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应对艾滋病毒过程中解决性别不平等和亲密伴侣暴力问题:迈向非洲南部和东部的有效干预措施

Tackling gender inequalities and intimate partner violence in the response to HIV: moving towards effective interventions in Southern and Eastern Africa.

作者信息

Gibbs Andrew

机构信息

a Health Economics and HIV and AIDS Research Division (HEARD) , University of KwaZulu-Natal , Durban , South Africa.

出版信息

Afr J AIDS Res. 2016 Jul;15(2):141-8. doi: 10.2989/16085906.2016.1204331.

DOI:10.2989/16085906.2016.1204331
PMID:27399043
Abstract

Ending intimate partner violence (IPV) and reducing gender inequalities are recognised as critical to "'ending AIDS" by 2030. Amongst women, experiencing IPV has been shown to increase HIV acquisition, reduce women's ability to use HIV prevention strategies and reduce adherence to antiretroviral therapy (ART). In Southern and Eastern Africa there has recently been a significant push to strengthen programming around this through broad funding and programming streams. However, while gender inequality underpins IPV and HIV acquisition, in different contexts a variety of other factors intersect to shape this vulnerability. Using reflections focused on young women living in urban informal settlements and the Stepping Stones and Creating Futures intervention, this paper illustrates the need to understand the specific drivers of HIV and IPV in any given context and the need for interventions to prevent this. Any intervention needs to include three key components: 1) resonate with the lived realities of women they target; 2) tackle multiple factors shaping women's vulnerability to IPV and HIV simultaneously; and 3) consider how best to work with men and boys to achieve improved outcomes for women. Such an approach, it is argued, resonating with the "slow research" movement, will yield better outcomes for interventions, but will also require a fundamental rethinking of how interventions to prevent IPV and HIV amongst women are conceptualised, with a greater emphasis on understanding the ways in which gender resonates in each context and how interventions can operate.

摘要

终结亲密伴侣暴力(IPV)和减少性别不平等被认为是到2030年“终结艾滋病”的关键。在女性中,遭受亲密伴侣暴力已被证明会增加感染艾滋病毒的几率,降低女性采取艾滋病毒预防策略的能力,并降低对抗逆转录病毒疗法(ART)的依从性。最近在南部非洲和东部非洲,通过广泛的资金和项目渠道大力推动围绕这一问题加强项目规划。然而,虽然性别不平等是亲密伴侣暴力和感染艾滋病毒的基础,但在不同背景下,各种其他因素相互交织,形成了这种脆弱性。本文通过关注生活在城市非正式住区的年轻女性以及“垫脚石与创造未来”干预措施的思考,说明了有必要了解在任何特定背景下艾滋病毒和亲密伴侣暴力的具体驱动因素,以及采取干预措施预防这种情况的必要性。任何干预措施都需要包括三个关键要素:1)与目标女性的生活现实产生共鸣;2)同时解决造成女性易遭受亲密伴侣暴力和感染艾滋病毒的多种因素;3)考虑如何最好地与男性和男孩合作,以改善女性的状况。有人认为,这种方法与“慢研究”运动相呼应,将为干预措施带来更好的效果,但也需要从根本上重新思考如何构思针对女性预防亲密伴侣暴力和艾滋病毒的干预措施,更加注重理解性别在每种背景下的表现方式以及干预措施如何发挥作用。

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