UNICEF The United Nations Children's Fund

There are around 1.4 million people living with HIV in China and women make up around 23.7% of them, according to the latest data from Chinese health authorities. Among those living with HIV are pregnant women who are in a particularly vulnerable position due to the stigma surrounding the disease.

In order to counter such stigma and discrimination, women living with HIV and Hepatitis B came together at The Voice of Resilience event to tell their stories and to call for additional resources for community-based organizations (CBOs) working on the frontlines providing services for women living with and affected by HIV.

In 2023 alone, more than 5,000 pregnant women were diagnosed with HIV and over 400,000 with hepatitis B, and some of them were diagnosed at very late stage to be able to receive HIV services to prevent transmission to their children, according to China’s National Health Commission. Even though services are in place to prevent the transmission of HIV to their babies, discrimination, including denial of healthcare, obstructs women from accessing such services.

“I received a call from the doctor telling me that I couldn’t receive services from their hospital because I was HIV positive,” explained Xia Jing, one of the mothers, after she went to a general hospital in Beijing for a routine maternal exam. She still cannot hold her tears when she remembers her traumatic experience. She challenged back and told the doctor r that under the law they had no right to reject her.

She was eventually referred to Beijing’s You’an Hospital, a designated hospital for infectious diseases and people living with HIV where she delivered her baby. Now she is a happy mother of a four-year-old boy. Doctor Zhu Yunxia was the doctor who helped Jing deliver her baby. Dedicated to her job for more than 30 years, she is proud of having helped so many women deliver healthy babies. She calls for empathy with people facing discrimination and unfair treatment and urges all people to look at women living with HIV without prejudice.

“Stigma undermines public health objectives by creating barriers to accessing health and social services and can reduce the quality of the services that members of affected communities receive,” said Mark Vcislo, the First Secretary at Canadian Embassy to China, which has supported the work to tackle stigma. He called for breaking down “the prejudices that can prevent and deter marginalized communities, including persons living with HIV, from accessing the health and social services they need and deserve.”

Community-based organizations (CBO) are vital support for women living with HIV. Sister Xin, for instance, who herself received help from community volunteers when she was first diagnosed with HIV, created Firefly, a community-based organization that has help more than 20,000 women living with HIV in the last 20 years. Zhang Yu whose CBO supports women living with HIV in rural areas of China’s southwestern Yunnan Province, called for more resources for CBO’s work. “CBOs are struggling with their survival due to lack of resources,” she said. “I sincerely hope the government, the charity organizations and everybody can support us to continue our work.”

China has developed a strong and ambitious plan to significantly reduce the transmission rates of HIV, syphilis, and hepatitis B by 2025 outlined in China Women’s Development Plan and Healthy China 2030. China has achieved around 99 percent national screening rates among pregnant women living with HIV over the past five years. In 2023 alone, more than 9 million pregnant women have received HIV testing services. 

The Chinese government has partnered with UN agencies for the “last mile” by building a patient-centred and family-centred community service model to enable a holistic set of services and help break the barriers for both mothers and infants.

“Thanks to the combination of development of technology and social progress, women living with HIV can today give birth to healthy babies,” said Sister Xin.

Read the profile of the storytellers and more unsung community heroes committed to  helping mothers and babies: http://www.unaids.org.cn/page122?_l=en&article_id=1233.

Despite significant gains in many countries, critical gaps continue to undermine efforts to end AIDS in children

GENEVA/MUNICH, 22 July 2024—Despite progress made in reducing HIV infections and AIDS-related deaths among children, a new report released today by the Global Alliance for Ending AIDS in Children by 2030 shows that an urgent scale up of HIV services in countries worst affected by the pandemic is required to end AIDS by 2030.

The report, Transforming Vision Into Reality, shows that programmes targeting vertical transmission of HIV have averted 4 million infections among children aged 0-14 years old since 2000. Globally, new HIV infections among children aged 0-14 years old have declined by 38% since 2015 and AIDS-related deaths have fallen by 43%.     

Among the 12 Global Alliance countries, several have achieved strong coverage of lifelong antiretroviral therapy among pregnant and breastfeeding women living with HIV, with Uganda nearing 100%, United Republic of Tanzania at 98%, and South Africa at 97%. Mozambique has achieved 90% coverage, with Zambia at 90%, Angola at 89%, Kenya at 89%, Zimbabwe at 88%, and Cote d'Ivoire at 84%.

