Impact of HIV/AIDS on Women and Girls: hearings

Meeting report

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

Chairperson: Ms P Govender (ANC)

Documents distributed:
Presentation by AIDS Legal Network: HIV/AIDS & Law Reform: Reducing the Impact on and the Vulnerability of Women and Girl Children
Report by SpeakOut: HIV/AIDS and Sexual Violence
CASE Survey of HIV/AIDS Service Organisations

SUMMARY
The Committee continued their public hearings on HIV/ AIDS. The AIDS Legal Network focused on the failure to recognise pre-existing social and economic conditions that increase women’s vulnerability to HIV/AIDS and the need to address the gaps in the existing legal network.
The organisation, Speak out!, emphasised the increasing incidence of rape of young children and girls and the need for effective rape care, including post-exposure prophylaxis (PEP).

MINUTES
AIDS Legal Network
The presentation by Mary Caesar, National Co-ordinator: AIDS Legal Network, is the product of research with women’s organisations, provincial workshops and community based organisations addressing the challenges of HIV and AIDS in respect of women. It focuses on the failure to recognise pre-existing social and economic conditions that increase women’s vulnerability to HIV/AIDS and the need to address the gaps in the existing legal network. Recommendations were made concerning mother-to-child transmission of HIV; Rape and HIV; access to medical treatment for HIV+ women; age of consent for marriage; the unemployment insurance act; female circumcision and the need for female officials in correctional services. The ALN said that there is a need for government to train those who are implementing the laws and a need to recognise that the realisation of socio-economic rights goes beyond the right to vote.

Discussion
Ms Magazi (ANC) asked what was meant by a comprehensive policy on HIV/AIDS. As a legislator she believed that the government has a clear, broad policy on HIV/AIDS. Concerning rape offenders, there are mechanisms are in place. Organisations like POWA, WOWA, Dumela AIDS etc do the work of counseling women, and clinics immediately call police so that the statement is taken at the same time as the examination. She believed the police themselves to be adequately trained to council and to deal with rape victims.

The ALN responded that in spite of the issuing of policy guidelines, implementation is dependent on the budget of a particular province. The example of the Western Cape was used, where five HIV/AIDS projects are in place, while in the Eastern Cape, despite guidelines, those structures are not in place. Reliance on NGO’s was not enough, this was a government responsibility. Further clarity was needed to address the shortcomings of acts. There is a need to explore enforcement mechanisms to enable women to access any rights embodied in a particular legislation. For example, Domestic Violence required services, such as shelters, to be in place.
One Member commented that female circumcision needs to be further investigated. Is it taking away the rights of that person or is it a traditional practice that cannot be removed? The ALN agreed that this is an emotive issue. While it was not possible to totally ban the practice, procedures need to be examined to allow for the possibility of regulating the practice from a public health perspective.

Another Member was impressed by this report. She called for further research on prophylaxis in rural areas, remarking on the unavailability of clinics. A criticism was launched by another Member, who questioned the necessity of further investigations. It is necessary that all service providers receive training to administer these drugs, but where were these drugs? What kind of testing was being done to test effectiveness of PEP (post exposure prophylaxis)?

The ALN admitted that there was a possibility that the proposal for post-exposure prophylaxis would be refused as this would have to happen at the state’s expense. Nonetheless training was underway. In rural areas work is being done with employers to provide for access to PEP’s in their workplace policies, as well as other community support options. Testing of PEP’s did not seem ethical, for example giving half of a sample of twenty women treatment and not treating the other half. However, groups of health care workers who sustained needle-stick injuries were being treated successfully with PEP’s.

SPEAKOUT!
A non-profit, voluntary organisation of rape survivors, victims of violence, and others who are HIV+. It sets up seminars intended to train and equip all members of communities to deal with sexual violence and the prevention and management of HIV. SPEAKOUT advises several institutions on effective rape care, including post-exposure prophylaxis (PEP). Charlene Smith spoke about the war on AIDS. A child who becomes HIV+ after being raped is likely to die within eight to eighteen months because of the weakening of the immune system due to post-traumatic stress. Figures around PEP research showed that the administration of treatment within 72 hours resulted in a zero infection rate. This is a once off cost of R1400, as opposed to the cost of treating HIV over a long period. The lifetime cost is R648 000. Reference was made to the Medical Research Council report on the appalling condition of rape care centres in Gauteng. Clinics are closed from 4pm till 8am, the time when most rapes happen. The increasing incidence of rape amongst children was alarming, with the major cause of death of girls from 16 to 18 years was through HIV contracted during rape. An example was given of the gang rape of a 16-year-old girl. She was continually treated for opportunistic diseases, never HIV, and died after the seventeenth court appearance, after which the suspects were released. Charlene Smith ended with a quote by Thabo Mbeki, ‘One rape is one rape too many’, and she said it is the children of the revolution who are dying of AIDS.

Discussion
Ms Sono (ANC) asked how accessible SpeakOut and Charlene herself is, as well as how much access they have to other areas. A Member recommended that PEP be administered to the whole family for three months. Another Member raised the issue of male rape in prisons, saying that prisoners awaiting trial were a major source of HIV infection. The disease must be fought inside as well as outside. Ms Sophie Maine (ANC) said that there was a need to recognise what was being done. It is necessary then to account for local and national gaps in the campaigns and to ask why the necessary things are not being done in these structures? A Member asked what the impact of dealing with AIDS is, against the current statistics.

Ms Smith responded that remarkable work was being done in the communities, but there is a lack of willingness to share findings. There is a need to look at the maximum that can be done with the minimum funds. A culture of voluntarism should be encouraged. There is a need to look at HIV/AIDS as related to sexual violence, and to come up with cutting edge solutions. SpeakOut advocates treating everyone, 1000 prisoners died of HIV last year, R54 million was spent on prisoners with HIV. There is a need for a multi-disciplinary approach. Counseling after rape is not sufficient. There is a need to educate children before rape happens, conflict resolution should be taught in schools, for example. She referred to the role played by the media in sexual violence as completely irresponsible in use of phrases such as ‘death sentence’ when referring to HIV+ diagnosis. She said it was also necessary to acknowledge the work being done. South Africa has some of the best researchers in the world, for example those working on the vaccine for sub-type –C at the MRC, which was not being sufficiently funded or recognised. Bombardment with statistics only led to despair, but that there is hope in the good work being done. She concluded by recommending that each Member should go for an HIV test, as an act of solidarity with their communities, and ‘nothing focuses the mind like an AIDS test’.

Ms P Govender raised the critical issue of the budget, in light of the non-renewal of government support for SpeakOut. She highlighted the committee’s three key priorities: HIV/AIDS, poverty, and violence against women to guide budget choices, against unsustainable donor funding.

The Medical Research Council did not present to the committee as scheduled. A fax from Prof Malegapuru Makgoba was received saying that owing to ‘urgent and unforeseen circumstances’ he would be unable to keep the appointment. Several members expressed their dissatisfaction at this.

The meeting was adjourned.