Impact of HIV/AIDS on Women and Girls: hearings

Meeting Summary

A summary of this committee meeting is not yet available.

Meeting report

JOINT MONITORING COMMITTEE ON THE IMPROVEMENT OF QUALITY OF LIFE AND STATUS OF WOMEN

JOINT MONITORING COMMITTEE ON THE IMPROVEMENT OF QUALITY OF LIFE AND STATUS OF WOMEN
28 September 2001
IMPACT OF HIV/AIDS ON WOMEN AND GIRLS: HEARINGS

Chairperson: Ms P Govender (ANC)

Documents handed out:
- DTI presentation on HIV/AIDS: the DTI Quality of Worklife unit
-
Preliminary Report: The National Children’s Forum on HIV/AIDS
- Department of Education Presentation: Engendering the Budget
-
The HIV/AIDS Crisis in Africa (WHO presentation)

SUMMARY
The purpose of the meeting was to hear evidence on the impact of HIV/AIDS on women and girls, and South Africa’s response. Presentations were made by representatives from the Department of Trade and Industry, the World Health Organisation, the Joint Monitoring Committee on Improvement of Quality of Life and Status of Children, Youth and Disabled Persons, the Women’s Health Project, the Department of Education and the Campaign for Sexual Rights. Each presentation drew out certain issues around the impact of HIV/AIDS on women and girls. Particular issues which were repeated were the link between violence against women and the spread of HIV/AIDS, women’s subordinated position in society which affected their ability to negotiate their position in sexual relationships and their concomitant inability to negotiate condom use, and in general the fact that women’s continuing marginalisation, economic and socio-political, had a negative impact on efforts to contain the spread of HIV/AIDS. Due to time constraints, not all of the presenters were able to answer questions, and it was agreed that written responses would be sought at a later date.

MINUTES
Department of Trade and Industry
The Department of Trade and Industry presentation was delivered by Mr Kasakwala and Ms Dlamini. They explained the details of the DTI’s HIV/AIDS unit, established last January as well as the new Gender Office. However, the representative from the Gender Office was not present to answer questions.

Questions
Q. Where is the program for HIV/AIDS located?
The program has an office within the national department, which has a staff complement of one psychologist and two psycho-metrists. However, the psychologist has recently resigned and the position is in the process of being filled.

Q. With regard to the Gender Office, there seems to be an apparent contradiction between the pursuit of an integrated approach, and the creation of a separate office for gender issues.
The Gender Office is new, as indicated in the presentation, and it will work hand-in-hand with the Human Resources division. At the moment most of the work being done is on the study and analysis of data, but from the beginning there has been a recognition that not integrating gender issues into the mainstream would not be advisable. Consequently, there is an ongoing attempt to strengthen the links between the Office and the Human Resources staff.

Q. How is the program going to assist MP’s to help the communities?
We have an office which deals with external relations, and they are busy engaging with stakeholders through executive board meetings in each of the provinces. The focus at the moment is on sensitising the communities towards the work of the DTI, and at present there is no link with HIV/AIDS. However, I will advise them to look into this.

Q. How many people are targeted by the Quality of Worklife Unit?
The entire DTI staff is targeted, so the number is 1200 people.

Q. Does the Gender Office have a focus on sexual harassment, given the link between sexual violence and HIV/AIDS?
The issue is examined, and the internal focus at the moment is on implementing a sexual harassment policy. We can also recommend that the office look at creating programs to increase awareness of the issue.

Q. The department’s policy seems to revolve around education. Are there any practical measures involved, such as the provision of anti-retrovirals, home-based or hospice care etc?
We would like more information on what exactly the comprehensive integrated program for HIV/AIDS is. For example, does it look at employee medical aids?
At the moment, it is mainly counselling which is offered. At the moment, no official has ben identified in the department as someone that is HIV positive. We are engaged in assessing the medical aid schemes of staff to make recommendations in relation to AIDS cover. There is a related problem in that many of our staff are living in debt, and this has implications for their ability to afford quality medical aid cover. We are taking steps to address this. We have also asked the Department of Health for a medical practitioner to be seconded to the department, to deal with all primary healthcare issues.

