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Office of Global AIDS Coordinator Releases Report on PEPFAR Activities on Gender Based Violence

In late November 2006, the Office of the Global Coordinator submitted it’s mandated Report on Gender Based Violence and HIV/AIDS to Congress detailing the activities of the President’s Emergency Plan for AIDS Relief (PEPFAR) as they relate to the five priority gender strategies specified in the Act’s authorizing legislation.1 The five priority gender strategies outlined in the legislation are: increasing gender equity in HIV/AIDS activities and services, reducing violence and coercion, addressing male norms and behaviors, increasing women’s legal protection, and increasing women’s access to income and productive resources. While it is encouraging that the administration realizes the importance of addressing gender and gender-based violence (GBV) in the fight against HIV, the report raises several concerns.

The report indicates that in Fiscal Year 2006, “there were over 830 reported gender-related activities within the 15 PEPFAR focus countries2, each covering one or more gender strategic focus areas, including 243 that incorporate a GBV component.  In FY 2006, over $104 million in support activities has been provided for a GBV component.”3  Although these numbers may seem encouraging, global population-based research has found that up to 50% of women report physical assault by an intimate partner and at least one-third of women have reported some form of sexual coercion.4  In reality, $104 million dollars dispersed over 15 countries is entirely too small of a sum to adequately address the persistent problems relating to gender and HIV/AIDS.  Additionally, the report provides no information as to what constitutes a gender-related activity or what types of curricula or education tools are implemented in teaching about gender and HIV.

While the low funding levels and lack of transparency regarding PEPFAR activities are troublesome, perhaps the most disturbing portion of this report is the reliance on abstinence and be-faithful programming as a means of controlling gender-based violence.  According to the Office of the Global AIDS Coordinator (OGAC), “interventions aimed at reducing vulnerability to HIV by communicating the merits of positive behaviors such as abstinence, faithfulness and partner reduction are well suited to provide education on the hazards of sexual coercion and the links between gender-based violence and HIV.”5   Abstinence-until-marriage and be-faithful programs operate from the framework of simply restraining sexual desire.  In reality, gender-based violence is not about sexual desire but is based on power dynamics “grounded in the broader context of systemic gender-based discrimination against women and other forms of subordination.”6  Equating the restraint of sexual desire with a reduction in gender-based violence is dangerous because it perpetuates the myth that marriage and faithfulness means gender equality.  Recent information from Uganda—where 42% of new HIV cases occurred within married couples—shows once again that promotion of abstinence-until-marriage does little to address issues of gender that may fuel the spread of the epidemic.7

Additionally, the report fails to address the full spectrum of gender issues that may impact the AIDS epidemic by limiting its definition of gender-based violence to “any act that results in, physical, sexual, or psychological harm, or suffering to women, including threats of such acts, coercion, or arbitrary deprivation of liberty, whether occurring in public or private life.”8  Although it is extremely promising that OGAC has included psychological harm and threats of harm in its definition, it has effectively eliminated consideration of same-sex gender violence by limiting the definition to violence against women only.  While it can not be overemphasized that the majority of GBV occurs against women, this definition is particularly problematic when talking about strategies for addressing violence in the context of HIV/AIDS because it ignores the reality of gender-based violence against gay and bisexual men or transgender individuals that occurs globally. 

For example, surveys of male sex workers in Asian countries have found that as many as 37% had been raped and almost 80% reported some type of mental or physical violence, greatly increasing their already high-risk of contracting HIV.9  PEPFAR further stigmatizes this group by implementing abstinence-until-marriage programming to address GBV, as marriage is not a possibility for LGBT individuals in most of the 15 focus countries.  Other than South Africa, none of the other countries allow same-sex unions, and many have laws which criminalize LGBT relationships thereby limiting the likelihood that a victim of same-sex violence would come forward for fear of being prosecuted or jailed themselves.

“While it is a positive step that OGAC recognizes the link between gender and HIV, this report does little to inspire confidence that PEPFAR has effective policies in place to adequately address the problems of GBV and AIDS,” said William Smith, vice president for public policy at SIECUS. “Until inclusive and evidenced-based programs are put in place to address the core issues underlying gender-based violence, we have little hope in reducing the spread of HIV/AIDS.”


  1. The President’s Emergency Plan for AIDS Relief Report on Gender-Based Violence and HIV/AIDS, (Washington, DC: Office of the Global AIDS Coordinator, 2006), accessed 21 December 2006, <>. 
  2. The 15 PEPFAR focus countries are Botswana, Cote D’Ivoire, Ethiopia, Guyana, Haiti, Kenya, Mozambique, Nigeria, Namibia, Rwanda, South Africa, Tanzania, Uganda, Vietnam and Zambia.
  3. 3The President’s Emergency Plan for AIDS Relief Report on Gender-Based Violence and HIV/AIDS, 1. 
  4. Integrating Gender into HIV/AIDS Programmes, (Geneva: World Health Organization, 2003), accessed 21 December 2006, < >.
  5. The President’s Emergency Plan for AIDS Relief Report on Gender-Based Violence and HIV/AIDS,  9.
  6. In depth Study on all Forms of Violence Against Women: Report of the Secretary-General (New York: United Nations General Assembly, 2006), 27 accessed 21 December 2006, <>. 
  7. Andrew Bagala, “Uganda: Married Couples Top HIV Infection,” The Monitor, 4 December 2006, <>.
  8. The President’s Emergency Plan for AIDS Relief Report on Gender-Based Violence and HIV/AIDS, 5.
  9. MSM and HIV/AIDS Risk in Asia: What is Fueling the Epidemic Among MSM and How Can it Be Stopped, (New York: TREAT Asia, August 2006), 25, accessed 21 December 2006, <>.