Ring in the changes

Gahsiena van der Schaff Advocacy, Campaign and Networking Co-ordinator at Aids Legal Network (ALN)

It’s a bit of a case of “good” news and very “bad” news… good news is that there is hope to reduce HIV infection among women.

The results of the long-awaited vaginal ring trials are promising in that it, along with other bio-medical technolo-gies, potentially could reduce women’s risk to HIV by 61 percent in women older than 25, according to reports.

It is indeed a major setback that “the ring” does little to reduce young women’s HIV risk since young women in all their diversity on the African continent mainly are predisposed to HIV infection (According to the South African National Aids Council, young girls are acquiring HIV infection five to seven years earlier than men and are three to six times more likely to become infected compared with young boys in the same age group).

Many of us might be persuaded that this is indeed “progress” and /or “promising” developments, but this is no “miracle” ring with “miracle powers”.

In fact this “ring” has little benefit to women, and we are many, who have issues with having to insert this “foreign object” into one’s vagina, every 28 days, and without telling my partner or risk unexpected dire consequences telling my partner.

Young women’s increased risk to HIV infection is non-medical hence medical/bio-medical remedies are of little help, though for some bewildering reason/s remain to be a major focus for states on the continent in their search for a magic solution.

Our problem is simple. Most women in South Africa and elsewhere on the continent are not in charge of our choices, especially regarding our bodies and sex lives. Everyone knows it, and everyone abuses this. For example, at clinics, based on my age, sex, gender, gender identity it is already decided that I will test for HIV on every visit; I will take the implant (implanon); I will take male condoms (“for my partner”, who might be a she, but who cares?) to name but a few examples.

The one occasion when I do make a decision for myself ie to terminate my pregnancy, I get judged, insulted, by my partner, family, community, my place of worship, media and politicians alike.

What women need are not rings or other things. What we need is agency. What we need is for services to be free of discrimination, judgement, coercion, free of robbery of our agency; fewer people around who know what is “best” for me, without even knowing me.

What we need is for available tools and services to be accessible as possible. What we need is to have our decisions, dignity, rights and freedoms to be respected – all the time, everywhere, by everyone. What we need is an enabling, supportive and an engendered social environment in which women are in a position/ have the capacity to claim agency and realise all of our human and legal rights and freedoms.

The solutions are simple too, and as huge as the proverbial white elephants in the room.

Stop ignoring the obvious. Gender inequality leads to high rates of gender violence and rape, which result in women’s disproportionate risk to HIV and rights violations, we know it and you know it. Key to the next NSP on HIV/STIs and TB must be to reduce gender violence and rape.

Gender equality, accessible services free of judgement, coercion and other rights abuse, and a gender equal social environment where women’s agency, rights and freedoms are respected, is a sure way to increase the number of people accessing and benefiting from available healthcare service and reduce non-adherence.

Monitor and effectively address the rampant violations of rights happening at health facility level.

It is simple really, we know what the problem is, all we need to do is fix the problem; a will to do it will not only be a totally “promising” development but will indeed be progress.

blob The ring referred to is a monthly ring, which slowly releases the ARV drug dapivirine over time to protect against HIV.