“I applaud the progress that many countries are making in rolling out HIV services to keep young women healthy and to protect babies and children from HIV,” said UNAIDS Executive Director, Winnie Byanyima. “With the medicines and science available today, we can ensure that all babies are born – and remain – HIV-free, and that all children who are living with HIV get on and stay on treatment. Services for treatment and prevention must be ramped up immediately to ensure that they reach all children everywhere. We cannot rest on our laurels. The death of any child from AIDS related causes is not only a tragedy, but also an outrage. Where I come from, all children are our children. The world can and must keep its promise to end AIDS in children by 2030.”

Global Alliance countries are innovating to overcome barriers and accelerate progress towards ending AIDS in children. However, despite advances neither the world nor Global Alliance countries are currently on track to reach HIV-related commitments for children and adolescents and the pace of progress in preventing new HIV infections and AIDS-related deaths among children has slowed in recent years.

“Accelerating the delivery and uptake of HIV services for children and adolescents is a moral obligation, and a political choice,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “Twelve countries are demonstrating they have made that choice, but significant challenges remain. While we have made progress in increasing access for pregnant women to testing and treatment to prevent vertical transmission of HIV, we are still far from closing the paediatric treatment gap. We need to further strengthen the collaboration and reach of the Global Alliance, and we must do this work with focus, purpose and in solidarity with all affected mothers, children, and adolescents.”

Around 120 000 children aged 0-14 years old became infected with HIV in 2023, with around 77 000 of these new infections occurring in the Global Alliance countries. AIDS-related deaths among children aged 0-14 years old numbered 76 000 globally with Global Alliance countries accounting for 49 000 of these unnecessary deaths. Vertical transmission rates remain extremely high in some locations, particularly in Western and Central Africa, with rates exceeding 20% in countries including Nigeria and the Democratic Republic of the Congo.

“In the fight against HIV, we must do a much better job for children,” said Peter Sands, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, which provides funding for HIV programmes in over 100 countries through a country-led partnership model. “In support of national programmes, we have been procuring the latest dolutegravir-based paediatric treatment regimens at negotiated prices. Our investments in laboratory systems are helping ensure exposed infants are rapidly tested and that those that test positive are quickly initiated on age-appropriate antiretroviral treatment. Differentiated testing and treatment approaches are helping close the diagnostic gap and ensuring more child-centred service delivery.”

It is concerning that the treatment gap between adults and children continues to widen.

“Just 57 per cent of children living with HIV receive life-saving treatment, compared to 77 per cent of adults,” said UNICEF Associate Director HIV/AIDS, Anurita Bains. “Without early and effective testing and treatment, HIV remains a persistent threat to the health and well-being of children and adolescents and puts them at risk of death. To close the treatment gap, we must support governments to scale up innovative testing approaches and ensure children and adolescents living with HIV receive the treatment and support they need.”

In 2023, there were 210 000 new infections globally among young women and girls aged 15—24 years old (130 000 in Global Alliance countries), four times higher than the 2025 goal set at 50 000. Preventing new infections among this age group is critical both to protect the health and wellbeing of young women and to reduce the risk of new infections among children.

Gender inequalities and human rights violations are increasing women’s vulnerability to HIV and diminishing their ability to access essential services. Globally, nearly one in three women have encountered some form of violence during their lifetime, with adolescent girls and young women disproportionately affected by intimate partner violence. In the four Global Alliance countries with available data, countries are not currently on track to achieve the target of ensuring that by 2025 less than 10% of women, key populations and people living with HIV experience gender-based inequalities and gender violence.

"It has been remarkable to see how many more children's lives can be saved when all stakeholders and partners come together to commit to end AIDS in children. While much progress has been made, notably through the successful introduction of pediatric dolutegravir, large gaps still remain across the pediatric cascade and we must recommit ourselves with purpose and innovation to fulfill the promises we have made by 2025 and beyond,” said Ambassador John N. Nkengasong, United States Global AIDS Coordinator and Special Representative for Global Health Diplomacy.

