What women face

It’s Women’s Month. A time to remember the courage and activism of the Women’s March and to celebrate women’s contribution to our democracy. But it is equally important to reflect on the challenges South African women continue to face and what can be done to combat this.

Vulnerability to HIV

Women and girls carry the bulk of the HIV burden in South Africa. They are more at risk of infection and more likely to be caring for those affected. HIV incidence is highest in young women aged 15-24 at 2.3%, making up a quarter of all new infections. Adolescent girls have an HIV prevalence which is 8 times higher than their male counterparts and almost 2,000 young South African women are newly infected every week.

Harmful attitudes, gender inequality and social norms create HIV risk factors for young women such as early sexual debut and early and unwanted pregnancy. Poverty and the disproportionate burden of domestic work make girls more likely to engage in transactional sex (sex in exchange for money, things or favours) and inter-generational sex (sex with older men).

Particularly at risk are female sex workers, who face a multiplicity of issues such as chronic violence, exploitation, alcohol and drug misuse, stigma and isolation, criminalization and lack of access to justice and services.

South Africa’s women and girls need a range of prevention technologies and strategies which address their diverse realities and integrate with their lives.

Gendered TB burden

People living with HIV are more likely to develop TB. South Africa’s high HIV burden means we also have an extremely high prevalence of TB – the third highest in the world. While Men are significantly more at risk of contracting and dying from TB than women, the disease can have particularly severe consequences for women, especially during their reproductive years. TB in pregnant women living with HIV increases the risk of maternal and infant mortality by almost 300% and TB among mothers is associated with a six-fold increase in perinatal deaths and a two-fold risk of premature birth and low birth-weight.

According to the World Health Organization, TB is one of the top five killers of adult women worldwide. Cultural and financial barriers can act as major obstacles for women seeking care resulting in delays and more severe illness.

Being on anti-retroviral treatment (ART) makes people living with HIV less likely to get sick and die from TB so people need to understand the link between TB and HIV and get screened. Barriers to care for women should be eliminated.

An epidemic of violence

Gender based violence (GBV) is one of the biggest drivers of HIV in women and girls. South Africa has a significant and well-publicised GBV problem, although data on the true extent of the problem is lacking. While all forms of gender based violence are a fundamental violation of human rights, as enshrined in our constitution and legal and policy framework, studies show that women who have experienced gender based violence are 1.5 times more likely to acquire HIV.

Power relations, discrimination and gender inequality make children, sex workers and lesbian, bisexual and transgender women more vulnerable to gender based violence. Addressing gender equality is critical. Worldwide, support for women’s movements has been found to be a significant predictor of government action to redress GBV.

Integrated programmes that tackle GBV and its link with HIV, addressing both the causes and consequences of GBV, are required. South Africa urgently needs a coherent, coordinated and budgeted national plan to start to turn the tide on the violence.

What can you do?

• Awareness is the first vital step. As women, we need to understand our elevated risk of HIV and protect ourselves. Get tested, get onto treatment if you test positive and help other women and girls to be aware of the risks.
• Talk about TB. Ending the stigma surrounding TB will help to end TB itself. Go to a doctor or clinic if have the symptoms of TB and get onto treatment as soon as possible.
• Advocate for a national strategic plan on gender based violence by adding your voice to the Stop Gender Violence campaign: follow @SGVCampaign on Twitter or @NSPGBVCampaign on Facebook.