To reduce violence against women and girls and HIV, long-term interventions that address structural factors, gender inequalities and harmful gender norms are essential, as are shorter-term efforts focused on prevention of violence and HIV and provision of adequate and quality responses.
Implementing a comprehensive approach includes developing policies, systems, and services, as well as community support mechanisms to prevent and respond to violence against women and girls and HIV. This section presents sample actions in the key areas of legal and policy reform, health systems reform, and health-based community mobilization. For each area, suggested activities for integration are specifically identified for violence programmers and for HIV programmers, as well as intersections—or points of mutuality—in violence and HIV programming. These points of mutuality represent responsibilities that both violence programmes and HIV programmes should assume in their programming.
Despite a limited evidence-base on what works, emerging promising practices and practitioner consensus, identify several key considerations to address the dual pandemics, including:
- Implementing measures at all levels to promote gender equality and preventing as well as redressing violence against women and girls should be incorporated as important targets in national HIV strategies and plans.
- HIV prevention, treatment and care efforts should include an assessment of impact on violence against women and girls and gender inequality. Links between reducing poverty, increasing gender equality, reducing violence against women and girls and reducing HIV should be explicitly acknowledged and addressed in strategic plans for all relevant sectors.
- National strategic plans should explicitly recognize the community level as a key focal point of change.
- support should be provided for the development of regional networks of organizations and practitioners, with a focus on supporting inclusion of gender equality and eliminating VAW as an integral part of HIV programming.
- Existing approaches that have been shown to be effective or promising should be adapted, replicated and scaled up. A solid evaluation component must be included and is key to building up the evidence base in this field. Building on existing examples, other locally relevant interventions to address structural drivers must be encouraged and evaluated.
- Sustainable funding must be allocated for such programmes.
- Programmes designed to reduce violence in the context of HIV prevention should consider the full range of diversity of persons experiencing and perpetrating gender-based violence.
- Integrating VAW into HIV programming should be informed by a human rights approach, and should tackle stigma and discrimination.
- Access to quality, comprehensive post-rape care services including PEP should be ensured, according to WHO guidelines.
- Post-rape care should be implemented, based on the various existing evidence-based models appropriate to the setting, and with multisectoral linkages.
- Support should be provided to young women and men for active HIV prevention that specifically incorporates gender-based violence prevention and gender equality perspectives.
- Programmes must be developed to address the high levels of violence and related HIV risk experienced by adolescents who sell sex.
- Programming must recognize that sex workers experience violence from a range of perpetrators, including clients, individuals such as brothel owners or other go-betweens who control clients’ access to sex workers or sex workers’ access to clients (controllers) and law enforcement. Perpetrators also include longterm partners, relatives, neighbours and other members of the community.
- The programmatic response should not be limited to sex workers, but should include the full scope of those involved in sex work, VAW and HIV prevention, including the law enforcement, clients, partners, controllers and family.
- Interventions also need to address stigma and discrimination against sex workers in the broader community, in the media and in law and policy.
- Programmes should include a strong monitoring and evaluation component that can contribute to strengthening the evidence base for addressing the intersections of VAW and HIV/AIDS.
- It is important to monitor gender equality and reducing VAW incidence as positive process and outcome indicators related to reducing HIV risk.
- It is also important to monitor increased VAW incidence as a potential adverse outcome of HIV-related interventions.
- Reporting should be improved so that there is a systematic way of assessing the extent and progress or deterioration in type and level of VAW, specifically including violence.
Source: extracted and slightly modified from Addressing Violence against Women and HIV/AIDS, What Works? (WHO and UNAIDS, 2010).