Tuesday, August 17, 2010

Common Concern


Stay informed of the World YWCA's work in over 125 countries by subscribing to Common Concern, a magazine that documents and profiles the work of the movement. Published three times a year, Common Concern, highlights the global issues women and girls face around the world as they relate to the World YWCA's strategic plan. Common Concern is available in English, French and Spanish.
Sign up for your annual subscription today, which will includes three Common Concerns , the World YWCA Annual Report and the YWCA-YMCA Week of Prayer Booklet .

June 2010: Comprehensive Prevention for a Safer World

In a world where the spread of HIV and violence intersect, and where women and girls are disproportionately affected, a comprehensive approach to prevention is urgently needed. Central to this is the creation of safe spaces where women and girls can make choices about their sexual and reproductive health and live free from violence, stigma and discrimination.

March 2010: Beyond Beijing

When the Beijing Declaration and Platform for Action were adopted, the YWCA movement was there. 15 years later, we reflect on what this meant for the YWCA then and what it means to us now.

http://www.worldywca.org/Resources/Common-Concern

What does sexual and reproductive health rights mean to young women of the world?

Maria Morena Galvelo, World YWCA Board Member and YWCA of Philippines member
Contraception, sexuality, pregnancy, violence, menstruation, sexually transmitted infections…it can be information overload for young women when discussing sexual and reproductive health rights. We asked young women from around the world to share what sexual and reproductive health rights (SRHR) means to them.
Maria Morena Galvelo, 30, Philippines (World YWCA Board Member and YWCA of Philippines member)

Sexual reproductive health and rights are integral to our existence as humans. God created us with sexuality that should be treated with respect and free from all forms of discrimination and violence that rob human dignity.

It disturbs me to hear that my fellow Filipino women work abroad and suffer physical and sexual abuse from their foreign employers.

Discrimination, cruelty and violence against young women’s SRHR will continue if no action is taken. Everyone plays a role in changing this– individuals, families, communities and the government that leads the nation.
Andrea Núñez Argote, 24, Mexico (World YWCA Advocacy Intern and YWCA of Naucalpan member)

I first heard about sexual reproductive health and rights during my phone interview for the World YWCA Internship. I wasn't sure what it meant or the difference so I used the Internet to find out.

When young people are unaware of SRHR or what the difference is between them, they can make uninformed choices and be left vulnerable to violations of these rights that they start to accept as normal.

I did not get taught sexual or reproductive health at school. These topics were in our health books but teachers just skipped the subject. Only now I realise how important it is for young people that these issues are addressed. Today, teachers still refuse to teach about sexual health.

In the YWCA of Naucalpan we provide workshops for students to understand and exercise their SRHR in the best possible way. We are filling the gap teachers do not want to fill.
Sita Shahi, 30, Nepal (Srijansil Mahila Samuha, People Living with HIV (PLHA) women’s group)

Sexual reproductive health and rights are important to young people. Due to the lack of education on sexual and reproductive health, many women are becoming infected with HIV. If young women are not informed of their sexual and reproductive health rights, they can engage in risky sexual behaviour which can lead to HIV and sexually transmitted infections. Family, school and society need to talk openly about these issues.

Women who are uninformed of SRHR can become victims of physical and mental violence, early and unplanned pregnancy and HIV.

Young women have a right to live a free life and their SRHR should not be exploited.
Sepora Tagaloa, 22, America Samoa (World YWCA Board member and YWCA of America Samoa member)

I am a young woman that belongs to a conservative culture that labels all things sexual as taboo. I learned about my sexual health when I was prescribed birth control to regulate an irregular cycle. The nurse scoffed at me, presuming I was an out-of-control sexually active teenager. I was 14 years old and unaware of what my body was experiencing. My parents, and schools I attended did not discuss my reproductive health.

I believe sexual education should be included in the education framework of primary schooling. Providing young women with sexual education enables them to make well-informed decisions about their sexual health. Also, providing the entire community with sexual education will generate an open and understanding perspective for the betterment of young women’s social and sexual wellbeing.
Aika Temu, 30, Tanzania (World YWCA Accountant)

Wait until you’re married. Abstain. You will get an STD. Pregnant. No man will want you. He is your husband. You must please him. Condoms are against Gods plans for procreation…a snapshot of the information young women received where I grew up.

