Sexual Violence and AIDS, a Link That Starts at Youth

Girls with AIDS in Vietnam
A young girl named Nguyen in Vietnam took this photograph of her friends in a summer storm. Nguyen receives drug therapy for AIDS and hopes to savor a long life.

The President’s Emergency Plan for AIDS Relief, or Pepfar, announced that it was donating $5 million to Together for Girls, a public-private partnership, to address violence against not only girls but also boys, including harassment, rape and pornography or prostitution activities. Millions of girls are lured into prostitution every year, while about 73 million boys suffer sexual violence as well. Women and girls also make up half the world population of people living with HIV.

The connection between sexual violence and AIDS is the high cost to society, the partnership says: young women and girls who have been assaulted are three times more likely to become pregnant, and those under 15 years old who are pregnant are five times more likely to die in childbirth than women aged 20 to 24. These girls are also susceptible to contracting HIV/AIDS and other sexually transmitted diseases and becoming depressed and drug abusers. Moreover, studies reveal that early sexual activity, early marriage and sexual violence are significantly linked with a higher risk for contracting HIV.

The $5 million donation was announced recently by Eric Goosby, the United States global AIDS ambassador, at the 19th international AIDS conference, held in Washington D.C., from July 22 to 27. The money is meant to enhance governments’ ability to end violence against children by doing surveys that measure the extent of such attacks, creating prevention and recovery plans and passing legal reforms to cope with the problem.

In Tanzania, for example, one survey of 3,739 males and females 13 to 24 years old found that almost 30 percent of girls and more than 10 percent of boys endured unwanted sexual advances before age 18. The most common forms of abuse were sexual touching and attempted sexual intercourse. Almost three-quarters of those surveyed also suffered physical violence – kicking, punching, whipping – by a relative, authority figure (including teachers) or intimate partner.

A separate study found that Tanzanian girls who suffered sexual abuse were twice as likely to avoid using condoms during sex than that of their nonabused peers.

The Together for Girls partnership began in 2009 with private groups that included the Nduna Foundation, Becton, Dickinson and Company and Grupo ABC; with United Nations agencies: Unicef, Unaids, UN Population Fund, UN Women and the World Health Organization; and with the US government through the Centers for Disease Control and Prevention, Pepfar, the US Agency for International Development, the Department of Defense and the Peace Corps, collaborating with the State Department’s Office of Global Women’s Issues.

Gary M. Cohen, executive vice president of Becton, Dickinson, a worldwide medical technology company, founded Together for Girls at the Clinton Global Initiative annual forum in New York. Cohen is also the chairman of the board of the CDC Foundation and a board director for the United States Fund for Unicef, which raises money for the UN entity.

Michele Moloney-Kitts is the managing director of Together for Girls and a Unaids staff member. Previously, she worked as an assistant global AIDS coordinator for Pepfar.

In addition to Tanzania, surveys have been done in Swaziland, Kenya and Zimbabwe and are under way in Haiti, Malawi and the Philippines.

President George W. Bush started Pepfar in 2003 to combat AIDS from an emergency-response mode that in recent years has taken a fuller approach to preventing and treating the disease worldwide. Pepfar has succeeded in financing generic drugs for people with AIDS rather than paying for more expensive brand-name versions and better coordinating efforts with the Global Fund to Fight AIDS, Malaria and Tuberculosis, another public-private partnership. The US is the largest donor to the fund, giving $7.1 billion over the years.


 

 

“Where we used to work independently of each other, we now sit down together to decide, for example, which of us will fund AIDS treatment somewhere and which of us will fund the delivery of that treatment,” Hillary Clinton said of Pepfar and the Global Fund at the AIDS conference in Washington.

Pepfar’s work has most recently promoted condom use and staving off disease transmission by encouraging voluntary male circumcision and providing antiviral drugs to HIV-positive mothers who are pregnant or are breast-feeding.

About 34 million people were living with HIV in 2011 (about 23 million of whom are in sub-Saharan Africa), and approximately 1.7 million people died of AIDS-related illnesses in 2011, a 24 percent drop from the peak in 2005, says data from Pepfar. About 2.5 million people were newly infected last year, a 20 percent decrease from 2010; and more than 8 million people who are HIV positive had access to antiviral drugs to help them live longer, an increase of 20 percent from 2010 to 2011.

The AIDS epidemic faces big hurdles in finding a cure and in prevention and treatment, but more countries are taking charge of the problem on their home turf. A UN report released in July on AIDS says that low- and middle-income countries invested $8.6 billion for HIV/AIDS care in 2011, a 20 percent rise over 2010. International funding, however, remained flat at 2008 levels, at $8.2 billion.

The disease is still a taboo subject in many places, a situation that at least one grass-roots educator, Piya Sorcar, has tried to alleviate through her nonprofit, TeachAIDS.org. Its educational animated videos present the basics of the disease and its transmission channels through metaphors and other symbolism. Instead of showing people kissing, say, two birds “kiss” in a video. So far, Sorcar’s curriculum, which is free and was developed while she was a Ph.D. student at Stanford University, is used in China, South Africa, Rwanda, India and elsewhere.

Another major barrier in preventing and treating AIDS is the harsh legal environments in many countries – where laws, enforcement and judicial systems hurt progress in stemming the disease, a new independent report, commissioned by the UN Development Program, said. The Global Commission on HIV and the Law, released this month, also recommended decriminalizing “voluntary sex work,” which some activists working against human trafficking say does not necessarily protect prostitutes from contracting AIDS.

The strategy, also recommended in the Unaids report, “puts the emphasis on protecting male buyers from disease rather than protecting women and girls from male buyers,” said Ruchira Gupta, the founder of Apne Aap Women Worldwide, a nonprofit group that strives to end sex trafficking. “It also ignores the fact that so many ‘sex workers’ began their ‘careers’ as trafficked children and ignores the nature of survival sex that is based on women’s inequality across the world.”

The position of the UN Office of the High Commissioner for Human Rights is that adult sex work that involves no victimization should be decriminalized, Fred Kirungi, a public information officer, wrote in an e-mail to PassBlue. He added that the “occupational health and safety conditions should be legally regulated to protect sex workers and their clients.”

At the same time, Kirungi noted, “criminal law should ensure that children and adult sex workers who have been trafficked or otherwise coerced into sex work are protected from the sex industry. They should not be prosecuted or penalized. Rather, they should be rescued from sex work and provided with all the necessary support to regain their lives.”

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