The Global Alliance for Ending AIDS in Children by 2030 was launched in 2022 by WHO, UNICEF and WHO to reinvigorate the paediatric HIV agenda. It has now grown, and in addition to the United Nations agencies, the alliance includes civil society movements, including the Global Network of People living with HIV, national governments in the most affected countries, and international partners, including PEPFAR and the Global Fund. Twelve countries are members: Angola, Cameroon, Côte d'Ivoire, The Democratic Republic of the Congo (DRC), Kenya, Mozambique, Nigeria, South Africa, Tanzania, Uganda, Zambia, and Zimbabwe.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

In April, at the United Nations Headquarters in New York, governments renewed their commitment and determination to accelerate the implementation of the Programme of Action of the 1994 International Conference on Population and Development (ICPD), the principles of which are embedded in the United Nations Sustainable Development Goals (SDGs), including commitments to ensure universal access to sexual and reproductive health-care services and to advance reproductive rights.1

Significant progress has been made over the past three decades. Since 1990, the number of women using modern contraception has doubled. Since 2000, maternal mortality has declined by 34 per cent. By 2022, access to HIV treatment had averted an estimated 20.8 million deaths globally. More recently, however, this progress has stalled and in some instances is reversing. Looking forward, the prospect of continued progress is far from guaranteed. The ongoing effects of the COVID-19 pandemic, persistent and increasing conflict, climate change, rising inequalities and deepening polarization are all undermining access to quality, essential health services. These setbacks demand urgent action.

Women and girls are disproportionately affected by these challenges, hindering their right to make informed decisions and exercise full bodily autonomy without coercion, violence or discrimination – fundamental human rights. Equitable and sustainable access to human rights–based sexual and reproductive health interventions and information remains beyond the reach of many – especially marginalized women, adolescent girls and those living in humanitarian crises and conflict zones. The latest data show that close to half of women of reproductive age cannot make their own informed decisions about whether or when to become pregnant, and many still lack the autonomy and agency to fully exercise their reproductive rights.

On World Population Day, as UN agencies mandated to advance the health and rights of all people and ensure no one is left behind, we call upon the global community, including governments, donors, civil society organizations, and the private sector to strengthen access to a comprehensive package of sexual and reproductive health services as part of universal health coverage, delivered through resilient health systems including at the primary healthcare level. We underscore the need to implement evidence-based, normative guidance to strengthen access to affordable, high quality and rights-based care. To ensure services are acceptable to all, efforts are needed to eliminate stigma and discrimination and dismantle harmful social and gender norms.

We also call for accelerated access to comprehensive sexuality education and strengthened action across social sectors, such as education and gender, to enhance the health and well-being of girls and women throughout their lives. Promoting comprehensive sexual and reproductive health and rights is not only the right thing to do – it is also the smart thing to do. Investing in women’s and girls’ reproductive rights and agency and expanding access to services is proven to have remarkable returns, including in terms of social wellbeing, economic prosperity and peace, which our world so desperately needs. Additional financing from all sources – domestic, international, public, private – is essential to create long-term positive outcomes for women and girls.

We must also urgently support the increasing efforts of young people, women and communities to speak up about sexual and reproductive health concerns and to design and deliver solutions that respond to their needs and to the realities of a changing world, where climate change in particular, affects sexual and reproductive health and rights. An inclusive, bottom-up approach to designing and delivering health interventions with and for communities can deliver more sustainable results and reach those who are furthest left behind.

We urge the public and private sectors to collaborate in exploring cutting-edge technologies like telemedicine, artificial intelligence, big data analytics and predictive modeling to bridge geospatial gaps and expand access to essential services, particularly in remote and underserved areas. At the same time, we call on innovators to address the risks inherent in these new technologies, including gender gaps in access, technology-facilitated gender-based violence, and systematic biases embedded in tech design.

Finally, we call upon governments, communities, civil society organizations and the private sector to unite to prioritize universal access to comprehensive sexual and reproductive health, in ways that advance gender equality and promote the full realization of human rights, in line with the groundbreaking vision of the ICPD Programme of Action. We ask for more than a commitment, more than business as usual — this is an appeal to collaborate and innovate in ways that ensure everyone can realize their rights to health, dignity and security. As we head towards the Summit of the Future at the United Nations General Assembly in September, now is the time to act boldly and decisively, forging a path towards a more just, equitable and sustainable world for all.

Thirty years ago in Cairo, 179 governments adopted a framework that recognized sexual and reproductive health and reproductive rights and the empowerment of women and girls as foundational pillars of sustainable development – the landmark Programme of Action of the International Conference on Population and Development. As UN agencies, we stand together committed to advancing comprehensive sexual and reproductive health and rights, which are integral to everyone’s right to the enjoyment of the highest attainable standard of physical and mental health and essential for the achievement of gender equality.