No one talked about how to handle advances from men in positions of power, how to negotiate safe sex or the facilities available if you had difficult decisions to make.

So we watched in silence hiding behind guilt, shame, religion, culture and society as women suffered and some died. We have done this for too long.

Bulletin of the World Health Organization Print version ISSN 0042-9686

Young people, sexual and reproductive health and HIV
Raoul Fransen-dos Santos*

International Civil Society Support, Van Diemenstraat 192, Amsterdam, 1013 CP, Netherlands

One quarter of the world's population is made up of 1.7 billion young people aged 10-24, 1.5 billion of whom live in developing countries where HIV/AIDS has reduced their chances of living to the age of 60 by 20%.1 Despite their vulnerability to HIV infection, young people's needs are often overlooked when national AIDS strategies are designed and implemented.1

Half of all new HIV infections occur among young people, aged 15-24.2 In 2007, an estimated 33.2 million people were living with HIV, 5.4 million of whom were aged 15-24 years. In sub-Saharan Africa, there are 3.2 million young people living with HIV, with a ratio of three young women infected for every young man.3

In 2001, governments committed that 90% of young people would be able to correctly identify modes of HIV transmission and prevention by 2005.4 Yet, by 2007 only 40% of young males and 36% of young females had accurate HIV knowledge.4

Until recently, these statistics were only used to address youth as a target group for prevention messages, rather than allowing each new generation to work through the issues themselves. We are slowly recognizing youth as a resource and actively involving them in finding solutions. Is it too little, too late?

One of the great challenges in HIV prevention is that today's young people have never known a world without AIDS; they did not experience the shocking early days of the "new disease". Improved (access to) treatment has changed HIV and the image of AIDS from a fatal disease to "just a sexually transmitted infection". Many young people are fatigued by prevention campaigns that are out-dated or unrealistic. Not all youth experience the same HIV vulnerabilities. An impoverished young girl in a rural village in Malawi has different needs in terms of effective HIV prevention than emerging gay youth in the favelas of Rio. The key lies in providing young people with the information and tools they need to make safe and healthy choices. But they must be true choices, not based on other people's ideologies.

Girls and boys


Young women and girls are disproportionately vulnerable to contracting HIV/AIDS due to biological factors and structural elements of culture, economic and social inequalities. Marriage and long-term relationships do not protect them from contracting HIV and insisting on abstinence is simply not realistic.

To address the global feminization of the epidemic, policies, programmes, legislative frameworks and social norms must guarantee women's rights, ensure protection from gender-based violence and discrimination. Despite the numerous references in national and international documents to the rights of women and girls, few countries have actually implemented and enforced policies and laws that protect such rights.

While the focus on young women and girls remains necessary, particularly in areas such as sub-Saharan Africa where more than 75% of those living with HIV are female, it risks excluding the very group whose involvement is essential if we are to successfully turn the tide on HIV; namely, young men, particularly those living with HIV.5 The engagement of young men is also essential to improve their own health outcomes.

The importance of directly engaging young men and boys in shaping the response to HIV and AIDS is clearly reflected within the 1994 International Conference on Population and Development Programme of Action. Commitments to ensure special efforts around this have been reiterated in several key international declarations since then.6

Traditional sex education and HIV prevention often focus (intentionally or otherwise) on young women and do not adequately address the needs of young men.7 Sexual and reproductive health clinics are often perceived, and indeed sometimes promote themselves, as "feminine spaces". Young men often feel uncomfortable visiting these clinics, which frequently lack services catering for their specific needs. There is a shortage of male service providers, who have a vital role in helping young men articulate their thoughts and feelings about sex and sexually transmitted infections. Programmes need to be gender-transformative, changing preconceived gender notions and promoting relationships between men and women that are fair and just.8

Prevention

Too often, prevention activities focus merely on the biological or medical facts or provide ideological approaches to sexuality and choice, rather than addressing the needs of young people living with HIV and enabling them to continue living positively.

Young people who contract HIV around birth experience unique challenges. Interventions targeting this group to date have tended to emphasize delaying sexual debut, reducing the number of sexual partners and condom use, rather than providing comprehensive information and support on sexual reproductive health and rights. With an increasing number of young people born with HIV reaching adolescence, it is more important than ever to address the specific needs of this group.