Q. Can you provide some more information on the program with Eskom, as well as information on the costs involved?
The partnership with Eskom is brand new and still being pursued. I am not aware of the status and focus of the Eskom program, but can provide feedback.

Q. Can you provide us with information regarding the impact of HIV/AIDS on the economy?
We concentrate on the issue of job creation in line with our mandate, as well as incentives for job creation etc. The preliminary study we conducted looked at the financing of existing incentive programs for HIV, at that stage (earlier this year) no programs existed, but we have advised that they be developed.

Q. In terms of investor incentives etc., to what extent is HIV included in the definition of social responsibility programs?
I am not sure how these programs impact on HIV but I can advise the committee at a later date.

Q. The government won its court case against the pharmaceutical companies and this was expected to lead to more affordable medications for HIV/AIDS. What is the status of the negotiations for example between the department and the World Trade Organisation? How is South Africa taking the issue forward?
Negotiations are set for November, and I can keep the committee informed about any developments.

Q. What is South Africa’s position in these negotiations?
My understanding is that the issues are around the implementation of the Act, and we are seeking to implement parallel importation of medications to reduce costs, as well as the compulsory disclosure by pharmaceutical companies, as the most important matters.

Q. How are the community outreach programs reaching the communities, are they accessing the rural areas and are the counsellors committed?
My focus (Ms. Dlamini) is with the Quality-of-Worklife unit. However, there is an initiative by the Department of Health to involve all government members engaged in HIV issues to discuss their projects etc. The DTI needs to be transformed to shift its focus from the economy to people, in order to successfully address HIV/AIDS. Other departments, such as Social Development, do not have this difficulty since they are consciously focussed on people all the time, therefore community outreach is easier for them. The thinking is that the Gender Office will take the lead in outreach programmes. The focus of the Quality of Worklife unit is on people in the workplace, although we recognise that when dealing with HIV/AIDS, the family is included. At the moment, our efforts in this regard have been directed at raising money for charities by, for example, selling AIDS pins and ribbons.

It was agreed that any further questions would be submitted for a written response.

Joint Monitoring Committee for the Improvement of the Quality of Life and Status of Children, Youth and the Disabled
The presentation was made by the chairperson of the committee, Ms H Bogopane. She noted that the request had been for an overview of the influence of HIV/AIDS on girls. Children were particularly vulnerable and that the number of orphans constituted a national emergency. AIDS raised issues around the needs and rights of affected children, both those who became infected and those who were abandoned or orphaned.

In terms of infected children, she said that the major cause of infection in children below the age of thirteen was mother-to-child transmission (MTCT). Risk of transmission was affected by various maternal conditions, such as the viral load of the mother. In developing countries, the illnesses seen in infected children are the same as in other children, but that they are more frequent, severe and persistent. They are also not usually present at birth. There were also a number of children who had been infected through sexual activity. This is reflected in the fact that the highest rate of infection is in females between 15 and 29 years old. The reasons for this related both to biological factors as well as the fact that women, and girls in particular, were less in control when it came to sex. She explained that various health practices in Africa contributed to infection rates, although these were more rare in South Africa. These included traditional health practices such as circumcision and female genital mutilation, as well as inadequate disposal of medical waste.

The kinship and extended family has traditionally provided support for children, particularly orphans. But this support system has been eroded due to urbanisation, the migrant labour system and in general the fragmentation of families fostered by economic realities. As a result, at a time when the extended family was the most needed, it was not available.

