Women’s Rights in the Fight against HIV/AIDS

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The article can seen at

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A Dose of Reality

Women's Rights in the Fight against HIV/AIDS

The global HIV/AIDS pandemic is taking a catastrophic toll on women

and girls. The number of HIV infections among women and girls has

risen in every region in recent years, and in sub-Saharan Africa,

women and girls constitute nearly 60 percent of those living with

HIV. In some countries, the HIV infection rates for girls are many

times higher than for boys. The rising number of HIV infections

among women and girls is directly related to violence against women

and their unequal legal, economic, and social status.

Abuses of women's and girls' human rights impede their access to

HIV/AIDS information and services, including testing and treatment.

Those who do obtain HIV services sometimes face disclosure of their

confidential HIV test results by public health officials without the

women's consent. This heightens women's risk of being ostracized by

their communities and abused by their intimate partners.

Governments around the world have done far too little to combat the

entrenched, chronic abuses of women's and girls' human rights that

put them at risk of HIV. Misguided HIV/AIDS programs and policies,

such as those emphasizing abstinence until marriage, ignore the

brutal realities many women and girls face. By failing to enact and

effectively enforce laws on domestic violence, marital rape, women's

equal property rights, and sexual abuse of girls, and by tolerating

customs and traditions that subordinate women, governments are

enabling HIV/AIDS to continue claiming the lives of women and

girls.

Chronic Abuses Made Deadlier by HIV/AIDS

Human Rights Watch has interviewed hundreds of women and girls

living with HIV around the world. Their accounts are harrowing,

ranging from trafficking to rape during armed conflict. This

briefing paper focuses on the links between HIV/AIDS and abuses of

women's and girls' human rights that literally hit closest to home:

domestic violence, including marital rape;

violations of property and inheritance rights;

the harmful traditional practices of bride price, widow inheritance,

and ritual sexual " cleansing " ; and

sexual abuse of girls.

These abuses are perpetrated by families and tolerated by

governments. They are among the most pervasive and dangerous abuses

for women and girls. In the context of HIV/AIDS, they can be

lethal.

Domestic Violence

Domestic violence is not only inherently dehumanizing, it is a

central cause of women's HIV exposure. Domestic violence limits

women's capacity to resist sex and to insist on their spouse's

fidelity or condom use. Yet most countries dismally fail to prevent

domestic violence, prosecute or otherwise punish perpetrators, or

provide health or legal services to survivors. Most do not even

recognize its link with HIV/AIDS. Marital rape is rarely treated as

a crime.

Human Rights Watch has interviewed woman after woman across Africa

and in the Caribbean, many of whom said that domestic violence and

spousal rape caused or contributed to their HIV infection. Hadija

Namaganda, a Ugandan woman living with HIV, told Human Rights Watch

that her husband routinely forced her to have unprotected sex with

him and beat her viciously. Himself HIV-positive, he once attacked

her so violently that he bit off half of her left ear. When he lay

dying of AIDS and was too weak to beat her, he ordered his younger

brother to do so. a López, a twenty-four-year-old Dominican

woman with five children, told Human Rights Watch that she became

infected with HIV after repeated rapes by her husband. After she

tested positive for HIV, her husband abandoned her and their

children.

Studies have shown that domestic violence contributes to higher HIV

infection rates. A recent South African study found significantly

higher rates of HIV infection in women who were physically abused,

sexually assaulted, or otherwise mistreated by their intimate male

partners.

Abuses of Women's Property and Inheritance Rights

In some regions, most prominently in sub-Saharan Africa, women are

denied equal property rights.

Many widows are barred by law and custom from inheriting property,

evicted from their lands and homes by in-laws, and stripped of their

possessions.

Divorced women are often expelled from their homes with only the

clothes on their backs.

