UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

UN Women estimates that globally in the past 12 months 243 million women and girls aged 15–49 years were subjected to sexual and/or physical violence perpetrated by an intimate partner. As a result of the lockdowns imposed to stop the spread of COVID-19, emerging data show that such violence has intensified. In France, for example, reports of domestic violence have increased by 30% since the lockdown started on 17 March, and in Argentina emergency calls about domestic violence have increased by 25% since its lockdown started on 20 March. Many other countries have reported such increases.

Recently, the Odnoklassniki social network, known as OK, hosted a broadcast for experts and others to discuss how to survive lockdown and avoid family conflict and gender-based violence. The broadcast was seen by 1.7 million OK network users across eastern Europe and central Asia.

“I live in Kyrgyzstan,” Ulzisuren Jamstran, a representative of UN Women in Kyrgyzstan, said. “Here, according to the government, the level of domestic violence increased by 65%. We see an increase in aggression against women and children in Kyrgyzstan, we see an increase in suicides among children, even young children.”

Lyudmila Petranovskaya, a Russian psychologist, explained how isolation made good relationships become better and problematic relationships become more problematic. She emphasized that people need to be aware of the options if they are locked down with an abuser. “People have to look for contacts, a hotline, call friends, try to find another place to survive isolation. Staying with the abuser is dangerous. This threat is more serious than coronavirus,” she said.

Julia Godunova, Deputy Head of the Board of the Eurasian Women’s Network on AIDS, spoke about studies in eastern Europe and central Asia that show that more than 70% of women who survived violence do not seek help because of the perceived shame.

Dina Smailova, the founder of the #DontBeSilentKZ nongovernmental organization, addressed female survivors of violence. “When we are silent, we allow these crimes to multiply. I urge women not to be silent. Our movement is expanding, we are active not only in Kazakhstan, but also in other countries of central Asia and beyond.”

The broadcast highlighted successful experiences around the world in responding to gender-based violence. The example in Spain, where women in danger can visit pharmacies and use a code word to alert staff that they need help, was praised. The role of the private sector was also shown to be important—since many shelters are not open at present, hotels are stepping in and providing shelter, either for free or at a minimal cost.

The broadcast was part of a joint initiative of the UNAIDS regional office for eastern Europe and central Asia, the UNESCO Institute for Information Technologies in Education and OK, in partnership with the regional office of UN Women for eastern Europe and central Asia.

Restrictions in movement, social isolation and increased socioeconomic pressures around the world have led to an increase in violence against women and girls since the start of the COVID-19 pandemic. As the United Nations Secretary-General António Guterres said, “Peace is not just the absence of war. Many women under lockdown for COVID-19 face violence where they should be safest: in their homes.”

Before the COVID-19 outbreak, at least one in three women and girls experienced physical and/or sexual violence, one of the most widespread human rights violations in the world. In areas with a high prevalence of HIV, intimate partner violence has been found to increase the risk of women acquiring HIV by 50%. Ending violence against women and girls must be a priority everywhere. 

The United Nations has asked that governments dedicate funding in national COVID-19 response plans for domestic violence shelters, increased support for call-in lines, including text services, so reports of abuse can take place discreetly, online legal support and psychosocial services for women and girls. As UNAIDS knows well, these services are usually run by civil society organizations and community-led networks, which now need financial support more than ever. Finally, shelters should be designated as essential services and kept open, in the same way that pharmacies and food shops are.

When hundreds of millions of women and girls continue to be subjected to abuse and violence, it comes at a huge cost to themselves and to their families, communities, societies and economic development.

“We need to break this vicious cycle of violence, abuse and inequality,” said Winnie Byanyima, UNAIDS Executive Director, in a recent opinion piece. She added that there can be no impunity and survivors must be heard and justice must be done.

Nining Ivana, the local coordinator of the Indonesia Positive Women Network (IPPI), Jakarta, was shocked when she received a voice message from one of the network’s new members.

