World AIDS Day is commemorated every year on 1 December. World Aids Day recognition commenced in 1988, today individuals and organisations globally observe the day with different yearly themes. Whilst the end of HIV is still a very long way to go, progress continues. The 2020 theme, End the HIV/AIDS Epidemic through Resilience and Impact focuses on the essential role of resilience against impact, which enables individuals and communities to meet the HIV/AIDS challenge even in times of adversity, such the current year, where we are impacted by Covid-19 and an increase in gender based violence. There is a need to reinforce and concretise interventions to specific emerging barriers in ending the HIV/AIDS epidemic.
In many parts of the world, Zimbabwe not spared, COVID-19 is colliding with the ongoing HIV pandemic. As the latest UNAIDS report shows, the HIV epidemic remains enormous, unfinished business. Gender inequalities, gender-based violence and the criminalization and marginalization of vulnerable groups continue to drive HIV forward, explains António Guterres, United Nations Secretary-General (2020). As we commemorate World Aids Day let us not forget the intersectionality of Gender based violence and HIV/AIDS, as it falls within the 16 Days of Activism against GBV. The biological risk of transmission in a violent sexual encounter and marital violence such as forced or coercive sexual intercourse with an HIV infected partner is one of the routes of transmission for HIV and sexually transmitted infections (STI). These circumstances can be experienced by all gender identities, expressions and orientations. These are exacerbating factors that have contributed to new HIV infections among intimate partners. Gender and sexual norms related to masculinity and femininity play a central role in contributing to violence against womxn as non-consensual sexual activities often target those who may be vulnerable based off genetic composition or economic imbalance.
The impact of the COVID-19 pandemic has been far reaching, with devastating effects on individuals, communities, and societies across the world. COVID-19 spread quickly throughout the world impacting on people who contract the virus especially PLWHA and have pre-existing conditions are at risk of severe illness or death. PLWHA and not taking ART or whose disease is not well managed were at increased risk for contracting COVID-19 due to having a compromised immune system and also may be at increased risk for serious symptoms and death. Healthcare systems in many countries came to a halt prioritising the Covid -19 pandemic. The WHO’s recommendation for physical distancing to limit the spread of COVID-19, echoed by the Centers for Disease Control and Prevention in the United States (US), resulted in stay-at-home orders in many places, including enforced lockdowns in Zimbabwe from March to May 2020. These periods however, were also marked by increased GBV and IPV, as well as drops in HIV treatment adherence.
Women and key populations Are the most vulnerable, marginalised communities.
Women: It is important to highlight in numbers how the HIV pandemic has affected women, adolescents and girls with exacerbating factors so that as we build resilience mechanisms against impact we are clear of the magnitude of the challenge at hand:
Every week, around 5500 young women aged 15–24 years become infected with HIV. In sub-Saharan Africa, five in six new infections among adolescents aged 15–19 years are among girls. Young women aged 15–24 years are twice as more likely to be living with HIV than men.
More than one third (35%) of women around the world have experienced physical and/or sexual violence by an intimate partner or sexual violence by a non-partner at some time in their lives.
In some regions, women who have experienced physical or sexual intimate partner violence are 1.5 times more likely to acquire HIV than women who have not experienced such violence.
Women and girls accounted for about 48% of all new HIV infections in 2019. In sub-Saharan Africa, women and girls accounted for 59% of all new HIV infections.
Key Populations: Key populations and their sexual partners account for 62% of new HIV infections globally and 28% of new HIV infections in eastern and southern Africa.
General population: Globally there are 38.0 million people living with HIV as of 2019 to June 2020 which is an increase from 37.3million in 2018. New infections are 1.7 million as of 2019 to June 2020 and the number has remained stable at 1.7million in 2018. Aids related deaths in 2018 were 730 000 and 2019 to June 2020 are 690 000 with the decrease of 40 000 deaths being noted. It is of paramount importance that we have of the total infected 26.0 million accessing antiretroviral treatment as of 2019 to June 2020 and increase from 23.1 million of 2018.
Given the statics above, the epidemic is changing: in 2018, more than half of all new HIV infections were among key populations—sex workers, people who use drugs, gay men and other men who have sex with men, transgender people and prisoners and their partners. It is relief and good news, but of course, it remains unacceptable that 5500 adolescent girls and young women become infected with HIV every week. The sexual and reproductive health and rights of women and young people are still too often denied. Increasingly, the concept of ‘resilience’ has achieved significant attention within the development and humanitarian sectors. Communities make a difference theme in 2019 builds home grown capacities and strengths at grassroots level. This is based on the growing recognition that different types of risks – violence and conflict, climate change, food insecurity, human immunodeficiency virus (HIV), gender-based violence (GBV), and rising inequality – are inter-connected. Congregating on single issues and in silos no longer delivers sustainable results or outcomes. If these issues are to be clearly understood and addressed, a more comprehensive framework is required, moving from risk reduction towards resilience building interventions.
On this day, we reflect on those we have lost to HIV/AIDS, COVID-19 and gender based violence. Let us commemorate and build resilience on in relation to certain populations who are often more vulnerable to HIV than the general population: people living with HIV (PLHIV); adolescent girls and young women; prisoners; migrants; people who inject drugs; sex workers; gay men and men who have sex with men; transgender people; children and pregnant women living with HIV; displaced persons; people with disabilities; and people aged 50 years and over. Communities renew commitment to work with our wide and diverse populations striving for inclusions, to save and improve lives. Community resilience interventions are vital and these come from a systems approach to widen support systems, good networks that can interconnect together to fight the HIV epidemic: outreach workers, community focal persons, peer educators, counsellors, advocates, healthcare workers. This approach affords the opportunity to place at its core the men, women and communities who are required to build resilience in order to withstand shocks in times of stress and disaster. The LGBTI community
Grace Badza is a gender activist, human rights defender and current lead of the GALZ Counselling, Membership and Psychosocial Support Unit. Her key focus is the mental health and wellbeing of LGBTI persons. She can be reached at grace.badza@galz.co or counselling@galz.co