|'ABC' (partner reduction) is important but NOT sufficient without gender equality!|
Partner Reduction and Violence Against Women and Girls
Increasingly, from a public health perspective, partner reduction is touted as the most obvious strategy to reduce HIV prevalence. This particular approach is premised on a strong belief is that once people accept the reality of AIDS and know how to protect themselves, they would simply adopt the appropriate behaviours. Thus putting a heavy emphasis on the ABC strategy – A for abstinence, B for being faithful (or reducing the number of sexual partners) and C for condom use.
However, women’s rights actors have argued from the beginning that issues of profound vulnerability and inequality that drive HIV transmission are much more complex than most people initially thought. In reality, enduring gender inequalities, including economic inequality and gender violence, which continue to contribute to women's vulnerability to HIV is still alarming. In fact, in the context of women and girls vulnerability to violence, without the ability to control their sexual lives, women and girls are in no position to abstain form sex. From a scientific and epidemiological perspective, partner reduction sounds like the logical or rational approach. Yet, as a strategy it is ineffective for many married women, including women in abusive relationships who are not able to abstain because their husbands force sex on them, women who choose to be monogamous but have no control over their husband’s monogamy, or women who risk physical violence if they request condom use by their partner.
This is confirmed by research conducted in diverse countries which found that violence and the fear of violence acts as a significant barrier to women negotiating condom use or fidelity with their partners or choosing to leave risky relationships. In addition, women’s economic dependence on men often makes it difficult for them to refuse sex, and indeed makes it more likely that many will participate in sex for favoursWhile the “ABC” prevention approach is important, it is NOT sufficient. Strategies addressing gender inequalities are urgently needed. The problem with the ABC approach, is that without shifting deeply gendered dynamics within intimate and familial relationships between women and men, and without addressing the root causes of male entitlement and female subservience, as an AIDS strategy, it is doomed to fail.
An approach that places too much emphasis on partner reduction, further increases the HIV vulnerability of socially marginalised groups such as sex workers. The danger is that at the social level, sex workers could face increased stigmatization and also risk of violence. In addition, this could result in states justifying inadequate health care, information, education and other basic rights to the most marginalised of their citizens.
International Members of the “Women Won’t Wait – End HIV and Violence Against Women. Now.” campaign:Action Aid; African Women’s Development and Communications Network (FEMNET); Association for Women’s Rights in Development (AWID); Center for Women’s Global Leadership (CWGL); Center for Health and Gender Equity (CHANGE); Fundación para Estudio e Investigación de la Mujer (FEIM); GESTOS-Soropositividade, Comunicação & Gênero; International Community of Women Living with HIV&AIDS Southern Africa (ICW-Southern Africa); International Women’s AIDS Caucus; International Women’s Health Coalition (IWHC); Latin American and Caribbean Women’s Health Network; Open Society Initiative for Southern Africa (OSISA); Program on International Health and Human Rights, Harvard School of Public Health; SANGRAM; VAMP; and Women and Law in Southern Africa (WLSA).
 Wilson D (2004). Partner Reduction and the Prevention of HIV & AIDS. BMJ. http://www.bmj.com/cgi/content/full/328/7444/848.
 Duvvury N, Prasad N and Kishore N (2006). HIV & AIDS – Stigma and Violence Reduction Intervention Manual – Change is Possible. ICRW. http://www.icrw.org/docs/2006_SVRI-Manual.pdf.
 Msimang S (2006). Women and HIV/AIDS. Unpublished paper presented at Putting Feminist on the Agenda, South Africa, November 2006.