A woman's access to property usually hinges on her relationship to a

man. When the relationship ends, the woman stands a good chance of

losing her home, land, livestock, household goods, and other

property. While this discrimination stems from customs that favor

men for inheritance and property ownership, it is also enabled by

government policies and laws that discriminate in inheritance and

divorce matters.

In countries like Kenya, where twice as many women are HIV-positive

as men, the AIDS epidemic magnifies the devastation of women's

property violations. AIDS deaths expected in the coming years in

Africa will result in millions more women becoming widows at younger

ages than would otherwise be the case. These women and their

children will likely face not only stigma against people affected by

HIV/AIDS, but also deprivations caused by property rights

violations.

Imelda Orimba, a Kenyan widow with AIDS, told Human Rights Watch

that when her husband died, she told her in-laws that she had AIDS

and wanted to stay in the house. They grabbed her property anyway.

She recalled: " I told my in-laws I'm sick . . . but they took

everything. I had to start over. . . . They took sofa sets,

household materials, cows, a goat, and land. I said, `Why are you

taking these things when you know my condition?' My in-laws do not

believe in AIDS. They said that witchcraft killed my husband. "

Children orphaned and affected by HIV/AIDS, especially girls, are

also at risk of property-grabbing when their parents are sick or

die. A sixteen-year-old orphan girl in Zambia told Human Rights

Watch that after her father died, " The relatives grabbed all our

property, even my clothes. I didn't even get a single spoon. This

was my father's relatives. " When her mother died, she ended up

living with an uncle who sexually abused her and who is feared to be

HIV-positive.

Divorced and separated women fare no better. Many countries have no

statutory law on division of family property upon divorce, leaving

the matter to the discretion of judges or traditional leaders.

Countless divorced women have told Human Rights Watch that they have

no hope of prevailing in property rights claims due to the biases

against women among judges and traditional authorities. Denying

women equal property rights upon divorce also facilitates domestic

violence, again posing the risk of HIV. Women in Kenya and Uganda

told us that they remained in violent relationships because leaving

would mean losing their homes and other material belongings.

Harmful Traditional Practices

Traditional practices of some communities heighten the HIV risk for

women and girls. While customs are important to community identities

and human rights law supports the preservation of customs and

traditions, this cannot be at the expense of women's and girls'

rights and health. Just as discriminatory statutes must be amended

to protect women's and girls' rights, harmful traditional practices

must be transformed to eliminate abusive aspects.

Human Rights Watch has documented the dangers of a number of

traditional practices in the context of HIV/AIDS, including:

payment of bride price;

widow inheritance; and

ritual sexual " cleansing. "

The payment of bride price by a man's family to his future wife's

family is a considerable obstacle for women attempting to leave

abusive relationships. Though the intent may be to show appreciation

to the bride's parents and reinforce relations between families,

bride price is perceived by many to be an outright purchase of a

wife. Masturah Tibegwya, a Ugandan woman, told us, " They take you as

property so if the man comes for sex you don't say no. " A study of

several districts in Uganda found that 62 percent of the respondents

identified bride price as a major cause of domestic violence, as it

encouraged men to beat wives who did not " measure up. " This dynamic

also obstructs women's ability to negotiate safer sex.

In some places, widows are coerced into engaging in risky sexual

practices upon the death of their husband. These practices

include " widow inheritance " (also known as " wife inheritance " ) and

ritual sexual " cleansing. " " Widow inheritance " is where a male

relative of the dead husband takes over the widow as a wife,

sometimes in a polygamous family. " Cleansing " usually involves sex

with a social outcast who is paid by the dead husband's family,

supposedly to cleanse the woman of her dead husband's evil spirits.

In both of these practices, safer sex is seldom practiced and sex is

often coerced. While some women consent to these practices, others

are coerced into them in order to stay in their homes and keep their

property. Rejecting these practices can result in social exclusion

or rape. Succumbing to them can contribute to HIV infection.

