In 2008, AIDSTAR-One began the process of compiling a compendium of programs and conducting case studies illustrating HIV prevention, treatment, care, and support programs in sub-Saharan Africa that integrate multiple gender strategies. The main goal of this two-phase activity was to expand the knowledge base of how to design and implement HIV programs that seek to reduce gender-based vulnerability to HIV infection. The compendium includes detailed descriptions of 31 programs, each of which integrates at least two PEPFAR gender strategies. From the 31 programs, 5 were chosen for in-depth case studies. These case studies, which were conducted in Kenya, Mozambique, Rwanda, South Africa, and Zambia, more fully explore the successes and challenges in designing and implementing HIV programs that integrate multiple approaches to gender. Finally, a summary and findings report explores recommendations for integrating PEPFAR gender strategies into other programs.
In Zambia's border towns and commercial corridors, the HIV prevalence rate has been significantly increased by a high transient population. This case study details the efforts of the Corridors of Hope program to promote HIV prevention and testing efforts in both the general population and among at-risk groups.
In South Africa, men are increasingly rejecting wide-spread stereotypes of manhood by stepping forward to challenge gender roles that compromise their well-being and the health of their partners and their families. This case study documents the Sonke Gender Justice Network’s Fatherhood project, which was designed to reduce HIV transmission and address related problems, such as gender-based violence, women’s overwhelming burden of care, and the preponderance of children in need of care and support.
In 1994, Rwanda experienced a genocide that left 1 million dead and 3 million as refugees. Further, militia youth and military men used mass rape and sexual and gender-based violence (GBV) as weapons of war, leaving tens of thousands of women infected with HIV. The case study describes the Polyclinic of Hope in Rwanda, which takes a comprehensive approach to combating gender-based violence for genocide survivors affected by HIV by facilitating support groups, encouraging income generation activities and providing HIV testing and treatment services.
A complex matrix of factors, such as low literacy, early sexual initiation, and limited economic opportunities, increases the vulnerability of women to HIV infection in Mozambique. The Women First program addresses the role that poverty and lack of access to health information play in the spread of HIV through legal rights and income-generating activities. This case study features the Women First program and how it helps rural Mozambican women protect themselves against HIV and other health risks by addressing the multiple needs that can leave them vulnerable to infection.
In Kenya, the government's work against HIV is supplemented frequently by civil society organizations (CSOs). These organizations, however, are often faced with a lack of available funding and knowledge. The Maanisha Community Focused Initiative, a program that works in many of Kenya's provinces, works to provide CSOs with both grants and capacity building in all HIV program areas while simultaneously addressing multiple gender-related issues.
Despite increased understanding of the link between gender and HIV and, more recently, the value of using multiple gender strategies to mitigate women’s and men’s vulnerability, little is known about how HIV programs are applying these insights to improve programs and services. This findings and recommendations report reviews how five programs in Africa are combining strategies and identifies gaps, lessons learned, common experiences, and recommendations for future work.
Integrating Multiple Gender Strategies to Improve HIV and AIDS Interventions: A Compendium of Programs In Africa
The public health and international development communities know that gender strongly influences HIV vulnerability and how people respond to the epidemic. There is growing recognition that using multiple approaches in HIV/AIDS programming is more effective than single strategies. Recognizing the many links between gender and the continuing global AIDS epidemic, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) advocates for the inclusion of gender strategies in HIV prevention, treatment, and care and support programs around the world. Despite increased understanding of the link between gender and HIV and, more recently, the value of using multiple gender strategies to mitigate women’s and men’s vulnerability, little is known about how HIV programs are applying these insights to improve programs and services. To expand this knowledge base, PEPFAR’s Gender Technical Working Group commissioned AIDSTAR-One to compile a compendium of HIV prevention, treatment, and care and support programs in sub-Saharan Africa that are integrating multiple gender strategies into their work. The resulting compendium describes how 31 programs in Africa are using gender strategies to improve HIV services and reduce vulnerability to HIV infection. The compendium provides examples of how strategies are combined, where gaps exist, lessons learned, and common experiences across programs.