[1] https://www.un.org/development/desa/pd/content/regional-reviews-icpd-programme-action

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Girls’ education as a tool to prevent HIV infection has been centered at the 1st African Union Pan-African Conference on Girls’ and Women’s Education in Africa. This followed African leaders designating education as the 2024 African Union theme of the year.

At a high-level side event hosted by the Education Plus Initiative on the first day of conference held at the African Union Commission in Addis Ababa, Ethiopia, leaders, girls’ and women’s networks and advocates called for greater investments in girls’ education.

“Some people claim that providing girls with secondary education is too expensive. Such claims fail to consider the exponentially higher cost of not educating them,” said UNAIDS Executive Director, Winnie Byanyima. “We can get all our girls and boys to complete secondary education; that should be our legacy."

UNICEF calculates that 34 million girls in sub-Saharan Africa are out of secondary school. According to the Global Education Monitoring (GEM) Report 2023, in all regions in Africa, there are more girls out of school at the secondary level than boys, with gender disparities worsening as children move up to higher levels of education in favour of boys over girls. In sub-Saharan Africa, less than half of adolescent girls complete secondary education, their percentage standing at 42% and there has been no progress at all in closing this gap in the past 20 years.  Sub-Saharan Africa is the region furthest from parity at the expense of girls, with no progress since 2011 at the lower secondary level and since 2014 in upper secondary.

Gender is a key factor linked to disparities in enrolment, retention, completion, and learning outcomes through social conditioning, gender-based differences in parental expectations and education-related investments, child marriages and early childbearing, female genital mutilation, child labour, gender-based violence, period poverty and discrimination.

More than forty years into the HIV response, Africa remains an epicenter of the AIDS epidemic with adolescent girls and young women being disproportionately affected. Every week 3100 adolescent girls and young women acquired HIV in sub-Saharan Africa. Every three minutes, an adolescent girl or young woman aged 15-24 years acquired HIV in 2022 in sub-Saharan Africa.  Adolescent girls and young women aged 15-24 years in the region were more than three times as likely to acquire HIV than their male peers in 2022.

UN agencies, African Union representatives, government ministers, and young women leaders called for accelerated actions to translate commitments to action through leveraging girls' education for gender equality and preventing HIV, child marriage, teenage pregnancies, violence, gender-related stigma and discrimination in Africa.

Speakers emphasized the connection between health and education. Ministers spoke about key policy reforms and best practices aimed at promoting girls' education, including creating safe and inclusive school environments, strategies to get girls into secondary school, and the readmission policy that addresses high dropout rates due to pregnancy.  UN co-leads emphasised the need for improved collection of data disaggregated by sex and other relevant population characteristics to better understand educational participation, progression, and learning, and using gender-sensitive data for policymaking and planning. 

Other issues highlighted included the integration of digital literacy programs into the secondary education and vocational training curriculum to facilitate smooth transitions from school to employment; integrate gender equality into all aspects of the education system, including curriculum-based comprehensive sexuality education  and life skills, address gender-based violence  within schools and discriminatory laws and practices, and access to information, non-discriminatory HIV and sexual and reproductive health services access.

Young women leaders spoke on the role of partnerships and young women's leadership. Participants highlighted the upcoming 30th anniversary of the Beijing Declaration as an opportunity moment to accelerate accountability and commitments, as well as the CSW Resolution 60/2, Women, the Girl Child and HIV and AIDS as significant mechanisms to address political and resource gaps so no woman or girl is behind in the HIV response.

Education Plus is a rights-based, gender-responsive action agenda to ensure adolescent girls and young women have equal access to quality secondary education, alongside key education and health services and support for their economic autonomy and empowerment.  Co-led by five UN agencies, the initiative builds on existing frameworks like the Transforming Education Summit, the Continental Education Strategy for Africa (CESA) and the Dakar Education for All (EFA) Declaration to push for access and completion of education for women and girls in Africa.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Despite substantial declines in new HIV infections globally, the HIV/AIDS epidemic continues to disproportionately impact adolescent girls and young women in many countries, particularly in sub-Saharan Africa. In 2022, there were 3,100 new weekly infections among adolescent girls and young women aged 15-24 years.  In sub-Saharan Africa, adolescent girls and young women accounted for more than 77% of new infections among people aged 15-24 years in 2022.