In the message, Mutiara Ayu (not her real name) said that she had been beaten by her husband and abused by her husband’s family when they discovered that both her and her son were living with HIV. Research by IPPI in 2011 found that, like Ms Ayu, more than 28% of its members across Indonesia had experienced violence from their partners and family members because of their HIV status. It is known that women who are victims of sexual abuse are also at a higher risk of contracting HIV.

To address the linkages between HIV and violence against women, IPPI is holding a series of workshops to better integrate services for HIV care, support and treatment and against violence against women across eight cities in Indonesia. IPPI members who are survivors of violence, local HIV service workers from public health clinics and managers of women’s shelters have been attending the workshops, at which the results of the IPPI’s research are disseminated, needs are discussed, experiences are shared and a local action plan to better integrate both services is decided upon.

“I heard stories from HIV service providers at public health clinics. They couldn’t understand how a woman living with HIV had such a low CD4 level despite routinely visiting the clinic. Apparently, her husband banned her from taking her antiretroviral medicine. They know that these women are more likely to be victims of violence, but they do not know where to refer them to, since there is no standard operating procedure beyond their health care,” said Chintya Novemi, the person in charge of integrating services for HIV and violence against women at IPPI.

In addition to HIV care, support and treatment services, women living with HIV who are victims of violence may need counselling for trauma and legal aid should they decide to pursue litigation. Through its HIV & Violence against Women Services Integration Project, IPPI aims to bridge this gap. When there is not a formal relationship or mechanism, or it is not clear, informal referral mechanisms made by local stakeholders could save a woman’s life.

“After meeting with workers from services for HIV and violence against women at the workshop, it became clearer to me where I should refer IPPI members who encountered violence and how we should handle their cases,” said Ms Ivana, who joined the workshop in Jakarta.

Upon finishing the series of workshops, IPPI hopes to disseminate the results to national stakeholders, including the National Commission on the Elimination of Violence against Women, the Ministry of Health, the Ministry of Law and Human Rights and others. The ultimate goals are to gather evidence regarding these interlinked issues and advocate for a national standardized mechanism to protect women living with HIV from all forms of gender-based violence. 

“I was walking to work, like I do every morning. There was a man on a motorbike at the end of the street. As I walked pass him, he grabbed my breasts and sped off.” This is a quote from one of the many stories featured on Hollaback! Jakarta’s website.

Sexual harassment and other forms of gender-based violence remain a serious issue for women in Indonesia. According to the National Commission on Violence Against Women’s Annual Report, there were more than 400 000 reported cases of violence against women in 2019, of which 28% were in public spaces. Public facilities, public transport and streets have become places where women do not feel safe and secure.

Hollaback! Jakarta is part of the global movement to end harassment in public spaces. In its quest to create safer spaces for women in the city, Hollaback! Jakarta works with ride-hailing app companies, public transport services, schools and campuses to provide training on gender-based violence.

“By training motorbike taxi drivers, they are not only able to understand forms of harassment, but also take an active part in intervening against harassment they see in public spaces,” said Noval Auliady, Co-Director of Hollaback! Jakarta. In Jakarta, where streets are filled with motorbike taxis, this is incredibly important.

Currently, women do not have full legal protection from gender-based violence. While there are laws that exist, gaps still remain. The Draft Bill on the Elimination of Sexual Violence was set to fill the gap, with an expanded definition of sexual violence and a focus on protection and victim restitution.

For several weeks in September 2019, students, activists and young people took to the streets of major cities in Indonesia to demand the passing of the draft bill. Hollaback! Jakarta was part of the core team for the campaign, creating a social media buzz, mobilizing people and meeting with parliamentarians.

Unfortunately, the draft bill was not passed in the last parliamentary sitting as conservative groups strongly argued against the clauses on the criminalization of marital rape. It is notable that the bill is still included in this year’s priority list of the national legislation programme. The massive support from civil society groups for the bill does increase its likelihood of passing and brings hope to the fight for ending gender-based violence in Indonesia.

The Internet has become a great ally for the movement. Not only was social media vital in mobilizing people to support the draft bill, it has also been a powerful platform to spread the important message of ending violence against women.

On its website, Hollaback! Jakarta encourages people to share their stories, showing how widespread, serious and familiar experiences of violence are for women. Like the quote above, people share personal experiences and some share cases they have witnessed as bystanders.