Owino, a Kenyan widow, told us that shortly after her husband

died, her in-laws took all her possessions—including farm equipment,

livestock, household goods, and clothing. They insisted that she

be " cleansed " by having sex with a social outcast as a condition of

staying in her home. They paid a herdsman the equivalent of U.S. $6

to have sex with Owino, against her will and without a condom. She

told us, " I tried to refuse, but my in-laws said I must be cleansed

or they'd beat me and chase me out of my home. " The in-laws

eventually forced her out of her home anyway. She and her children

were homeless until someone offered her a small, leaky shack. No

longer able to afford school fees, her children had to drop out of

school.

Sexual Abuse of Girls

In many countries in sub-Saharan Africa, HIV prevalence among girls

under age eighteen is four to seven times higher than among boys the

same age, and girls have a lower average age of death from AIDS.

Sexual abuse contributes directly to this disparity in HIV infection

and mortality. Coercion—physical, psychological, and economic—looms

large in many girls' sexual experiences. Yet governments are failing

to provide basic protections from sexual abuse that would lessen

girls' vulnerability to AIDS.

Sexual abuse of girls by male family members is frequently kept

secret, and law enforcement agencies are often complicit in hiding

the abuses. In Zambia, where nearly 17 percent of the population

aged fifteen to forty-nine is living with HIV, girls told Human

Rights Watch of sexual and other physical abuse at the hands of

uncles, stepfathers, fathers, cousins, and brothers. Orphan girls

dependent on their abusers said they feared losing support,

including for schooling, if they revealed the abuse. A twelve-year-

old girl told Human Rights Watch, " My uncle used to beat me with

electricity wires. Before I went to live my uncle and auntie, I

stayed with my big sister's mother, and my brother used to take me

in the bush. Then he raped me. I was eight or nine. I was scared. He

said `I'm going to beat you if you ever tell anyone.' "

HIV Information and Services: Insensitivity to Women's and Girls'

Concerns

HIV prevention, testing, and treatment programs are central to

fighting AIDS. Yet insensitivity to the concerns of women and girls

in these programs often make the solution part of the problem.

Misguided HIV Policies and Programs

HIV risk is fundamentally linked to abuses of women's and girls'

rights, yet prevention policies and programs often ignore this link.

A prime example of misguided HIV prevention programs are those that

emphasize an " ABC " approach ( " A " for abstinence, " B " for be

faithful, and " C " for condom use) over programs promoting women's

and girls' rights. ABC programs advocate behavioral changes that do

not address the social realities limiting women's and girls' sexual

autonomy and putting them at risk of HIV. Many women and girls

cannot " abstain " from being brutally raped, cannot stop their

husband's infidelity, and lack the negotiating power within their

abusive relationship to insist on condom use. Sules Kiliesa, a

Ugandan widow, told Human Rights Watch that her husband " would beat

me to the point that he was too ashamed to take me to the doctor. He

forced me to have sex with him and beat me if I refused. . . . Even

when he was HIV-positive he still wanted sex. He refused to use a

condom. He said he cannot eat sweets with the paper [wrapper] on. "

The focus on marriage as a preventive factor in HIV policies (as

in " abstinence until marriage " programs) is also misguided. In some

countries, married young women have higher HIV prevalence than their

unmarried counterparts. A recent study among sexually active young

women in Kenya and Zambia found that HIV infection levels were 10

percent higher for married than for sexually active unmarried girls.

In rural Uganda, another study found that 88 percent of young women

living with HIV were married. Another disturbing study in Zambia

found that only 11 percent of women believed they had the right to

ask their husbands to use a condom—even if he had proven to be

unfaithful and was HIV-positive.

Abusive HIV Testing Practices

Testing for HIV is the first step toward obtaining necessary support

and treatment. But if testing is done without respect for women's

human rights it can have devastating consequences.

