For several years now it has been recognized that HIV and AIDS is a feminized phenomenon. Women’s rights activists have asserted that in order to address the pandemic, it is necessary for women’s rights to be central to interventions. Now it seems like the battle for a women’s rights centred approach could be over before it has barely even begun.

Male circumcision on the rise

Studies conducted in Kenya and Uganda have shown that men’s susceptibility to HIV infection can be reduced by up to sixty per cent if they are circumcised.[1] The Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) have recommended that male circumcision be promoted as an intervention against HIV and AIDS. The trend of men getting circumcised with the intention of avoiding contracting the virus is rising.[2] There has also been an increase in interventions aimed getting men to reduce the number of their sexual partners.

Women’s rights advocates are circumspect and their problem is not circumcision or partner reduction per se. Any reduction in the prevalence of HIV and AIDS is welcome. The problem is that the focus on these two issues detracts from the underlying socio-cultural issues that fuel the spread of HIV and the disproportionate way in which women and girls are affected by HIV and AIDS.

Women are physiologically more prone to contracting HIV. However it is not only their physiological make up that increases their risk of getting the virus. Social, cultural and economic factors play a huge role in their susceptibility. In many cases, women do not have control over whether or when to have sex, and if condoms are used. Rape and domestic violence are major contributing factors. Early marriages of teenage girls- usually to much older men, and often into polygamous marriages- , the cultural practice of widow inheritance, and generally the socialisation of girls and women to refrain from asserting what they want or deserve all contribute to their susceptibility to contracting the virus that causes AIDS.

Feminization of HIV and AIDS ignored

Even if no new infections were to occur, which is currently unfathomable, HIV and AIDS would still have gendered dimensions, unfavourably stacked against girls and women. Women and girls are the primary care givers for people living with HIV and AIDS. Girls’ schooling is negatively impacted by their roles as care givers of HIV and AIDS patients and there are scores of grandmothers raising AIDS orphans.

For circumcision to have a real impact it needs to be accompanied by messages that promote respect for women’s rights and emphasize that circumcision does not confer immunity against infection with HIV. In Swaziland it is reported that some men use circumcision as an excuse not to use condoms.[3] In several African cultures, male circumcision defined the coming of age of young men. Modern manifestations of these cultures, at least, have encouraged the sexual adventurousness and proof of ‘prowess’ of newly circumcised young men.

Interventions that address men should also address the social and economic burden of HIV and AIDS, which is disproportionately borne by women. Instead of merely talking about – and sometimes celebrating - the longsuffering of women and girls who are caregivers to HIV and AIDS patients, men and boys need to take up some of the responsibilities.

The focus on male circumcision and partner reduction is likely to affect women in other ways. Funding for women-centred interventions is likely to decrease. According to Everjoice Win of Action Aid International, the door on funding for these interventions is slowly being shut. Win sounds another alarm: some influential voices are now saying that there is no evidence that violence against women and gender inequality contribute to HIV and AIDS.[4]

Sarah Mukasa of the African Women’s Development Fund (AWDF) says that a women’s rights approach to HIV and AIDS has never really taken off. Women, and particularly young women, have been problematized in most interventions, and regarded as vectors or victims.[5] Even though the feminization of HIV and AIDS has long been recognized, a women’s rights based approach to confronting the pandemic has largely been absent despite advocacy. Now advocacy efforts are likely to be drowned further by the drive for male circumcision and partner reduction.

[1] See Major Shift in HIV Prevention Priorities Needed’ Harvard School of Public Health, May, 2008. http://www.hsph.harvard.edu/news/press-releases/2008-releases/major-shift-in-hiv-prevention-priorities-needed.html

[2]See ‘More men seek circumcision.’ Daily Nation August 15, 2008. http://www.nation.co.ke/News/-/1056/444042/-/tj1h4m/-/index.html

[3] See ‘Circumcision gives men excuse not to use condoms.’ IRIN News July 31, 2008. http://www.irinnews.org/Report.aspx?ReportId=79557

[4] Interview with AWID, July 18, 2008.

[5] Interview with AWID, August 7, 2008.