The Hollaback! Jakarta website has posted more than 300 stories of women experiencing various forms of gender-based violence, from catcalling to abuse. With each story posted, others can show their solidarity by clicking “I’ve got your back”. With its website and social media presence, Hollaback! Jakarta recognizes the potential to create a virtual safe space for women experiencing such issues.

“The more stories there are, the more people are willing to speak up and show their support. More bystanders are willing to intervene when seeing it first-hand. This is what we hope to achieve,” said Mr Auliady.

Juliana Atieno volunteers in her local health facility as a mentor mother, providing advice and support to pregnant women newly diagnosed with HIV. She is also a passionate advocate for survivors of gender-based violence and works to ensure that they receive the support and care they deserve, including by linking them to HIV prevention and treatment services. 

Ms Atieno, who is 29 years old and a survivor of gender-based violence, was diagnosed with HIV as a teenager, in 2008, when she was already very ill. She was linked to treatment immediately and today she is healthy and the mother of two young boys, aged two years and nine years, both born free of HIV. Her partner is also HIV-negative. The family lives in the Kiambiu informal settlement, near Nairobi.

On the eve of the launch of UNAIDS’ new report, Power to the people, Ms Atieno told the UNAIDS Executive Director, Winnie Byanyima, how much her work means to her.

“I love my work encouraging young women and girls to get tested for HIV, to take treatment if they need to and to adhere to it so that they can stay healthy and give birth to babies free of HIV,” she says. “I tell them not to worry, that if I made it through, then they can too.”    

Women and girls like Ms Atieno are the backbone of care support in their families and communities, providing unpaid and often undervalued work in caring for children, the sick, the elderly and the disabled and underpinning fragile social support systems. The involvement and leadership of women like Ms Atieno is critical in the response to HIV.  

“Whenever I meet women like Juliana, I am moved and inspired by their courage and resilience,” said Ms Byanyima. “It’s clear that when women like Juliana have power and agency, real and positive change flows to their families and to their wider communities.”

Ms Byanyima’s meeting with Ms Atieno coincided with the beginning of the 16 days of activism campaign against gender-based violence.

Monique McDonald is an HIV peer educator who tells the story of her childhood with unflinching courage. “I was sexually abused by my uncle at the age of 12 and contracted HIV.”

Ms McDonald has written about her experiences in a book called I am now free. It uses her old diary entries to describe the abuse she suffered as a child and her journey to recovery. Today, she supports young women living with HIV, helping them to come to terms with their status and advising them on adhering to treatment. She has also founded the Ashley Fund to help other sexual abuse survivors to continue their education.

She admits that it’s been a long road.

“I was so depressed, I didn’t know who to trust,” she remembers. “How could this happen, and everybody turned their eyes?”

Rushell Gray reflects on her past with a similar mix of sorrow and disbelief.  

“As a young girl everybody turned a blind eye and blamed me. I was the AIDS girl walking around in the community. Nobody said, “this man needs to go to jail.” At one point I almost gave up because the stress was too high,” she said.  

Ms Gray now works as a Mentor Mom. The Mentor Mom programme enlists young mothers living with HIV to share their experiences and help other young women coping with similar situations. Mentor Moms answer questions and offer reassurance, accompany young women and girls on their health visits and reinforce clinical guidance on the importance of taking medicines regularly.  

Both Ms McDonald and Ms Gray are employees and past clients of Eve for Life, a Jamaican nongovernmental organization that helps to prevent new HIV infections and improve the quality of life of women and children living with or affected by HIV. Clients benefit from peer support groups, psychological care and empowerment programmes.  

Joy Crawford and Patricia Watson founded Eve for Life 11 years ago. While supporting young women and girls affected by HIV, they quickly learned that there was a clear link between HIV infection, adolescent pregnancy and child sexual abuse. According to Situation analysis of Jamaican children, a 2018 report by the United Nations Children’s Fund (UNICEF), more than one in five (21%) adolescent girls in Jamaica said that they had survived sexual violence.  

