Women and HIV

1. Women and HIV Roundtable Discussion on the Occasion of International Women’s Day 2010 “ Equal Rights, Equal Opportunities: Progress for All” Annami Löfving, UNAIDS

2. Women and HIVGlobal and Regional Situation • International Women’s Day 2004 dedicated to Women, Girls, HIV and AIDS; • HIV is still the leading cause of death and disease among women of reproductive age (15-49 years) worldwide; • Today women account for 50% of People living with HIV worldwide; • In Asia, steep increase in proportion of People Living with HIV who are women from 19% in 2000 to 35% in 2008

3. Women’s vulnerabilities to HIV Mostly female partners of MARPs

4. 4 • This includes children. • From Spectrum 2009

5. 5 From Spectrum 2009

6. Responding to Gender and HIV in Myanmar • Desk review on Gender and HIV (Sept/Oct 09) • Multi-stakeholder Gender Review of NSP 2006-10 (Oct/Nov 09) • Operational research and pilot on prevention of HIV in intimate partner relationships (planned for 2010) • Formation and capacity building of Positive Women’s Network

7. Knowing one’s HIV status and disclosing to others: • Many men get tested late and go for treatment late • Women often decide to get tested after their partner/husband has fallen ill or passed away • Men less likely than women to disclose their status to their partner • Study among PLHIV shows 63% of respondents find disclosure empowering Recommendations from gender review of NSP: • strengthen capacity among health care workers to help men and women personalise and evaluate risk, to promote benefits of knowing one’s status; • Offer VCCT as part of routine reproductive health care and STI care • Develop interventions which support men to disclose and access treatment earlier • Reduce stigma and discrimination to promote voluntary HIV testing and disclosure among couples.

8. Accessing Sexual and Reproductive Health and Prevention Services • Women often fall into category ‘men and women of reproductive age’ where HIV risk is thought to be low and targeted prevention strategies are lacking A recent study among PLHIV found (female respondents): • 40% reporting being denied family planning services in the last 12 months. • 75% decided not to have more children after learning of their HIV status Recommendations from Gender Review of NSP Develop and strengthen targeted services for: • female partners of MSM and clients of SW and IDU and; • female drug users • Conduct operational research on reproductive health needs, family planning and pregnancy decision making among PLHIV on treatment • Develop SOPs for reproductive health and HIV services to promote positive prevention, encourage partner testing, support disclosure.

9. Accessing Treatment • 43% of ART patients in Myanmar are women • Some reports of wives sacrificing their treatment opportunity in favour of their husband • Coverage of PMCT is improving but still not full coverage of pregnant women who need ART Recommendations from Gender Review of NSP • Increase treatment literacy and preparedness to support scale up • Create stronger links between PMTCT sites and treatment centres • Ensure women meeting eligibility criteria begin ART during pregnancy

10. Promoting a protective socio-economic environment for People Living with HIV Findings from MPG Stigma Index Study (female respondents): • Over 35 % fear physical assault and harassment; As a result of their HIV positive status: • 50% decided not to get married; • 45% decided to isolate themselves from family and friends ( female sex worker respondents): • 85% report low self esteem • 36% currently feel suicidal; Recommendations from Gender Review of NSP • Conduct further research on the relation between GBV and HIV transmission • Explore approaches for livelihood support to mitigate impact