Mercy Global Concern - 2003

EMPOWERING GIRLS TO BEAT THE RISK OF HIV/AIDS

The WHO (World Health Organization) said in 1995, "Prevention (of HIV infections), particularly as it relates to the vulnerability of female adolescents and younger girls, should be accorded the highest priority in national strategies." In 2002, the UN General Assembly Declaration of Commitment on HIV/AIDS said,"...in particular, girls are the most vulnerable." It is now 2004 and where is the improvement?

Exposure to HIV infection represents a gross violation of girls' rights, guaranteed by the Convention on the Rights of the Child and other international commitments. These rights include non-discrimination, health, education, participation, protection from abuse and exploitation.

I. FACING THE FACTS: HIV/AIDS IS TAKING A HEAVY TOLL ON GIRLS

The rate of girls' infection is rising at an alarming rate worldwide. It has already surpassed that of boys in sub Sahara Africa and is rapidly closing the gap in other regions.

Of the 40 million people worldwide living with HIV/AIDS, over 50% are women, and 50% of all new HIV infections are among young people aged 15-24. Of these, almost two thirds are girls. In some countries in sub-Sahara Africa, new infections are five times higher for girls than for boys aged 15-19.

The Caribbean shows alarming increases in the rate of girls' infection: in Trinidad and Tobago, it is 5 times that of boys; in Jamaica it is twice that of older women. In Latin America, the overall male/female ratio is rapidly closing. In South Asia, where prevalence rates are lower overall, India and Nepal are showing disturbing increases among girls and women.

Where there is no direct HIV data about girls, related evidence of unprotected sex indicates high risk. For example, about 40% of pregnancies in Latin America and the Caribbean occur among girls aged 10-19. In some Indian states, up to 85% of prenatal clinic visits are from young women below age 20.

II WHAT PUTS GIRLS IN THE PATH OF HIV/AIDS?

Cultural dictates and skewed power relations make girls vulnerable to HIV infection.

The simple act of unprotected sex is the most direct and immediate cause. But centuries of social, economic and cultural practices, expectations and demands imposed on girls are also important causes.

Poverty is a fertile breeding ground for HIV/AIDS. It can endanger girls' access to health services, to good nutrition and deny their right to education. Poverty exposes girls to HIV through sexual exploitation in harmful work settings, such as domestic labor and factories.

I understand the importance of using condoms, but I have no income. I have three younger sisters, two brothers and a mother with tuberculosis to take care of. When a business man from China offered me money to have sex without a condom, I agreed. He told me he had Aids and that if I were a virgin, he would be cured.
15 year old girl from South Asia

A disproportionate share of household burdens fall on girls who are orphaned or whose families are living with AIDS. They are pulled out of school to work or to care for affected families; they lose future opportunity for gainful employment and are often forced to survive through providing sex for money or food.

Physically, girls are more vulnerable to HIV than boys or adult women. Their body structures allow the virus to penetrate more easily and they are more susceptible to STIs, which greatly increase the likelihood of HIV infection when they go undetected.

Girls in many societies have no power to protect themselves from rape, incest and other forms of sexual violence, especially in situations of armed conflict. Married or unmarried, they are powerless to refuse sex or negotiate condom use. They are often unprotected, by laws, policies and practices of governments. Communities, schools and families also often fail to protect them.

Girls are socialized to be chaste and submissive at the same time. This increases their risk of HIV both through sexual compliance and reluctance to communicate their need for safe sex or for information or services, especially when they are married. Pregnant girls are at risk of infection not only for themselves but their babies.

DRAWING TO GO WITH THIS; LET'S TALK

Age Mixing: If there's a single common behaviour and risk factor among girls in all regions, it is the widespread practice of having "sugar daddies," sexual relationships with older men. For girls, this means self-worth, protection, economic support, and stability, that include survival, school fees or a new life style. For men, young girls are desirable and compliant.

"We do not have 14-year-old girls sleeping with 14-year-old boys. No, the girls sleep with men who are over 30. They do it out of poverty, to get food to eat." A social worker from South Africa. The greater the disparity in age, the greater the risk if HIV for girls.

All girls are at risk to HIV, but particular populations of girls are at special risk.

III. EMPOWERING GIRLS TO BEAT THE RISK OF HIV/AIDS.

WHAT DO GIRLS NEED

• EDUCATION
• LOVE, SUPPORT AND RESPECT FROM THEIR FAMILIES AND OTHER ADULTS
• PRODUCTIVE SKILLS AND GAINFUL WORK
• SAFETY, PRIVACY AND PROTECTION FROM VIOLENCE ABUSE AND UNWANTED SEX
• RESPECT AND FRIENDSHIP FROM THEIR MALE AND FEMALE PEERS
• PARTICIPATION IN DECISIONS ABOUT THEIR OWN LIVES
• A ROLE IN SOCIAL CHANGE
• CONTROL OVER THEIR OWN BODIES

HOW CAN WE MAKE IT HAPPEN?

