Approaches to gender and sexuality: responding to HIV

Gender and sexuality – and their related norms and practices – have long been recognised as key factors affecting the dynamics of HIV and the global response to it. This survey report, published by the International HIV/AIDS Alliance, maps current work and assesses the capacity, challenges and aspirations around gender and sexuality programming. Whereas issues vary across communities and countries, the authors contend that 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.

Key findings of this survey are:

• gender inequality and discrimination, fuelled by socio-cultural issues, are the most common gender concerns.
• there are mixed opinions about how much national programmes respond to these gender-related challenges.
• many respondents believe a gender and sexuality approach provides a useful way of understanding HIV work that is based on the roles and expectations that affect people’s lives, choices and interactions.
• key challenges to gender and sexuality work include discriminatory gender norms and inequality; low male involvement in programming and interventions.
• only 25% of respondents feel they have the capacity to apply a gender and sexuality approach.

To improve the Alliance’s work on gender and sexuality in the future, the authors recommend the development of a gender strategy for Alliance partners; carrying out of a more specific assessment of the capacity needs of partners for gender-transformative approaches, and development of a plan to address the ensuing needs; documentation examples of good practice of gender-transformative approaches; and ensure that gender transformation is fully integrated and addressed in existing and future work on good practice responses to HIV.

In conclusion, the authors note that 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 within and outside the Alliance have struggled to overcome the controversies, sensitivities and structural barriers that impede progress.