That’s why Education Plus Initiative co-hosted with the Grand Duchy of Luxembourg a high-level side event on the margins of the 68^th Commission on the Status of Women (CSW68) to bring attention to the cost of inaction, calling for more consistent investment in education, health and economic rights of adolescent girls and young women in Africa. The CSW, which runs from 11- 22 March 2024, is the United Nations largest annual gathering on gender equality and women’s empowerment, with this year’s priority theme, Accelerating the achievement of gender equality and the empowerment of all women and girls by addressing poverty and strengthening institutions and financing with a gender perspective.

Speakers included four ministers from Luxembourg, Benin, Sierra Leone, and Uganda, senior government officials from Cameroon and South Africa, and heads of UN agencies who co-lead Education Plus, ATHENA network. Hannah Dolly Kargbo, a young activist from Freetown, Sierra Leone, and founder of the Girls Advocacy Development Network (GADNET), pre-recorded a video that showed her work with young people to advance rights.

The event, Education Plus investment cases for transformative results: leveraging girls completion of secondary education for gender equality and HIV prevention mobilized government, partners and key stakeholders towards accelerated actions and translate commitments to action for gender equality and HIV prevention in Africa.

The costs of inaction on the rates of HIV in adolescent girls and young women remain significant, not only counted in terms of the harmful impacts on girls’ lives but in how they undermine prospects for poverty eradication and the well-being and resilience of families, communities, societies and national economies.  For instance, the lack of educational and economic opportunities that result in women’s diminished labour force participation is estimated to cost the African region US$60 billion in economic losses every year. And yet Africa could gain US$500 billion per year through multi-sectoral investments in adolescents and youth, especially girls, by capitalizing on demographic windows of opportunity.

Education Plus calls for investment in the education and empowerment of adolescent girls and young women, and 15 champion countries are already committed to using education as a means to reduce high HIV rates.  Investments that guarantee education for all young people, violence-free school environments, provision of stigma-free health services, comprehensive sexuality education, access to sexual reproductive health and rights services and economic autonomy and empowerment are key to ending AIDS as a public health threat by 2030. When adolescent girls and young women complete secondary school, their risk of getting HIV is reduced significantly.

GENEVA/NEW YORK, 11 March 2024 - UNAIDS is gearing up for the 68th session of the Commission on the Status of Women (#CSW68) which begins today and will run until 22 March 2024. #CSW68, the United Nations largest annual gathering on gender equality and women’s empowerment, is being held this year under the priority theme, Accelerating the achievement of gender equality and the empowerment of all women and girls by addressing poverty and strengthening institutions and financing with a gender perspective.

Despite progress, no country has achieved gender equality to date, and violations of women’s human rights and gender-based violence are continuing to fuel the AIDS pandemic. The world is off track to meet the gender targets set out in the Sustainable Development Goals (SDGs) and in many of the world’s poorest countries, the debt crisis is squeezing out investment in education, health, and social protection, particularly hurting women and girls.

Around the world today, 129 million girls are out of school, denying them lifesaving information on how to protect themselves from HIV. Every three minutes, an adolescent girl or young woman (15-24 years) acquired HIV in 2022 in sub-Saharan Africa, and across Africa, AIDS remains the leading cause of death among women of reproductive age.

"There can be no more excuses. Ending AIDS among women and girls is not only a moral imperative but also a strategic priority for achieving the Sustainable Development Goals,” said Winnie Byanyima, Executive Director of UNAIDS. “Only by protecting and investing in the rights of women and girls can we protect their health, and only by protecting women’s health can we end the AIDS pandemic. We must seize this opportunity to accelerate progress towards a world where every woman and girl can, not just survive, but thrive."

During #CSW68 UNAIDS will be co-hosting several key events including a high level meeting co-convened by the Grand Duchy of Luxembourg and Education Plus (a joint initiative of UNAIDS, UNESCO, UNFPA, UNICEF and UN Women) which will mobilize government, partners and stakeholders to accelerate scaled up actions on women’s rights and leverage girls’ education for gender equality and HIV prevention across Africa.

UNAIDS is urging renewed action and anticipates strong outcomes from #CSW68. UNAIDS looks forward to the partnerships that will be forged to accelerate progress towards gender equality and ending AIDS as a global public health threat.

UNAIDS remains steadfast in its commitment to working collaboratively with governments, civil society, and other partners to create a world where the rights and dignity of all women and girls are respected and protected, including women and girls living with, at risk of and affected by HIV.