As a long-standing provider of technical support and capacity-building around sustainability for Eve for Life, UNICEF is keen not only on supporting girls, but addressing the cultural norms that make them vulnerable.  

“There is this pervasive idea that adult men should have some level of access to a girl’s body if they are in their life, supporting the family or something like that,” explains Novia Condell, UNICEF Jamaica’s Adolescent Health and Empowerment Specialist. “Of course, the girl has no power to negotiate any protection in a situation where she has been abused or exploited.”

High on UNICEF’s agenda is supporting the community engagement necessary to shift attitudes around child sexual abuse. Eve for Life has spearheaded the “Nuh guh deh” (don’t go there) campaign, which aims to stop sexual abuse. They use complementary strategies—everything from community meetings to music videos—to get the message out.

The UNAIDS country office in Jamaica also provides technical support to Eve for Life and has helped the organization build partnerships for resource mobilization. The UNAIDS Caribbean subregional office is also working with Eve for Life to create safe spaces for young survivors and leaders to raise awareness about the link between gender-based violence and HIV.

There is also a focus on meeting young women’s basic needs, including food, clothes and health care. But beyond these services, work continues to provide teenage girls and young women living with HIV with a deeper level of emotional support and mentorship.   

“Jamaica’s Ministry of Health has found a strong partner in Eve for Life—one that is able to focus on resilience and life skills-building. They get the girls’ lives on track so they can improve their lot and the lot of their children,” says Ms Condell.

In Africa alone, there are currently seven peacekeeping operations and a large number of other humanitarian operations. Across the continent, 600 million people live in countries affected by fragility, conflict and violence and seven out of 10 women in conflict settings and in refugee populations are exposed to sexual and gender-based violence. In certain contexts, women who have experienced violence are 50% more likely to be living with HIV.

Uniformed personnel working in peacekeeping operations are routinely exposed to a range of health risks during their work, owing to the type of work they do, the locations they are sent to and the conditions in which they often have to serve. The health and welfare of uniformed personnel is therefore a matter of concern. Of equal importance, however, is the well-being of the people among whom the uniformed personnel work.

In order to protect both deployed personnel and civilians, a new code of conduct on preventing and reporting sexual and gender-based violence, including among peacekeeping operations, was drawn up by the African Union in November 2018.

“We urgently need a more overarching, concerted and harmonized strategy to tackle the issues of sexual and gender-based violence and HIV during conflicts and in humanitarian settings,” said Bineta Diop, the African Union Special Envoy for Women, Peace and Security.

The new code of conduct, outlined in the African Union policy on the prevention of and response to sexual exploitation and abuse during peacekeeping operations, prioritizes the elimination of all forms of gender-based violence and puts peacekeeping operations at the forefront of ensuring justice and the protection of vulnerable populations. The challenge now is to implement the code of conduct.

“The African Union has zero tolerance for sexual and gender-based violence and calls for the immediate implementation of policies by member states that use a survivor-centred approach and offer the full range of support services,” said Admore Kambudzi, Director of the Peace and Security Department of the African Union Commission.

In June, the African Union Commission and the UNAIDS Liaison Office to the African Union, in collaboration with the United Nations Office to the African Union, convened the first of a series of meetings to formulate practical recommendations for a collective way forward in addressing sexual and gender-based violence and HIV in fragile settings.

The participants agreed that it is essential to develop a survivor-centred approach to conflict-related sexual violence based on developing the resilience of survivors and to provide mental health and psychosocial support. Including men and boys in ending sexual and gender-based violence will be key to success.

The participants also called for the health and well-being of the uniformed personnel of peacekeeping operations to be ensured, both before and during active service. A protocol on integrating HIV programmes in African Union peacekeeping operations will be finalized and a team of experts to map the current situation in crisis-affected countries, to identify gaps and areas of strength and to suggest a way forward to end sexual and gender-based violence and exposure to HIV will be assembled.

“I urge partners to take action to eradicate sexual and gender-based violence and HIV in fragile settings within the context of the African Union theme for 2019, the Year of Refugees, Returnees and Internally Displaced Persons,” said Clémence A. Habi Bare, the Director of the UNAIDS Liaison Office to the African Union.