Women who test positive for HIV are at increased risk for domestic

violence and social exclusion. Sadly, many women Human Rights Watch

interviewed said that health workers had disclosed the women's

confidential HIV test results without their consent. Moreover, some

women described grossly inadequate pre-and post-HIV test counseling,

calling into question whether the tests were truly voluntary. In

some cases, HIV-positive women had necessary medical procedures

denied due to discriminatory attitudes of health care providers.

Polanco, an HIV-positive Dominican woman, told Human Rights

Watch that when she was hospitalized for a liver disease, her doctor

disclosed her HIV-positive status to her daughters without her

consent. When Polanco's mother discovered her status, she evicted

Polanco from the home she had shared with her parents and children.

Having no money and no hope for employment in a country where many

employers deny work to people with HIV, Polanco moved to a makeshift

wooden shack without sanitation, electricity, or running water in a

dangerous, remote informal settlement.

As health care providers around the world rush to embrace provider-

initiated rather than patient-initiated HIV testing, more women will

have the opportunity to test for HIV. But unless testing protocols

adequately address the need to protect women's rights to informed

consent and confidentiality, women will also face dangers in their

homes and communities. There is an urgent need for greater clarity

on what provider-initiated HIV testing means, and what counseling,

confidentiality, and other rights protections must accompany such

testing. At a minimum, such measures must ensure that women know

their options and are given tools to adequately deal with the

consequences of both a negative and a positive test result.

Meanwhile, governments must act now to ensure that confidentiality

measures are in place and enforced.

Rape Survivors Denied Post-Exposure Prophylaxis

HIV post-exposure prophylaxis (PEP), a short course of treatment

with antiretroviral medicines administered after rape, can keep rape

from being a death sentence by reducing the risk of HIV infection

from an HIV-positive attacker. PEP is the standard of care for rape

survivors in wealthy countries. Poorer countries have begun to offer

PEP to rape survivors, but not without challenges.

In South Africa, for example, the explosive AIDS epidemic and

shocking rates of rape and sexual violence make an effective PEP

program critical. Unfortunately, Human Rights Watch found that

government inaction and misinformation from high-level officials

have undermined the effectiveness of its program to provide rape

survivors with PEP. The government's failure to provide adequate

information and training on PEP has left both service providers and

rape survivors in the dark. Many rape survivors did not receive PEP

services simply because neither they nor police and nurses helping

them had any idea that such services existed. Poor women and girls

and those living in rural areas were often denied access to PEP

altogether.

Inequalities in Access to HIV Treatment

As countries gear up for massively expanded antiretroviral treatment

programs, urgent attention is needed to ensure that women and girls

will access ARVs equitably. Due to pervasive discrimination, women

are less likely than men to have the income or assets needed to pay

for antiretroviral therapy. Even where treatment is free, basic

costs like diagnostic tests or transportation to the hospital may be

out of reach of women. In some families, men determine whether women

and girls will be allowed to leave the home and take time away from

household duties to visit health centers. When male and female

family members are HIV-positive and resources are scarce, evidence

in some countries shows that men are the first to receive treatment.

If a woman defies a man and seeks treatment anyway, there can be

violent consequences.

Many Ugandan women told Human Rights Watch that violence, or the

fear of violence, prevents them from freely obtaining HIV/AIDS

testing and treatment. Service providers reported that many women

came to them secretly, fearing that their husbands would beat them

if they sought HIV testing or medical attention. Jane Nabulya, a

Ugandan woman, said that she secretly tested for HIV in 1999 when

she found out her husband had AIDS. She explained: " I was scared to

tell him that I had tested HIV-positive. He used to say that the

woman who gives him AIDS, `I will chop off her feet.' I have never

told him. "

In Kenya and Uganda, women told Human Rights Watch that they could

not reach HIV testing and treatment centers because they had no

money to travel or pay for care, were too afraid to ask abusive

husbands for funds, or were not allowed to leave the home.

Samanya told us, " I got counseling after he [her husband] had died.