There is no one-size-fits all approach to prevent HIV/AIDS. Ensuring girls a safe journey to adult womanhood requires uncompromising commitment, whole-hearted partnerships, new ideals of masculinity and femininity, resources, and making girls "the highest priority in national strategies."

NGOs already play a critical role in helping girls reduce their risk of HIV/AIDS. We advocate with governments, mobilize communities, provide services, form coalitions, raise awareness and resources and include girls and boys in all efforts we undertake on their behalf. But we can and must do much more.

1. PUT GIRLS ON THE DATA MAP

Girls are regularly ignored in publications and discussions about gender and HIV. They are hidden in data about "young women" ages 15-24, and appear as afterthoughts in the phrase "women...and girls." For younger girls (and boys), data is rare relating to actual or risk of HIV infection.

Girls' needs are also subsumed in the gender neutral 'children' and 'adolescents.' Increasing UN agency and other risk assessments or programs for young people are often based on boys as the norm.

An urgent task for all, NGOs, academic and research institutions and governments, is to identify the situation of girls. This includes developing and disseminating data about all girls - rural and urban, in and out of school, girls who are pregnant, and girls from aged five to age 18. Girls should be involved in collecting and analyzing and disseminating data and in evaluating programmes on their behalf.

2. DEVELOP AND USE LEGAL FRAMEWORKS TO PROTECT GIRLS

Rampant rape, incest and other forms of sexual violence put girls in the direct path of the deadly HIV virus. Few laws protect them; those that do are often ignored. Girls are afraid to report rape and trafficked girls are often treated as criminals.

NGOs should join together in coalitions to urge governments to pass, strengthen and enforce laws and policies that protect girls and their rights. These laws should raise the age of marriage for girls to 18 (guaranteed by the CRC), prohibit virgin testing, and other cultural practices that violate girls rights and expose them to HIV.

NGOs can promote laws that impose stiff penalties for adult men who violate adolescent and young girls; require girl-friendly training for police, judges and other law enforcement officials. Policies and programs to prevent abuse and provide services should be in place. Girls should be supported to give testimony, prepare data and work with NGOs to advocate for new laws and policies.

3. BUILD PARTNERSHIPS WITH THE MEDIA TO PROMOTE SOCIAL CHANGE

The media is an effective instrument for social change. NGOs can form partnerships with media to promote behaviour change and create new norms of masculinity and femininity Messages from sports or other celebrities and government officials, can portray men who abuse girls as weak. Media can show girls as leaders and boys and men as faithful boyfriends, husbands and nurturing parents. Girls should actively participate in planning, writing, producing media activities.

4. ENSURE ECONOMIC EQUALITY AND OPPORTUNITY

Affirmative economic action is critical to level the playing field for girls. NGOs can advocate for laws that equalize inheritance rights and promote policies that provide marketable skills and opportunities for girls. They can promote flexible school hours and establish partnerships with the private sector to provide skilled job training and education for working girls.

5. MOBILISE AND PROVIDE EDUCATION - SKILLS AND KNOWLEDGE

Being in school helps girls reduce their vulnerability to HIV. NGOs should continue to advocate for increasing their attendance, especially in secondary school, where the gender gap is especially high. Education is the best counter to misinformation and the best means to provide girls with the skills knowledge and opportunities to live their lives free of HIV/AIDS.

NGOs can raise awareness and advocate for safety, curricula and training that promote quality education, HIV and reproductive health information and life skills for girls in schools. They can disseminate convincing evidence-based messages to parents and policy makers that timely and relevant sex education, including frank discussions among families, produces delay and safe sex, not experimentation and promiscuity.

NGOs can campaign for reproductive health and sex education programs in primary school. Research notes that they have the greatest impact when offered prior to the onset of sexual activity.

NGOs can pressure school authorities to provide teachers with training to help them to be better informed, more comfortable with sex education and sensitive to the needs of girls.

Holistic approaches often prove more effective than a direct or single-minded focus on HIV. NGOs should see to it that school-based life skills programs give equal time to girls' needs, for example developing their negotiating skills, promoting respect by male peers and parenting classes for both boys and girls.

NGOs have a special expertise and responsibility to reach out of school girls - often isolated and at highest risk. Targeting programs to their specific needs might include providing street girls with food, shelter and services before approaching them with information about HIVAIDS.

Young female factory workers in Thailand did not recognize their own risk because they were 'not sex workers.' A successful peer education program began by talking about daily lives, gender roles and images before moving to protection from HIV. Among the Innovative strategies used by the World Association of Girls Guides and Girl Scouts were a romance novel about a young female factory worker who becomes infected with HIV and a comic book about an invisible flying condom that helped girls discuss condom use with boyfriends.

Girls must take part in designing, implementing, monitoring and evaluating programs. Let us ask girls what they want, listen to their answers and incorporate them in our organizations as participants, leaders and partners.