#CSW68, hosted by the United Nations, will convene leaders, advocates, governments, civil society organizations, activists and experts to discuss, agree on actions and investments that can end women’s poverty and advance gender equality.

Follow the Education Plus event live on Tuesday 12 March at 08:00 – 09:30 EST - Making Education Investment Cases Work for Gender Equality and HIV Prevention  

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

At Refuge des Femmes d'Haiti, a small women's community-based organization in the commune of Croix-des-Bouquets, Port-au-Prince, Martha Norcimè, a 34-year-old pregnant woman from the nearby commune of Delmas, completes her training in sewing and macramé—a form of textile produced using knotting techniques.

She is part of a group of vulnerable women deeply affected by the gang violence and warfare that has impacted several areas of the capital since early 2022. Most of her peers came from Croix-de-Bouquets. All of them—including women with HIV—living in challenging circumstances, who have seen their livelihood completely disappear throughout these past two years as violence rose.

"I will soon give birth to my first child. I used to sell food and cleaning products that I was buying on the Haitian-Dominican border between Jimani and Malpasse, and I was then selling in markets in the city and in my neighborhood,” recalls Martha. “But I could no longer continue, given the blockade of the North city entry controlled by armed gangs. So many women traders are raped, kidnapped, or robbed by them."

In the fall of 2022, a joint UN project coordinated by the UNAIDS Country Office in Haiti, with participation from UNFPA, UNDP, and UNICEF, has been launched in partnership with Refuge des Femmes d’Haiti and with the support of FOSREF, a Haitian non-governmental organization. The goal is to support women and girls living this daily reality by empowering and giving them the tools to remain healthy and overcome the feminization of HIV in Haiti.

Haiti’s significant gains made over the past decade in controlling its HIV epidemic are now under threat, particularly in the capital, where a third of the 11.8 million Haitians reside. The brunt of an ongoing socio-economic and security crisis triggered by the assassination of former President Jovenel Moïse in July 2021 is borne by adolescent girls, young and adult women.

The feminization of HIV has long been a feature of the Haiti pandemic with HIV prevalence for females at 2.3%, compared to 1.6% among men. Still, the continuing multi-faced and profound crisis, fueled by such levels of violence, is exposing thousands of women to HIV infection.

In October 2022, a joint human rights report published by the United Nations Integrated Office in Haiti (BINUH) and the Office of the United Nations High Commissioner for Human Rights (OHCHR), entitled Sexual violence in Port-au-Prince: a weapon used by gangs to instill fear denounced collective rape by gangs in the capital as a weapon of war. In May 2023, research conducted by the Global Initiative Against Transnational Organized Crime in Cité-Soleil, another impoverished commune in Port-au-Prince deeply hit by gang activity, found that 80% of the women and girls who participated in the study had been victims of one or more forms of gender-based violence by one or multiple perpetrators.

"We work closely with UN Agencies to support women, victims of violence, make them financially independent and thus reduce the feminization of HIV, sexual and gender-based violence and maternal and neonatal mortality," says Novia Augustin, President of Ref-Haiti, and of the Federation of Women Organizations for the Equality and Human Rights (FEDOFEDH). "Difficulties are several, but the biggest is insecurity and the lack of financial resources. My motivation comes from our results: When I look at the satisfaction on the faces of the women we have accompanied, the recognition they show, I tell myself that it is worth it, despite all the difficulties encountered and the risks incurred."

Martha recalls how Novia opened the door to her for intensive training every day from 8 a.m. to 4 p.m. At the time, she was already pregnant. And despite the pregnancy-related fatigue, she did not miss a single day of class. “I can sew skirts, bonnets, blouses and even sandals!" she says proudly. "But I can't do anything now because of this crisis. Sometimes I even miss my pre-natal appointments with the doctor just because I am afraid to go out."

Besides training, Ref-Haiti also included discussions  on HIV risk and prevention, gender-based violence, sexual and reproductive health, family planning, and cholera. The awareness-raising activities targeted women beneficiaries and hundreds of young girls of other affected communes.

"We are working to support an integrated health response for women and girls so severely affected by gang violence and by socio-economic inequality”, says Christian Mouala, UNAIDS Country Director for Haiti. “We are proud of women-led local organizations such as Refuge des Femmes and their immeasurable efforts to support women to overcome the challenges they face."

All photos by UNDP Haiti

Last year, Elina Kruglova made a bold decision. She disclosed her HIV status during the casting of a popular reality TV show in Uzbekistan.