I wanted to go before but I didn't have the means. I wouldn't ask

him. He would quarrel [fight]. " Many widows told us that after they

had been denied inheritance and lost everything to property-grabbing

in-laws, they had no money to survive, much less pay for

antiretroviral therapy and other health care.

Conclusion

The disproportionate impact of AIDS on women and girls is no

accident. It is the direct result of the pervasive abuses of their

human rights. Despite the growing consensus that HIV/AIDS is a

women's rights issue, little has been done to change laws and

practices that violate women's rights, put them at risk of HIV/AIDS,

and impede their access to HIV information and services.

Combating the rights abuses that put women and girls at risk of HIV

is essential to turning around the AIDS crisis. Concrete policy

measures are urgently needed and can have immediate and long-term

impact. Governments, with the support of donors and international

organizations, must act urgently to stop the abuses of women's and

girls' rights that fuel the AIDS epidemic and impede society's

response.

Recommendations for Action

Human Rights Watch calls on all governments, donors, and

international organizations to address gender inequity as an abuse

in its own right and as a central element of HIV/AIDS policy and

programs. Essential first steps include:

Governments

Legal Reform. Reform laws to protect women's equal rights,

especially in the areas of:

inheritance

sexual violence

domestic violence and spousal rape

marriage

division of property upon divorce

land use and ownership

access to housing and social services

Programmatic Reform. Implement programs designed to address women's

rights violations and improve enforcement of women's rights. This

includes:

ensuring that national HIV/AIDS programs include concrete measures

to combat discrimination and violence against women

providing training for judges, police, and other officials on

women's rights

improving data collection relating to domestic violence, women's

property rights, and sexual abuse of girls

designing ARV distribution systems to recognize the challenges women

and girls face in accessing treatment

ensuring the protection of confidential HIV test results and other

confidential patient information

Public Education. Undertake public education campaigns on women's

rights by distributing information in local languages and using

appropriate media about:

rights to inheritance and division of family property

writing wills

registering marriages

co-registering property

the health risks of customary sexual practices tied to property

rights

preventing domestic violence and obtaining assistance in the event

it occurs

Donors and international organizations

Assistance. Donor organizations should support NGO and government

initiatives to promote women's rights. This should include

initiatives that provide:

legal services

shelter

educational assistance

food and medical care (including ARVs)

human rights education programs on women's property rights, domestic

violence, and sexual abuse

credit for land purchases

job training and economic opportunities

training of authorities on women's rights

Political Influence. Donors and international organizations should

actively encourage governments to enact and implement laws and

policies that protect women's rights. They should use their unique

leverage to question programs that are not gender sensitive or fail

to take into account human rights abuses that place women and girls

at disproportionate risk of HIV and impede their capacity to seek

HIV-related services.

--- End forwarded message ---

[Guest guest]

Members,

You can read the entire report at

http://www.hrw.org/reports/2003/africa1203/ here we go...

SUMMARY

If it can be said, as it can, that by the year 2020, the number of

deaths from AIDS in Africa will approximate the number of deaths,

military and civilian combined, in both world wars of the 20th

century, then it should also be said that a pronounced majority of

those deaths will be women and girls. The toll on women and girls is

beyond human imagining; it presents Africa and the world with a

practical and moral challenge which places gender at the centre of

the human condition. The practice of ignoring a gender analysis has

turned out to be lethal. . . .For the African continent, it means

economic and social survival. For the women and girls of Africa,

it's a matter of life or death.

— , U.N. Secretary-General's Special Envoy on HIV/AIDS

in Africa, July 2002.

The story of the HIV/AIDS crisis in Africa, which has already

claimed more than 20 million lives, is one of massive neglect and

denial. Millions of Africans had already died before the continent's

AIDS epidemic even registered on the global radar screen or was

publicly recognized as a problem by decision-makers in affected

countries. It took even longer for Africa and the world to notice

that in this epidemic, unlike AIDS in other regions of the world,

women and girls became ill and died in greater numbers than men and

boys. Sadly, policymakers still are not taking into account the

extent to which AIDS prevalence in Africa is a direct result of

relentless human rights abuses that women and girls suffer because

of their gender.

