Jamra primary scholl for children affected by HIV/AIDS, drugs or poverty, Senegal (c) Nell Freeman/Alliance Participants in the Photovioce project, Ecuador © Marcela Nievas for the Alliance
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Empowering women to make choices

1
MAY
2013

Aids Alliance

As thousands of delegates travel to Malaysia to attend the 2013 Women Deliver conference at the end of this month, Shaleen - an outreach worker at a drop-in centre for sex workers – talks about the work she does to empower women to demand quality, user friendly integrated sexual and reproductive health and rights (SRHR) and HIV services.

The vast majority of Muslims living with HIV in Malaysia are men who have injected drugs.  However, over the last few years heterosexual sex has crept ahead of injection as the main way of transmitting HIV, with 45% of new cases the result of sex between men and women, compared to 38% for sharing needles.

Zaki Arzmi of the Malaysian AIDS Council, an Alliance Linking Organisation, says: “For years HIV has been seen as the problem of men who inject drugs, but these men don’t exist in a bubble – they have lives, they have sex – and as a result we are slowly seeing more women become infected. At the start of the Nineties, the ratio was one women infected for every 99 men. Now the ratio is one to four.”

Shaleen’s story

Shaleen works at a drop-in centre for sex workers in Pahang, a state on Malaysia’s south east coast.  She knows the reality of the sexual transmission of HIV only too well.“I had no idea that my first husband was using drugs,” she says, “I discovered I was HIV positive when I was pregnant with our first child. After my husband died I decided to start working here; I was inspired to start doing something for the community.”

In 2004 Shaleen met her second husband, a former drug user who is also living with HIV, and in 2007 they married. He also works at the drop in centre, which is supported by the Malaysian AIDS Council.

“I never thought I would get married again. I am inspired by what my husband has gone through,” says Shaleen. “He has taught me a lot about how to treat people. I am proud of what I am doing now; that people living with HIV are not being shunned and they have a place where they can find support.

“I also take pride in the fact that we can see behaviour change in the women coming here. Those that didn’t know how to put a condom on now do, those who weren’t able to negotiate safer sex can.

“Now that they know what a condom does they are more empowered to make choices, to make decisions, because they know what might happen to them without the condom. I see the change in their confidence that this brings.”

Women & HIV

Whilst progress in preventing death from AIDS has been impressive, globally it remains a fact that for women in their reproductive years (15-49), HIV is the leading cause of death.

In regions where HIV prevalence among pregnant women is as high as 15% (sub-Saharan Africa and the Caribbean), HIV-related maternal mortality accounts for 20% of all maternal deaths.And for those women and girls from the key populations that are most vulnerable to HIV and AIDS (including women living with HIV, transgender women, women who use drugs, and women who sell sex) an effective HIV response that can be delivered at scale is still very much needed.
  
Divya Bajpai, the Alliance’s Senior Adviser on SRHR and HIV, says: “Linking these two services has long been recognised as a highly efficient and priority way forward. Doing so can reduce vulnerability to HIV and other sexually transmitted infections, as well as reduce maternal mortality.

“The Alliance works with communities most at risk of HIV and we see on a daily basis the vital need for better access to quality SRHR and family planning services.”

Useful links:
  • Click here to read our key messages for Women Deliver and here about our activities at the conference
  • Click here to download Raise the Bar, a short briefing for donors, governments and civil society on the building blocks to successful SRHR and HIV integration.  This was developed by the UK SRHR Network (of which the Alliance is a member) for the July 2012 DFID and Gates Summit on Family Planning.
  • Click here to read more about the Uganda country mapping of our new project, Link Up, which aims to improve the sexual and reproductive health and rights (SRHR) of more than one million young people who are vulnerable to or affected by HIV and AIDS in five countries in Africa and Asia.
  • Download a list of key Alliance SRHR resources.