Young people living with HIV have their own specific needs and desires for sexual reproductive health. Greater focus is needed on the specific prevention, treatment and care required by this group, including psychosocial support and sexuality counselling. Such activities should be implemented in a "positive prevention" framework9 that aims to protect their sexual health, avoid other sexually transmitted infections, delay HIV/AIDS disease progression and avoid onward HIV transmission, including mother-to-child transmission, based on the following guiding principles.10

Promotion of human rights

This should ensure the right to privacy, confidentiality, informed consent and voluntary disclosure. Stigma and discrimination - including self-stigma - drive people underground and make prevention even more difficult. A supportive and enabling legal environment is a fundamental cornerstone as it recognizes that prevention strategies based on coercion and criminalization are not the answer.

Involvement

People living with HIV must be involved in the decisions relating to their life. In accordance with the Greater Involvement of People Living with HIV (GIPA) principle, the active engagement of people living with HIV in determining their own prevention approach is key to success in ensuring relevance, efficacy and applicability.

Shared ownership

Positive prevention places the responsibility for reducing HIV transmission on everybody and removes the undue burden on people who are aware of their status. Safer and responsible sexual behaviour is the responsibility of all partners - irrespective of status. Promoting a culture of shared responsibility could also improve communication and equality within relationships.

Recognition of diversity

People living with HIV are heterogeneous and represent a cross-section of all sectors of society. Issues of race, ethnicity, gender, orientation, age, language, and risk profile will all have an effect on how positive prevention initiatives need to be tailored, including approaches adopted in service delivery and programming as well as in advocacy efforts. With clinical settings being one obvious venue for interventions, positive prevention also needs to reach out to networks, organizations and support groups of people living with HIV. Specifically tailored information and support also needs to be provided to key vulnerable populations (sex workers, men who have sex with men and injecting drug users).

Positive prevention has to be conceived as part of the comprehensive prevention agenda. Moreover, HIV programmes should deliver a comprehensive package of inclusive messages - irrespective of status - which could act as a modality for stigma reduction. At a technical consultation held by the Global Network of People living with HIV (GNP+) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) in April 2009, people living with HIV reinforced the importance of a supportive and protective legal and policy environment free of stigma and discrimination in a new framework: "Positive Health, Dignity and Prevention,"11,12 promoting a more holistic approach to prevention, including equitable access to voluntary HIV testing, treatment, care and support services and the need to address psychosocial, economic, educational and sociocultural vulnerabilities, gender and sexuality. In this way positive prevention does not become an excuse for shifting the responsibility for prevention onto people who are already marginalized and particularly vulnerable. Furthermore, it does not aim to have disclosure as an end point - as disclosure does not guarantee safe behaviour(s).

Counselling and testing

Most young people living with HIV do not know their status. Most young people, who have been at risk of HIV infection, have never been tested.13 Merely increasing access to testing will not solve most of the issues around this. Rather than rolling out provider-initiated testing or even mandatory testing, we need to address the obstacles to HIV testing. Focusing efforts on increasing the number of people who know their (positive) status does not mean we will have made any improvements in fighting stigma and discrimination or in providing better care and prevention. Moreover, the different role and concept of counselling in voluntary versus provider-initiated counselling and testing needs to be seriously revised. The importance of good quality counselling (pre- and post-test, but also sexuality counselling) has not been sufficiently recognized in developing or revising strategies to get more people tested.

Sexual rights?

Possibly the greatest challenge is the increasing complexity of HIV. Nearly 30 years into the epidemic, HIV treatment has improved, quality of and access to medication, care and services are improving, but HIV-related stigma is getting worse in many settings, even in western Europe and North America. If we continue to fail to acknowledge, protect and celebrate people's rights and diversity, we are far from pushing back the epidemic. With governments and United Nations agencies struggling to adapt effective strategies on comprehensive sexuality education and counselling - even to mention such wording in publications - and with sexual rights still not much more than a concept, we will not be able to improve the quality of life of so many (young) people. Today's young people will be responsible for sustaining the response to HIV/AIDS. We have to enable new generations to take on this task.

Source:
http://www.scielosp.org/scielo.php?pid=S0042-96862009001100019&script=sci_arttext
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