Good Practice Guide: Gender-Transformative HIV Programming

From the International HIV/AIDS Alliance, this guide contains information, strategies, and resources to help practitioners ensure that HIV programming responds to and addresses harmful gender norms, structures, and stereotypes that act as a barrier to HIV prevention, treatment, and care. It considers the many ways in which gender and HIV interact, and how this is influenced by variables such as education, income, age, ethnicity, race, disability, migrant status, health, location, and sexual orientation. Evidence shows that HIV flourishes in conditions of inequality and lack of accountability. In many countries, HIV prevalence continues to rise among women, especially adolescent girls, young women, and women from key populations. While gender affects susceptibility to HIV and the impact of HIV, HIV also influences gender inequality, sexual and reproductive health and rights (SRHR), and human rights more generally.

In a section on language and the use of words such as "gender" and "women", the Alliance stresses: "The language we use matters. This is particularly true in the context of HIV. The impact of HIV is strongly influenced by a wide range of identity factors (including practices and behaviours) that make individuals and communities more or less vulnerable because of the stigma and discrimination attached to them. This guide provides a lens through which to identify and analyse these identities - and the stigma and discrimination that is often attached to them - in order to better understand and serve communities."

The Alliance standards for gender-transformative HIV programming can be used at any time in the programme cycle to: assess and share good practice; help develop proposals and monitoring and evaluation (M&E) frameworks; design and refine interventions; and facilitate community-led advocacy. The standards include:

1. Commitment to a gender-responsive approach and to advancing gender equality.
2. Promotion of the human rights of children, young people, and adults of all gender identities and sexual orientations.
3. Programmes and advocacy that are based on a comprehensive gender analysis that recognises and takes into account the intersectional nature of gender issues and the experiences of women and girls in all their diversity.
4. Commitment to the meaningful involvement of women and girls living with and most affected by HIV at all stages of programme design and implementation, including planning, monitoring, and evaluation.
5. Programmes and advocacy that promote the active participation, empowerment, and leadership of women and girls in all their diversity in all decision-making that affects their lives.
6. Programme activities that are designed to prevent and address gender-based violence (GBV) in all its forms in the context of and the response to HIV and that are designed and implemented in such a way that recognises and minimises the risk of GBV within HIV programming.
7. Programming that is designed to promote and contribute to the full realisation of the SRHR of women and girls in all their diversity, including those living with and most affected by HIV.
8. Programmes that address harmful gender norms and practices that make some people vulnerable to HIV and sexual and reproductive health (SRH) problems, or that limit access to services.
9. Efforts to ensure that national laws and policies do not criminalise or stigmatise people because of their gender identity or sexual orientation.

After introductory section that cover topics such as the relationship between HIV and gender inequality and the benefits of incorporating gender into HIV programming, Section 1 of the guide describes how gender analysis can strengthen programming by looking at three overlapping and mutually reinforcing areas:

• using available data and filling in the gaps
• promoting gender equality and addressing harmful gender norms
• removing gender-related barriers to access to services and information.

Section 2 provides practical guidance and tools for integrating gender considerations into HIV programmes, particularly for women and girls most impacted by HIV. The section comprises:

• A template for conducting a participatory gender analysis, including key questions to help design rights-based, gender-transformative programmes
• A series of fictional scenarios taken from true-to-life experiences:
  • Scenario 1: empowering women who sell sex and use drugs to be their own advocates
  • Scenario 2: increasing public awareness and including women who have sex with women when we talk about HIV
  • Scenario 3: reaching out to migrant women and eliminating GBV
  • Scenario 4: increasing support and services for transgender people, including those selling sex
  • Scenario 5: supporting adolescents and young people living with HIV and increasing access to SRH education
  • Scenario 6: reaching the female partners of men who have sex with men, with HIV prevention, treatment, and care for themselves and their children
• Intervention strategies, including "what works" and case studies highlighting examples of promising practices
• Evidence from around the world to deepen understanding of the relationship between gender and HIV.

This guide is one in a series of good practice guides produced by the Alliance in collaboration with partner organisations. The series brings together expertise from the organisation's global community-level HIV programming to define and guide good practice in a range of technical areas. (See Related Summaries, below.)