Shortcomings of current prevention strategies

Current HIV/AIDS prevention strategies commonly promote monogamy, fidelity and condom use, in connection with morality and religion (such as the ABC strategy which stands for Abstinence, Be faithful and Use Condoms). Since these strategies have failed to address the underlying concepts of masculinity and high-risk or even violent practices of sexuality, they have proven to be insufficient and even harmful. Due to systemic gender inequality and women's powerlessness, women have not been able to enforce these strategies vis-à-vis their male partners. Often, they have added to the existing burden on women’s lives, as safe sex negotiation has become the exclusive responsibility of women. These prevention strategies have victimised and further marginalised infected women.

Need for a new and inclusive understanding of the AIDS crisis

HIV/AIDS is not just a health issue, but also a development, gender, social and economic issue, and should be regarded inclusively. It is therefore necessary to approach the HIV/AIDS crisis also with a gender analysis and to look for gender-sensitive responses to the crisis. This requires comprehensive and contextualised programmes and a new language, which avoids stigmatisation and marginalisation.

The following table illustrates the results of the GOOD Conference, in the form of a proposal to contextualise the ABC strategy and to extend it into an ABCDE. Instead of addressing and blaming individuals  (women)  for  HIV-infection or the AIDS  crisis, which in fact the frequently used ABC strategy is doing, the responsibility for change must be given back to the local community. It is necessary to work and promote dialogue within the local context taking into account existing power relations. Men must be held  responsible for their sexual behaviour, and local authorities, churches or educational and social institutions must be challenged when they maintain and defend discriminatory and harmful norms and practices.

Recommendations to the leadership of the APRODEV agencies and international policy makers

A comprehensive and inclusive approach is needed that is based on advocacy of gender equality and that encourages women and men in the local communities to promote social change. We therefore present the following recommendations to the APRODEV agencies and policy makers. What applies to the APRODEV agencies is, of course, also relevant for other agencies which are active in the field of development and humanitarian aid.

Work in Context  

Priority should be given to new and innovative ways of addressing the underlying causes of the spread of HIV/AIDS at the community level in order to bring about behavioural change. An approach is needed that is not specifically target group orientated (excluding other groups in society) but tailor-made for different groups in society. An analysis in the planning stage of work on HIV/AIDS needs to look from an integrated and contextualised perspective that takes into consideration issues like gender inequality, violence, sexuality and the institutions that support norms, values and practices, like the family, churches, education, the state and the market.

Therefore APRODEV agencies should support small-scale initiatives and an in-depth South-South exchange, as well as  promote stronger input from the South on the agenda regarding HIV/AIDS. Existing methodologies such as peer group education for women and men, body literacy projects, capacity building of local communities and empowerment of women’s organisations  can bring about behavioural change. In particular, the empowerment and participation of HIV-positive people in prevention and care programmes will give AIDS a human face and challenge stigma and marginalisation of those infected by the virus.

Promote Dialogue

The silence surrounding sexuality has killed and will continue to kill people. This is particularly relevant for church-related partners, who are often very reluctant, or who even adamantly refuse, to talk openly about sexuality. Therefore we recommend that APRODEV agencies address the concepts of gender, sexuality, power (including violence against women) and culture in relation to HIV/AIDS in all their dialogue and cooperation with church-related partners. Prerequisite for a meaningful dialogue  is the admission of our own vulnerabilities in these areas. Religious institutions and churches  must be called to cooperate fully on prevention strategies and care programmes. Churches are well advised to take up the invitation of dialogue with HIV-positive people, who can give AIDS a human face and challenge stigma and marginalisation. Churches should recognise and benefit from the gift of spirituality being offered to them.

Empower for sharing of power

Gender inequalities are the underlying cause of high HIV/AIDS infection rates in girls and women and these inequalities further speed up the spread of the virus. It is important to develop ways in which men and women can be empowered to change gender relations, so that they can protect themselves, their children and their communities as a whole. Women's sexual rights should be promoted. APRODEV agencies should ensure organisation and staff capacity building in view of the strain and emotional stress that the AIDS crisis puts on staff in their own agencies and in their partner organisations.

Engage in Advocacy

Based on the recommendations from this conference, GOOD strongly urges the APRODEV agencies and other development actors to revise and adapt where necessary, in dialogue with the partner organisations, the strategies used in the fight against the spread of HIV/AIDS. In policy and partner dialogue, APRODEV agencies should advocate that a gender-based approach is crucial for a successful strategy against the spread of HIV/AIDS.