Girls were the most likely to leave jobs, and children in general were having to assume economic responsibilities and care for the sick. Girls in particular were entering the labour market earlier, getting married earlier and leaving school earlier. She also suggested that the majority of abandoned children were girls, although accurate information was not readily available. There had been an increase in the number of adolescent and grandparent headed households, and many children were faced with caring for their dying parents. She also indicated that one issue which had come across in the forum (see documents) was that children did not like being labelled AIDS orphans, as this increased stigmatisation. This had raised a debate over who had the power to attribute such labels to the children. There was also evidence that AIDS was producing younger orphans, many of whom were in poor health and malnourished. They were also more likely to not have been immunised and to receive inadequate healthcare.

Girls in particular are also increasingly vulnerable to prostitution, although there have been increases in the reported cases of sodomy recently. While there are no figures for child prostitution in this country, the estimated figure worldwide was that 1 million girls (i.e. between the ages of thirteen and 18) were involved. However, there are indications that the average age of these girls is decreasing, and the youngest girls involved are as young as nine years old. These children are also further marginalised because they lack access to educational facilities. Child abuse is linked to increased risk of HIV infection as well as prostitution, and eighty percent of abused children are girls, 55 percent of whom are under the age of ten. Ms Bogopane also indicated that only seven percent of incidents of abuse are by strangers. World-wide, there has been a growing awareness of child abuse as a factor in the spread of AIDS.

Some suggested reasons behind the increased vulnerability of children to HIV infection through sexual contact are the ‘prevention theory’ and the ‘cleansing theory’. The first myth involved is the belief that all sexually active people have AIDS, therefore to prevent oneself from getting AIDS, it is only safe to have sex with children. The cleansing theory is the belief that AIDS can be cured by having sex with a virgin. Mentally disturbed girls are particularly vulnerable in this regard. Another belief is that AIDS must be spread to all sectors in society, and this includes children. Domestic workers, many of whom are young girls, are vulnerable to sexual exploitation, particularly since many of them live on the premises and they are in relatively powerless positions in society. Street children are another category vulnerable economically and emotionally. Deaf girls are vulnerable because of the lack of reporting facilities and their inability to access information about HIV/AIDS. Blind girls are also vulnerable, since they cannot identify their abusers. And girls with psychiatric illnesses are vulnerable because there is a tendency to not believe them, as a result of their condition. Ms Bogopane also drew attention to the issue of anti-retrovirals for people with Down’s syndrome and epilepsy, saying that due to the large number of medications which they were forced to take, anti-retrovirals were not an acceptable method to combat HIV/AIDS for this group of people.

On the subject of children, Ms Bogopane made a few general comments. She said that when children lose their mothers in particular, they became vulnerable to some of the things outlined in the presentation, such as economic hardship, health problems and abuse. The Children’s Forum (see documents) had emphasised the role that poverty plays in HIV/AIDS. The children also reflected the fact that there was a lack of respect for their privacy, particularly by healthcare workers, and inadequate concern for their right to disclose, reflecting their lack of power generally. She also said that, in the schools, the teachers were insufficiently trained to deal with children affected by HIV/AIDS. The issue of poverty re-emphasised the basic needs of children, and the forum indicated that children needed support, economic as well as emotional. There was also a call for home-based care, to avoid the stigmatisation of institutional care and ease the burden. Ms Bogopane pointed out that her committee could only bring these issues to the attention of Parliament, and seek to promote the Convention on the Rights of the Child. She emphasised that the labelling of AIDS orphans was a human rights issue, closely linked to stigma issues, and the effects of this needed to be debated.

Ms Govender suggested that the issue was not just one of poverty but also of power relations in society, particularly as they affected women. She again asked that questions be written, as there was not enough time to answer questions in the meeting, as MsBogopane had another engagement.