The protection of the rights of women and girls in sub-Saharan

Africa is a key to turning around the continent's AIDS crisis.

Relative to the scale of the problem, however, such protection is

virtually ignored as a policy tool and certainly not viewed as a

central element in ever larger national AIDS programs. The challenge

of protecting women and girls from these AIDS-related human rights

abuses is enormous. The abuses are many and varied, including rape

within and outside of marriage, other sexual violence and coercion

often abetted by poverty, domestic violence, unequal property and

inheritance rights, divorce laws that exacerbate women's economic

dependence on their husbands, and discriminatory barriers to

education and health services. All of these human rights abuses have

existed for a long time and many have been life-threatening, but

with HIV/AIDS they are lethal on a massive scale.

HIV/AIDS impoverishes families. Its spectral presence in the

household makes it less likely that girls will be enrolled or kept

in school because families prefer to use their scarce resources for

boys' education. Girls are also more readily called upon to care for

the sick or to earn income in times of need. The absence of

antiretroviral treatment, still the rule and not the exception in

Africa, means that people are dying, not living, with AIDS. Women

widowed by AIDS suffer the injustice of both statutory and customary

law that militates against their being able to retain marital

property. The stigma of AIDS often leads to their being abandoned or

abused. The millions of children orphaned by AIDS face a stunning

array of human rights abuses, many of them more frequent and deadly

among girls than boys. Girls and women in households touched by AIDS

and by poverty frequently find their choices and possibilities so

diminished that they have to turn for survival to the sex trade or

to situations of lodging or work that expose them to sexual abuse

and violence, increasing the risk that they themselves will die of

AIDS.

Human Rights Watch has documented many gender-based human rights

abuses in Africa that fuel the epidemic and make unbearable the

lives of women and girls already living with HIV/AIDS. Our research

is based largely on the moving and often horrifying stories told to

us by African women and girls who have suffered abuse; many such

stories are featured in this report. It is our hope that some

understanding of the human reality of these abuses will lead to

greater protection of the rights of the girls and women like those

who have courageously told us of their experiences at the center of

a deadly epidemic.

AIDS distinguishes itself from other high-mortality infectious

diseases by the fact that young adults are disproportionately

stricken. This also means that the orphaning of children is a

consistent feature of AIDS deaths. In several African countries,

Human Rights Watch has documented a range of atrocious violations of

the rights of children orphaned by AIDS or whose parents are ill

with the disease. These include physical and sexual violence by

those who care for them in the absence of parental care, trafficking

for their labor, hazardous labor of other kinds, abuses associated

with living on the streets, and abusive treatment in schools. Girls

are more likely to suffer the worst consequences of these abuses,

especially sexual and physical violence. The plight of girls

affected by AIDS in Africa, as of all AIDS orphans, constitutes a

human rights emergency.

Even for girls whose families are not directly stricken by AIDS,

entrenched poverty, the favoring of boys' over girls' education, and

lack of legal protection against discrimination and exploitation

often contribute to situations in which they see no options but to

trade sex for survival. As a girl in Kenya told us, " I may have to

go into prostitution, and then I know I will get HIV and die; I

would rather have a real business, but it is not easy. " Even if they

understand the risk of AIDS, girls may through economic desperation

resign themselves to sex without condoms if there is a greater

return in money, food or other elements of survival. Others find

themselves unable to negotiate condom use out of fear of violence or

coercion. In spite of these abuses, it is difficult to find programs

of significant scale that attempt to protect African girls from

sexual abuse and coercion as part of national AIDS programs. It is

rare to find a decision-maker on the continent who links these

sexual and gender-based abuses to the strikingly higher HIV

prevalence among girls and young women than their male counterparts

that persists in many countries.

