As we observe the 16 Days of Activism Against Gender Violence, bookmarked by International Day for the Elimination of Violence Against Women on November 25 and International Human Rights Day on December 10, grassroots activists, civil society, faith-based organizations, the private sector, and governments around the world are calling attention to the critical importance of ending gender-based violence.
Gender-based violence (GBV) is rooted in structural inequalities between men and women and is characterized by the use and abuse of physical, emotional, and/or financial power and control. GBV takes on many forms and can occur throughout one's life. GBV can take such forms as female infanticide; harmful traditional practices such as early marriage, "honor" killings, and female genital cutting; child sexual abuse and slavery; trafficking in persons; sexual coercion and abuse; neglect; domestic violence; conflict-related sexual violence, including rape; and elder abuse. While women and girls are the most-at-risk and most affected by GBV, men and boys are also victims of these abuses.
The United States recognizes the importance of preventing and responding to GBV within our policies and programs -- to promote human rights, achieve global health and development goals, and advance our foreign policy objectives. The President's Emergency Plan for AIDS Relief (PEPFAR) recognizes that gender inequalities -- in particular, GBV -- fuel the spread of HIV. Sound science and evidence support this; country studies indicate that the risk of HIV among women who have experienced violence may be up to three times higher than among those who have not.
In her pivotal November 8 speech on creating an AIDS-Free generation, Secretary Clinton highlighted PEPFAR's “combination prevention strategy” which relies on evidence-driven interventions. Secretary Clinton also noted that PEPFAR's strategy depends on “stopping gender-based violence and exploitation, which continue to put women and girls at higher risk of HIV infection.”
It's essential to translate our high-level commitments into concrete changes on the ground and in the lives of those who experience violence. There are promising developments that are important steps in the right direction.
For the first time ever, the 2012 UNAIDS Global AIDS Response Progress Reporting Guidelines include a GBV indicator, one of 30 core indicators that countries will be asked to report on. The new indicator is the “proportion of ever-married or partnered women aged 15-49 who experienced physical or sexual violence from a male intimate partner in the past 12 months.” This will generate important evidence in its own right, but will also serve as a proxy for gender equality.
While the international community has for some years highlighted the important link between gender equality and HIV, this is the first time that GBV has been added to the core set of markers to track progress in an HIV response. UNAIDS should be congratulated for taking this important step forward.
The U.S. government is also doing its part to link GBV and HIV and bring awareness to these dual epidemics. To observe the 16 Days of Activism, our embassies and PEPFAR teams have organized their own activities in the field. For example, in South Africa, among many other activities, the U.S. mission is working in partnership with the Future of the African Daughter Project on a campaign to tackle issues of HIV/AIDS and abuse among youth. Another U.S.-supported program in South Africa is undertaking activities around medical male circumcision and the provision of HIV counseling and testing, with focused attention on GBV. In both Tanzania and Mozambique, two of PEPFAR's GBV response scale-up countries, the U.S. Ambassador recently wrote op-eds highlighting country efforts to address GBV. In Tanzania, the United States is supporting the development of national GBV guidelines and the launch of a media campaign on intimate partner violence.
Similar activities are happening in countries across the globe, beyond the 16 Days Campaign. Over the last two years, PEPFAR has invested close to $155 million in responding to GBV, a dramatic increase in our investments. Beyond resources alone, PEPFAR teams and partner governments have asked for guidance and “how to” recommendations for integrating GBV in existing HIV work. In response, last month PEPFAR released a program guide for Integrating Gender-Based Violence Prevention and Response in PEPFAR Programs. The guide serves as a tool for PEPFAR managers and implementing partners to address GBV within specific HIV programs and includes key ethical considerations for working with survivors of GBV. We believe this kind of hands-on tool will support our overall U.S. global health efforts to make GBV prevention and response a reality in the field.
Linking GBV and HIV efforts is a powerful strategy for eliminating the structural drivers of each. Just as no one intervention can create an AIDS-free generation on its own, no single intervention will eliminate GBV. But, with the right combination, we are transforming commitment into action.