World Health Organisation
Dr Shasha presented some ideas on HIV in Africa. he said that the report he had written did not include all the statistics, but that he would supply the committee with them if it was required, at a later stage. He proceeded to draw attention to certain aspects of his report. He said that the key difference between HIV/AIDS and other communicable diseases was that this disease had a stigma attached to it. Despite South Africa’s success in dealing with most communicable disease, and here he made reference to polio, measles, TB, cholera etc., HIV/AIDS continued to spread at a rapid rate. He said that stigma prevented disclosure as well as led to marginalisation of people with AIDS. Stigma is evident in the family and work contexts as well as in the wider social arena and the community. He recommended that other ways be sought to monitor the spread of the disease, since the statistics were often skewed due to non-disclosure. One potentially contentious suggestion from Dr Shasha was that a way be sought to make the disease notifiable, without causing people harm i.e. by ensuring that no-one aside from perhaps medical staff were aware of their status.. He stressed that this was not an official view of the World Health Organisation, but his own personal view. He cited Cuba as an example of a country where the disease was notifiable and people were then given access to treatment. He also said that the UN took the view that discrimination against PWA’s was on a par with all other forms of discrimination and was viewed very seriously.

With regard to the government’s role in fighting the disease as well as the stigma, he said that the issue of testing for leaders should be re-examined. He suggested that the members of the committee take the lead in going for a test and counselling, to help and promote awareness and challenge the stigma. He said that companies also needed to be encouraged to take the lead in encouraging testing, and raised the possibility of tax incentives to facilitate this. He did indicate that South Africa was not far behind in efforts to deal with MTC transmission, since most countries in the WHO were at the experimental stage in this regard. He suggested that successful development of a MTC program opened the door for other initiatives involving anti-retrovirals. Another area touched on was the use of traditional healers, which he said had potential, as was demonstrated by Burkina Faso which had had some success with traditional healers treating certain symptoms etc. He also recommended that the Urban Renewal Plan and the Integrated Sustainable Rural Development initiative should incorporate and aspect of HIV/AIDS awareness and response, to improve the situation in the country.

Questions
Q. With regard to the notification issue for statistical purposes, we do perhaps need some system to ensure anonymity, but I think that the person should be made aware if they are HIV positive, so that they can seek treatment.
If it was agreed upon, I feel you could have a number that people could phone to request the information, or some similar thing, so that they could request treatment. Obviously, it would be important to ensure confidentiality.
A member also supported the call for the committee to engage in testing, and suggested this to the chairperson.

A member of the education department present at the meeting was allowed to ask a question.:
Q. You said that 90 percent of transmission was due to sex, but your prevention strategy focusses on MTCT, which accounts for only 7 percent.
The approach is purely strategic, firstly to save children. This reflects society’s soft spot for children.

Q. How is it that people are prepared to undergo testing for insurance and there is no stigma attached?
When I was tested for insurance, I went to get the results and the nurses said they couldn’t find them, and then they turned around and carried on chatting. This illustrated to me the fact that testing is a particularly frightening thing, because the stakes are so high. I agree that we could learn from insurance companies. For example, would it be unreasonable to ask people their status before allowing them entry to our country?

Q. In situations such as persist in much of Africa where there is poverty, what are the implications of poor nutrition for the taking of anti-retroviral cocktails?
I have not talked about anti-retrovirals, merely that they be researched twelve months after the MTC programs are up and running. I also stressed that development is a general and necessary first step.

Q. You indicated that much of the infection rate is due to sex. Can you give us an indication of how much of this is due to sexual violence, particularly rape. What are the implications for young girls? We’d like a bit of a breakdown here.
I don’t have that information available, but I can try to access some for the committee.

Q. Has there been any WHO research into the use of prophylactics in cases of rape?
I don’t know that the World Health Organisation has an official policy, but I think that many countries are doing this.

Q. With regard to Cuba, can you give us an indication of the type of treatment given after people make their status known?
I would not like to answer that, because I don’t know the names of the medications, which are different over there in any case.