Child trafficking is a shocking and long-standing crime in many

parts of Africa, and it, too, takes on lethal dimensions in the face

of a raging AIDS epidemic. Orphans and other children without

parental care are plainly more vulnerable to being lured into

trafficking with the promise of schooling or lucrative work, as

Human Rights Watch discovered in its encounters with previously

trafficked children in Togo. Boys are also trafficked, but girls may

be the first to be pulled out of school and sent abroad in cases

where parents cannot afford school fees. Trafficking of girls is

also more likely to lead to situations of domestic work or work in

streets and markets where sexual violence is a high risk. A number

of girls who told us their stories had also been exposed to the risk

of sexual and physical violence in the course of their

transportation from Togo to another country in the region. Combating

child trafficking has been the subject of numerous high-profile

declarations by virtually all affected countries in Africa, but

states continue to allow anti-trafficking programs to be

underfinanced and inadequately supported by effective national and

regional laws and law enforcement practices. The link between child

trafficking and AIDS appears not to be appreciated at the policy

level.

Girls who have the opportunity to stay in school too often face

sexual abuse in school or on their way to or from school. In South

Africa, for example, Human Rights Watch encountered many girls who

had been raped and sexually harassed by teachers or school

administrators, a heinous abuse of power by those in authority over

children. Others recounted having been raped or harassed by fellow

students as school managers stood by and did nothing. South Africa

is hardly alone in this regard. To date there have been few well

financed programs that address protection for girls at school.

Married women in Africa may not be any more protected from HIV/AIDS

risk than other women and girls. In African society, as in many

parts of the world, married women often face violence and abuse if

they demand condom use or refuse sex from their husbands or long-

term partners. Human Rights Watch's investigation of the link

between domestic violence and HIV/AIDS in Uganda showed that men

were often ready to beat their wives rather than confront the

reality of AIDS or allow their wives to seek HIV testing and

counseling. In story after story, women were confronted with the

presumption that marriage entails automatic consent to sexual

relations of which the terms are dictated by the husband. In Uganda

as in many countries, this presumption is shored up by divorce and

property laws and customary practices that disadvantage women who

try to escape abusive marriages. With few exceptions across Africa,

marital rape is not recognized as a crime, and domestic violence is

seen as a right of married men. Even in Uganda, the African country

cited most frequently for its success against HIV/AIDS, domestic

violence and abusive subordination of women do not figure in AIDS

program priorities.

HIV/AIDS will cause many millions of African women to be widowed,

and widowed at a younger age than would have been the case in its

absence. Gender inequality in property and inheritance laws in

Africa poses a grave threat to women in these circumstances. African

women's rights to own, inherit, manage, and dispose of property are

under constant attack from customs, laws, and individuals, including

government officials, who believe that women cannot be trusted with

or do not deserve to own or control property. The devastating

effects of property rights violations¾including poverty, disease,

violence, and homelessness¾are only magnified and made more lethal

for women who face the stigma of having been widowed by AIDS or who

are themselves HIV-positive.

An in-depth study of property rights violations by Human Rights

Watch in Kenya recounted many stories of women excluded from

inheriting property, evicted from their lands and homes by in-laws,

stripped of their possessions, and forced to engage in risky sexual

practices in order to keep their property. Many widows we met were

coerced into the customary practice of " wife inheritance, " whereby a

widow is taken as a wife by a relative of her late husband, or

ritual " cleansing " whereby widows are obliged to have sex (usually

unprotected) one time or over a short period with a man who is a

social outcast. Not only do these practices demonstrate that many

African women have virtually no control over their own bodies but

they also place the women at risk of contracting and spreading HIV.

Their destitution in being stripped of all they have removes their

last hope for caring for themselves and their children. Injustices

in women's property rights have been ignored for decades by

governments across Africa, and redressing them seems to figure

nowhere in HIV/AIDS policies and programs.