“I disclosed my status right at the casting because the project lasted for several months, and I needed to take medicine daily,” she said. “I made the decision to be honest and mustered up the courage. I thought they wouldn't accept me, but I passed the casting," Ms Kruglova explained.

In her second-year student in the Faculty of Agricultural Economics at Tashkent State Agrarian University in Uzbekistan, she grew up in an orphanage. She was the first child living with HIV in her country to start antiretroviral (ARV) therapy seventeen years ago. Despite facing stigma, she has been taking life-saving medicine daily.

Uzbekistan struggles with HIV-related stigma and discrimination.

According to the recent Multiple Indicator Cluster Survey (MICS) in Uzbekistan, 76% of women aged 15-49 in the country would refuse to purchase vegetables from a vendor living with HIV and would not accept children living with HIV attend school with other children. Prejudice is fuelled by a lack of knowledge; only 14% of women in the same age group possess comprehensive information about HIV. Uzbekistan's HIV cases have steadily risen by 44 % in the last six years (31,088 in 2016 to an estimated 45,000 in 2022.)

Throughout the TV show, Ms Kruglova shared her experiences of being an orphan and living with HIV. Over time she became an inspiration for young people and those living with HIV.

"When the TV episode aired, I started contemplating how people would perceive me, what they would say, and how they would react,” she recalled. “Psychologists were working with us during the project, which made it easier for me to handle the pressure."  

To her surprise, people positively reacted when they recognized her on the streets, and she received numerous supportive messages from people living with HIV via Instagram.

"I am grateful for the trust they placed in me " she said.

For her, the Tashkent day-care center for children and families affected by HIV supported by UNICEF and UNAIDS played a crucial role in her life. It provided a safe haven, gave guidance throughout her childhood and teenage years. The center's support group, the professional consultations, and master classes helped her develop practical life skills. She is optimistic about the future and believes that people can change their attitudes towards HIV with the right information and education.  In her mind, hiding only makes things worse.

Aida Muravyova knows all about the power of disclosing her HIV status.

She is a 16-year-old school student in Kazakhstan and learned about her HIV status when she was 6 years old. Although advised against disclosing her status at school and extracurricular activities, Aida chose a different path.  She shared her HIV status with her classmates in school and took on the role of breaking down the myths and misconceptions surrounding HIV in front of her peers and adults.

“When I was told about my HIV diagnosis, I thought to myself, 'Okay, I have red hair, I have HIV, I take pills... what else?!'"

Ms Muravyova found solace through the Teenergizer Movement, a youth-led initiative supported by the Kazakhstan Government, UNICEF, UNAIDS and other donors. Teenergizer aims to empower young people living with HIV. It created a safe space for young women like her to connect, have fun, and share experiences without shame or stigma. The movement has reached many young people in the country, creating a ripple effect of reliable information and support.

When Teenergizer came along, Ms Muravyova invited classmates to join. "They got valid information, learned with me, and even conducted training sessions,” she said. “The most gratifying part was when one of my classmates' mothers, initially frightened by my HIV status, learned about HIV through her child's participation in Teenergizer.”

Her friend told her that her family had an open conversation, hashed out concerns, and now everything is okay.

Gender assessments conducted in several countries of Central Asia, including Kazakhstan, confirmed that gender inequality, stereotypes, customs and practices increase women’s vulnerability to HIV as well as limit their choices and expose them to socioeconomic and health difficulties.

Ms Muravyova refuses to let her HIV status define her or limit her dreams.. "I have seen many people living with HIV, but never in my field of Electrical and Aerospace Engineering... I want to change that perception and demonstrate that living with HIV can be different, cool, and interesting."

The UNAIDS Regional Policy and Equality Officer in Central Asia, Elena Kiryushina, sees role models like Elina and Aida as well as community networks as key.

“Promoting leadership among adolescent girls and young women, fostering positive masculinities in boys and men, providing care and support to adolescents living with HIV, especially those who lost parents and access to comprehensive sexuality education in and out of schools, and supporting gender-transformative approaches are essential steps to address HIV and gender-related stigma and to build foundation for the gender equality in Central Asia and beyond,” she said.

UNAIDS and partners believe empowering women and girls and challenging cultural norms is crucial to address HIV stigma and ensure equal access to support and health services.

Ms Muravyova has one mantra. “Speak, and don't be afraid!,” she said. “We are together, and together we'll make it through.”