Approaches to Gender and Sexuality: Responding to HIV

"Gender and sexuality have long been recognised as key factors affecting the dynamics of the HIV epidemic. Issues vary across communities and countries, but power imbalances, harmful social norms, violence and marginalisation affect women, men, girls, boys and transgender people across the world, limiting their ability to prevent HIV infection."

According to the International HIV/AIDS Alliance, there are a growing number of HIV and broader health initiatives that not only highlight gender issues but also aim to change harmful norms and practices. These are called ‘gender-transformative’ approaches. However, there are few approaches to achieve gender transformation, and many organisations have struggled to overcome the controversies, sensitivities, and structural barriers that impede progress.

In May 2010, the Alliance carried out a survey of their national Linking Organisations to map their current work; assess capacity, challenges and aspirations around gender and sexuality programming; and better understand the gender and sexuality context in which their partners work. Some 28 organisations from 19 countries responded.

From a policymaking perspective, gender lies at the heart of many of the political commitments made by the world's governments.  For example, the United Nations General Assembly Declaration of Commitment on HIV/AIDS and Political Declaration on HIV/AIDS acknowledge the need, within the framework of universal access, to challenge gender stereotypes, inequalities, and discrimination relating to women, girls, and vulnerable groups.

Some institutions have explicitly promoted a comprehensive understanding of, and commitment to, gender. For example, gender equality is one of the three strategic directions of UNAIDS’ 2011-15 strategy, with goals addressing both women and girls and sexual minorities. Also, while all of the priorities advocated in the UNAIDS Outcome Framework 2009-11 have gender dimensions, two specifically focus on gender commitments. Some agencies further require that organisations not only articulate their commitment to gender sensitivity but demonstrate how they will implement it through their work.

Programmatically, there are a growing number of HIV initiatives that aim to change harmful norms and practices.  While the contexts of different initiatives may vary, these 'gender-transformative' approaches hold in common a number of characteristics, including:

• actively involve and provide constructive roles for all these groups
• use diverse, creative, and context-appropriate methods to engage and mobilise participants 
• empower communities - enabling participants to identify their own gender issues, discuss them together, and identify ways to change harmful practices
• complement programmatic work with advocacy - or links to advocacy initiatives - to address structural barriers to gender transformation
• complement community mobilisation with providing or referring to HIV and gender services 
• build cross-sectoral action on gender, for example involving community gatekeepers and decision-makers 
• promote gender transformation within organisations and among people that provide services and programmes, through training of non-governmental organisation (NGO) staff and health workers.