1 High Level Consultation of Influential Leaders and Women Advocates One day consultation on the sexual and reproductive

health and rights of women and girls living with HIV 24th February, 2011 New York Commission on the Status of Women

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Thanks for the invitation to speak in this panel. I just want to thank UNAIDS for making the effort of including women living with HIV, our participation is not a given, and also wanted to thank Michel Sidibe for championing this kind of work, we know these are not easy times for women and HIV. Today I want to share, 3 important topics related to sexual and reproductive health and rights of women living with HIV and women at risk of being infected. • • • The first one, related to the integration of sexual and reproductive health and rights and HIV. The second, about the participation of women and how we envision this; And the third, what I am asking you as leaders of UNFPA, UN Women and UNAIDS.

1) Integration of SRHR services with HIV Sexual and reproductive health and RIGHTS for women living with HIV and women at risk of being infected is not happening at country level. This lack of integration has at least 2 consequences: • • The denial of our sexual and reproductive rights (human rights) as women living with HIV. The missed opportunities for other women at risk of getting infected, to be diagnosed earlier.

In many countries, women can benefit of HIV prevention ONLY: …being a sex worker …a drug user …or being pregnant Creating and implementing HIV prevention programs for women,

2 that go beyond the prevention from mother to child transmission is very important. We know about your commitment with maternal and child health, but unfortunately, not all women will be included in these programs. We need programs that acknowledge and take women’s rights in a respectful and serious way. Maybe we don’t need more consultations in New York, but more Comprehensive Sexuality Education programs for young women and girls, and programs that reach women in a life-long and holistic approach. The same need of integration relates to services for victims of violence and HIV services. Gender Based Violence is recognized by WHO as a cause for HIV, this is good, but we just want to highlight that HIV is also a cause for increased violence for women. There are many other specific topics in the integration of HIV and sexual and reproductive health and rights which my colleagues here, women living with HIV and women advocates will speak about. 2) Participation of women The second topic I will talk about is PARTICIPATION. Of course participation is have a place and speak HIV. But, I think you will room, on the fact that present in a meeting. translated in activities like this, where we as women, especially women living with agree with me and other women on this participation is much more than being

We would like to hear concrete translation of documents like the “UNAIDS Agenda for women and girls”, into ACTIONS, resources, ongoing involvement and consultation with women. We need to make sure grassroots; positive and young women are included in all process, especially access to funds, Universal Access regional consultations and in the programming of National AIDS Programs. At global level, we have expectations to hear more about the UNAIDS Business plan for women; we have not heard nothing more about that. What’s happening? A second topic related to participation, is the UN HIV/AIDS High Level Meeting which will happen in June 2011. We heard the report of the Secretary General is already being prepared. We hope the person who will do this, will consider women’s issues a priority as we do. But just in case he or she doesn’t know, we want to let you know

3 that some of us (women living with HIV and women advocates) are preparing a more consultative process, on line, which will focus on women. This will include voices of women from the grassroots levels (including women living with HIV), because we are not sure women will be invited to the regional consultations. Of course we will share this report globally using social media and you will not be able to miss it. 3. What we need from you as global leaders To all of you On the preparation and review of the Universal Access and UNGASS reports, I want to ask… Could it be that the Universal Access and the UNGASS indicators are so biomedical that they don’t capture the realities of women living with HIV or women at risk, (apart from pregnancy, sex work and drug use)? We heard the proposed indicator of Intimate Partner Violence, which would better inform about the growth of the epidemic among women, was rejected again. There are other topics which are key for us, for example cervical cancer, violence among women living with HIV and at risk of HIV, all of these, would give a better understanding of the epidemic among women, and we would overcome the epidemiological myth, that which says that women with HIV are not so many as men. You might be aware of the phenomenon of how fast HIV is falling out of the aid agenda (given the global economic crisis), sadly this is happening exactly as women are falling out of the HIV agenda. To UNFPA Please continue to advocate for the integration of sexual and reproductive services that acknowledge sexual and reproductive rights of women living with HIV and women at risk of getting infected, beyond maternal and child health. The lives of many women depend on this. To UN Women Dear Michelle Bachellete, you received a letter from women’s groups, we really would like to receive a written response as soon you have time to do it. We have great expectations of the role of UN Women as an agency which will drive the mainstreaming process of gender into the UN

4 agencies and monitor accountability. We really hope the UN Women will not be understood as the one agency, which has to deal with women’s issues alone. The creation of UN Women is a huge advantage, but it should be never used as an excuse by other UN agencies to stop doing the work with and for women. This includes UNAIDS. The responsibility for gender equality and gender equity is for all UN agencies, governments and the diverse civil society movements. To UNAIDS Dear Michel Sidibe, I wanted to highlight the fact that we are happy with the agenda for women and girls and your leadership on developing this. Thank you. This is a good a document, but is it more than a document? Your last letter to partners, said so, that many countries made it operational. Well, we at the grassroots levels, women living with HIV and women’s groups as experts on our health, we might have a different perspective: We are ready to speak, and to work, and we hope people are ready to listen and to provide support. We know about the commitment of UNAIDS at global level, but at country level, maybe we need to strengthen this advocacy. In many countries, the financial support is going only towards groups of men who have sex with men (especially those with “concentrated epidemics”), I am not saying this is wrong, I am just asking, which is the best way to avoid more HIV infections among women? Do we agree with the investment on men and boys? Yes we do, but just as the logistical note for this meeting said: “…the most economical and direct route for tickets”, the same way, “…the most economical and direct route for women’s empowerment” is women! Once we have been supported, we will reach out to men, we promise. One example of this is the Mama’s Club in Uganda, which now has a positive father’s mentors club. There is a research of Population Council that shows that this is the best way to work. If you being empowering men, one side effect could be that their power is further increased, and many will follow the temptation of keeping it for themselves, while women will share power with the communities around, just like the Population Council study demonstrated.

5 And what kind of support do women need? If you print my personal account of how I survived rape and HIV (or that of any other woman living with HIV), that is one thing; I will feel your solidarity and be thankful for it, but if you direct funds towards organizations of women living with HIV and women at the grassroots, right there, in the middle of our realities at country level, that is a different one, more practical and more real. An example of this is these drawings, body maps done by women living with HIV in Bolivia. The publication of this document was possible thanks to the financial support of the Global Fund project in Bolivia (Round 3) and UNFPA Bolivia. There is also this policy brief, prepared and signed by groups of women living with HIV around the world http://www.womeneurope.net/resources/PositiveWomenNetworksPol icy%20briefingfinal.pdf asking you and other global actors to support our work, in other words: “practice what you preach”, just in case you need to leave the meeting earlier, I wanted to give you a copy as gift, please read it whenever you have time. And just to remind the wonderful logo/idea of the Women Deliver Conference (Washington DC, 2010):

Invest on women, it pays back!
Thank you. Gracia Violeta Ross Bolivian Network of People Living with HIV/AIDS (REDBOL) graciavioleta@gmail.com

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Dr. Michel Sidibé (Executive Director UNAIDS); Ms. Irene Chan; Dr. Michelle Bachelet (Executive Director UN Women); Dr. Babatunde Osotimehin (Executive Director UNFPA); Ms. Gracia Violeta Ross (Bolivian Network of People Living with HIV/AIDS)