Q. Can you at least inform us as to whether or not they are anti-retrovirals?
That is what I was told.

Q. Have you gone through the report from the Presidential Advisory Committee? There are two groups evident there, one being the dissidents. If this position is accepted, what are the implications for treatment, since accepting that there is no viral cause means that anti-retrovirals are not necessary? Does the World Health Organisation have a position on the implications of the implications that the dissidents views have for policy?
In Durban, I met some of these dissidents and I gave them a piece of my mind. I said they are confusing our leaders, and asked why they don’t go home and confuse their own leaders. I think the dissidents should be ignored, and the government has said that it is making policy as if the dissident’s views did not exist. I heard the president on the radio in Europe discussing the virus, and got excited because he was admitting that there was a virus. All that remains is for the leaders to publicly state that the normal view holds true. I feel that the issue has now been left behind.

Q. I hear your point on the dissidents, but would suggest that as long as you have democracy, you will always have diverging views. To return to the issue of poverty, I think the question was more about how can you take anti-retrovirals on an empty stomach.
I’ve been to several countries in Africa, and I can tell you that the poverty there is not worse than that in some parts of South Africa. poverty is the result of an imbalance in resource distribution. It is this inequity which needs to be addressed. HIV is not a poverty disease, but this influences the control of the disease. I’m from the Eastern Cape, and there is inequity there which is absolutely amazing. To me, that is the problem. We had said that malnutrition was due to Apartheid. But it persists after the change of government - why? The rural development initiatives are seeking to address this.

At this point the chairperson asked for written answers to any further questions. The meeting was adjourned for tea.

Department of Education
The representatives present were the Chief Director for Education - Human Resources and the Ministerial Adviser on HIV/AIDS.

The Chief Director said that HIV/AIDS was a key priority, being one of the five key priorities within the department. The department identified ‘champions’ for each of these priorities, and the ‘champion’ for HIV/AIDS was Ms Mogome, who was the only one of the five to be selected from outside the department, as a reflection of the importance attached to the issue of HIV/AIDS. The focus of the presentation was to be on the steps being taken to deal with AIDS, with a focus on the engendered approach.

Ms Mogome stated that she would attempt to draw out certain issues in the department’s response. She started by saying that the core business of the DoE was to provide education, build skills and inculcate values and in so doing develop citizens of South Africa with increased access to opportunities. The response to HIV/AIDS is therefore in line with these core objectives. She went on to say that the DoE had a unique opportunity to turn the tide in the fight against AIDS because research has indicated that learners enter the school system HIV negative and leave HIV positive, and for this reason HIV/AIDS has been identified as a priority in the department’s Tirisano project. She said that a two-pronged strategy had been developed, on dealing with the education system as a whole and the impact of HIV on that system, the other dealing with the beneficiaries of the system i.e. the learners.

HIV and learners
HIV and life skills are part of the curriculum, in line with Curriculum 2005. In terms of this it is mandatory for all classrooms and all schools are required to have a life skills teacher and life skills are an examinable subject. The program focusses on sexuality education (including gender role orientation), self-awareness and empathy skills (including enhancing self-esteem), communication and interpersonal relationships, critical and creative thinking to enable an understanding of society and the social context, coping with emotions and stress and decision-making and problem-solving.

For girls, and educators are trained in this, there is education around the body and how it works (because there are indications that this understanding can help girls make informed choices), skills for analysing situations and evaluating risks, skills for extricating oneself such as negotiation, and peer education such as girls fora and clubs to turn peer pressure into a positive force. Ms Mogome also said that there were efforts to ensure that learner material was gender sensitive and highlights the issue of respect, and guidelines had been developed which ensured this. She also said these guidelines were available for the committee.

AIDS and the Curriculum
AIDS is to be integrated across the curriculum and educators were to be provided with guidelines for this. Programmes are being developed to deal with early childhood and learners with special needs, all other areas having been dealt with since 1998. The DoE is working with the South African University Vice Chancellors Association (SAUVCA) to develop programmes for higher education as there was a need for a comprehensive program to protect graduates as a valuable resource for the country. The DoE also supported the inclusion of HIV into pre-service training curricula at tertiary institutions.