Property ownership and domestic violence are examples of areas where

customary law is a major obstacle to the realization of women's

equal rights in Africa. Customary laws are mostly unwritten,

constantly evolving and prone to subjective interpretation. In some

countries, there are as many customary laws as there are ethnic or

tribal communities. Most African countries have ratified the

Convention on the Elimination of All Forms of Discrimination Against

Women (CEDAW), which obliges them to eliminate customary laws and

practices that are based on the idea of inferiority of women (or of

men) or on stereotypes of women. But the application of customary

laws that embody injustice for women still goes unchallenged across

the continent.

Among the most horrific gender-based violations of human rights in

Africa in recent years has been the use of rape as a weapon of war.

Although not as geographically widespread as other abuses described

in this report, sexual violence in war goes hand in hand with the

near universal subordination of women and girls on the continent.

Women and girls in the Democratic Republic of Congo, Sierra Leone,

northern Uganda, and Burundi told Human Rights Watch of unimaginably

horrific abuses they suffered in those country's civil conflicts.

Rape is used strategically in these cases to terrorize the

population and destabilize the economy, which is very effectively

done when women's economic activities are impeded by fear and

violence. The international bodies that can exercise some leverage

in these situations have done virtually nothing to push for basic

protections that could reduce these abuses and mitigate their worst

effects.

With respect to virtually all of the gender-based abuses described

here, Human Rights Watch has consistently found that legal and

judicial remedies for women and girls are inadequate or nonexistent.

Even where sexual violence laws are adequate, the laws are rarely

enforced. The stigma of rape keeps it underreported and its

perpetrators safe from prosecution. When women or girls are

courageous enough to file complaints, law enforcement officials are

rarely trained for sensitive and effective handling of sexual and

domestic violence cases.

Though the abuses are many and deep and are often shrouded in shame

and secrecy, they are not impervious to policy, legal and program

solutions. This report offers recommendations for concrete measures

that can have immediate and long-term impact on the worst

manifestations of HIV/AIDS-related human rights abuses against women

and girls. These include actions to promote equal access to health

services and education, equality in property and inheritance laws

and related elements of economic dependence, and measures to protect

women and girls from sexual abuse and to ensure that perpetrators

are brought to justice. In some cases, because these are relatively

new areas for policy and programs, it may not be easy to get the

policy right on the first try. But the policy paralysis that now

surrounds gender-based human rights abuses linked to AIDS in Africa

is scandalous and deadly.

There are some signs that since the U.N. General Assembly Special

Session on HIV/AIDS and the creation of the Global Fund to Fight

AIDS, Tuberculosis and Malaria, both in 2001, HIV/AIDS in Africa is

beginning to attract international funding, though still on a small

scale relative to the scale of the epidemic's destruction. As

national AIDS control programs across the continent draw greater

national and international resources, they provide an opportunity to

transform the level of support that the fight against gender

inequity in Africa has so far enjoyed.

It is a shame that a crisis of the proportion of HIV/AIDS is

necessary to focus attention on human rights abuses of women and

girls in Africa, but it would be unconscionable for governments to

miss this opportunity. African governments and donors alike must

begin to see protection and fulfillment of the rights of African

women and girls as a central strategy in the fight against HIV/AIDS.

This means more than occasional rhetorical flourishes or poorly

funded gender components in larger projects. It means real

resources, real coordination across sectors, and real participation

by women in decision-making. Without this commitment, the conspiring

forces of HIV/AIDS and gender inequality in Africa will win the day.1

1 Note on methodology: this report relies heavily on Human Rights

Watch's extensive documentation of human rights abuses against women

and girls in Africa and our experience advocating for elimination of

these abuses. A list of prior Human Rights Watch reports drawn upon

for this report, each of which includes detailed policy and legal

recommendations, is found on the back cover. These reports provide

first-hand testimony and additional legal and policy analysis

related to many of the issues discussed here.

http://www.hrw.org/reports/2003/africa1203/

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