institutions and practice of open society, with
the aim of establishing a vibrant southern African society, in
which in which people, free from material and other deprivation,
understand their rights and responsibilities and participate
democratically in all spheres of life.