HIV/AIDS and Learners in Distress
This project is concerned with the establishment of strategies for the identification and support of vulnerable children and or orphans. This was to ensure a comprehensive provision of education. There was a need to facilitate access to support and care services, and the primary school nutrition program formed part of this. This project also deals with the development of guidelines for educators in dealing with vulnerable children. There was also a need to re-communicate the SA Schools Act and the DoE HIV/AIDS policies to educators and managers to ensure that no child is excluded from educational opportunities. The final priority in this regard is to ensure that schools are safe havens for children.

AIDS at work
Many people who work for the department are affected by AIDS or infected with the disease. The HIV/AIDS policies for CS Educators and Public Service Employees has just been finalised, which provides direction in this regard. A workplace programme has been developed and adapted for the school environment. It entails a life-skills program similar to the one outlined above. The aim is to assist educators to deal with their beliefs, values and sexuality and it highlights gender and relationship issues. It also draws attention to the role of male and female educators as role models and providers of support, and is linked to other initiatives within the department dealing with the issue of professionalism. Emergency guidelines have been produced and distributed to all educators. The DoE was also engaged in providing training on participatory methods and how to teach sexuality education, linked to the in-service programme in the provinces.

HIV/AIDS and the System
It is recognised that there is a need to stabilise the system and soften the blow of HIV/AIDS to ensure that there is a continued provision of education and in this regard, the issue of absenteeism of both staff and learners is being looked at. The DoE is developing tools and planning models to facilitate analysis and understanding of the impact of HIV/AIDS on the education system. There are also moves to align legislation, policies and strategies (in conjunction with the Department of Public Service) to ensure the impact of HIV/AIDS is included. There is a need to improve the monitoring and evaluation systems as well as to establish dedicated capacity (in the form of units) to develop capacity and responses at the national and provincial levels. Ms Mogome highlighted the fact that there was a need to create enabling environments so that the system acted as an enabling environment for those with HIV/AIDS as well as ensure that people remain HIV negative. It was recognised that there is a need to strengthen family, parent and school governing body components so that they understand the issues involved in HIV/AIDS. The issue of the safe school environment is also receiving attention, with zero tolerance for rape and abuse in an attempt to make schools areas of minimal risk for HIV infection. Related to this was the need to ensure that communities supported the schools. Key policies in this regard include those governing sexual relations between learners and educators as well as discrimination. The legislation that deals with this is specifically the Schools Act and the Constitution.

The Budget
The budget for HIV/AIDS in the DoE comes from the HIV/AIDS conditional grant. R300 million is divided between the three social departments: social development, health and education. Education receives 50 percent of this budget, or R 150 million. Other funding for HIV/AIDS initiative within the department comes from the core budget.

Progress
So far, all nine provinces are implementing the curriculum-based program. There has been an effort to infuse HIV/AIDS and sexuality issues into sports, arts and cultural activities. The safe schools program is gaining momentum. And there has been an improvement in collaboration between the government and NGO’s. There has also been good collaboration with SAUVCA. Guidelines for the workplace are another area which has seen satisfactory progress.

Challenges and Strategies
One challenge has been the different implementation levels across the provinces. This has been addressed through the national department’s strengthening of monitoring and support capabilities to allow earlier detection to circumvent problems. Another area of concern has been the enforcement of national policies and legislation on the ground. To deal with this, a policy support and monitoring directorate has been set up to ensure implementation as well as to empower those who suffer due to for example abuse by teachers. Attention is also being directed towards developing the capacity to implement the policies of the department.

Conclusion
HIV/AIDS dictates non-traditional responses, and to this end, the department recognises the comparative strengths of the NGO’s. The desired behaviour changes as well as coping with trauma need supportive environments. There is a recognised need to attack the problem from all angles, and an integrated approach is felt to be the one which is the most promising.

The issue of engendering the budget was also dealt with briefly. It was indicated that the focus within the DoE has until now been on engendering policies. For this reason, very little had been done on engendering the budget. It was suggested by Ms Govender that the committee could assist the DoE in this regard, as they had experience with the National Budget. This was acknowledged and accepted because there was a feeling that the DoE did not have sufficient experience. Ms Govender again recommended that all questions be submitted for written responses.

The Sexual Rights Campaign
Ms____ from the Campaign for Sexual Rights addressed the committee and asked for its support. The objectives of the campaign are to display information about sexual rights everywhere and to speak publicly about sexual rights, a task which she asked the members of the committee to engage in. The campaign is a strategy developed by six NGO and advocacy groups. It builds on the idea of sexual rights, which had been expressed at the Fourth World Conference On Women, in Beijing in 1995. The aim was to seek open discussion about sex and in this way to challenge HIV/AIDS and violence against women. The presenter indicated that over the years there had been a strong correlation between sexual violence, coercion and violence against women. She also stressed that it was not necessary to engage in comparisons with other countries, but for example saying that South Africa had one of the highest rates of violence against women. This obscured the issue, since any violence against women is unacceptable.

She presented a range of statistics, among them that forty percent of reported rape cases are girls eighteen years and younger, two-thirds of youth pregnancies are unplanned and sixty-four percent of youth have their first sexual experience at age eighteen or younger. She suggested that the fact is that youth are having sex, irrespective of whether or not they have received sex education, and therefore objections to sex education are not justifiable. The campaign reflected a recognition that existing strategies to combat the spread of AIDS have been unsuccessful and it was necessary to make revisions.

Activities
the campaign focusses on training trainers and conducting sexual rights workshops to identify and take up community-specific actions to promote sexual rights. This was done to take into account the different reasons why condoms, in particular, were not being used in the communities. The campaign is also engaged in advocacy, addressing national and provincial decision-makers. It also aimed at identifying priority actions to promote sexual rights among the police and justice sector, the health sector, the education sector and among the youth.

Questions
- It seems we are doing a lot of things with little effect. I think we should investigate other possible routes. Are we going to press ahead with little effect?
- In some of the communities A-B-C is well known, but failing. Maybe, as you are dealing with this on a daily basis, are there any suggestions coming from the communities?
- Can you comment on what is being done in Swaziland? (From Dr Shasha)
- Related to the effectiveness of A-B-C, if we analyse what we are dealing with, it is fundamentally about the morality of society. Overall, we are facing a degeneration in the moral fibre of society, and HIV can’t be viewed in isolation from this. Aren’t there other things which aren’t working which influence the failure of A-B-C. Are we cutting ourselves of from the realities?
- the reality is that unequal power relations and sexual violence play a role in the spread of HIV/AIDS. The aims of the Sexual Rights Campaign include reforming masculinity. This has been shown to be a big gap - how do you address the issue of men’s responsibility?
The campaign realises that principally, you cannot tell people what to do. A-B-C is a top-down approach which ignores certain factors for example gender. The A-B-C strategy is effective but we need to look at why people aren’t doing this and what are the reasons behind not taking advantage of it. for example, in a workshop, you see that many men don’t support or want to live in a society which encourages violence. When gender roles are unpacked there is a recognition of the link between gender roles and violence, and hopefully this leads to change. However, often these roles are unexamined in everyday life. Older women also contribute to the subjugation of younger women, and I know of one older woman who said to her daughter-in-law during the course of a workshop that women are only there to provide food and sex for men. But generally, we are seeing that people are prepared to change, when they understand. With regard to society’s degeneration, it is a fact which the campaign recognises and addresses in the workshops. People recognise the need to improve the situation, for their children. The smaller groups we use in our workshops encourage a more positive outlook. The workshops also serve to recognise the strengths of the community in this regeneration. As for the code of dress in Swaziland, if they think that strategy will work, let them try it.

Ms Govender added that the issue of Swaziland could be addressed more strongly, since it raises fundamental issues about who has the right to decide how girls should dress. It also reflects an assumption that it is only the virginity of girls which is of concern.

At this point, she drew the meeting to a close.

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