Is There a Gender Gap in the HIV Response? Evaluating National HIV Responses From the United Nations General Assembly Special Session on HIV/AIDS Country Reports
Is There a Gender Gap in the HIV Response? Evaluating National HIV Responses From the United Nations General Assembly Special Session on HIV/AIDS Country Reports
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DOI：
10.1097/qai.0b013e3181baeec2
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发表时间：
2009-12-01
影响因子：
3.6
通讯作者：
Mendoza, Aurorita
中科院分区：
文献类型：
--
作者：
Carael, Michel;Marais, Hein;Mendoza, Aurorita
背景资料：2001年关于艾滋病毒/艾滋病问题的联合国大会特别会议（联大特别会议）的《承诺宣言》提出了与妇女和艾滋病毒流行病的性别方面有关的若干政策和方案承诺。其中一些是一般性的，而另一些则比较具体，包括有时限的目标。本文总结了各国报告的影响男女平等获得抗逆转录病毒治疗和其他艾滋病毒服务的政策和战略的数据，但没有涉及其他性别问题，如男男性行为。分析包括130个国家在回答与制定扶持政策进展情况有关的14个问题时报告的国家综合政策指数的数据女性的环境。关于艾滋病毒知识和获得艾滋病毒检测和抗逆转录病毒治疗方面的两性平等的更多数据是根据联大特别会议的其他核心指标获得的。结果：共有147个国家提交了国家报告，其中78%的联大特别会议相关指标完全或部分按性别分列。然而，16%的国家没有报告任何按性别分列的艾滋病毒指标（各区域范围为0%-29%）。共有82%（130个国家中的108个）的国家报告说，它们制定了政策，确保妇女平等获得艾滋病毒相关服务，但14%的报告国还制定了法律和政策，阻碍它们为妇女提供有效的艾滋病毒方案的能力。约80%的国家报告说，已将妇女作为一个具体“部门”纳入其多部门艾滋病战略或行动框架。然而，只有略多于一半（53%）的国家报告说，为解决妇女问题的方案编列了预算。截至2007年底，33%的需要者接受了抗逆转录病毒疗法，妇女在接受治疗的人中占略多。艾滋病毒知识的性别差距已经缩小，但对如何预防艾滋病毒的知识的总体水平仍然处于较低水平，只有约40%的青年男子（年龄在15-24岁）和36%的青年妇女正确的全面知识艾滋病prevention.Conclusions：自2001年以来，绝大多数国家已将妇女相关的问题纳入其国家艾滋病毒政策和战略计划。然而，艾滋病毒流行程度较低或集中的国家和区域在将注重妇女的政策纳入国家框架方面落后于流行广泛的国家。半数国家缺乏对妇女方案的预算支助，这表明这些政策没有充分转化为多部门活动。发展部在很大程度上仍然没有参与增强妇女的社会和经济权能，这引起了人们的关切，即更广泛的发展计划中可能也缺乏减少性别不平等的战略。在艾滋病毒检测和提供抗逆转录病毒治疗方面显然实现了两性平等，这是一项重要成就。各国收集和报告按性别和年龄分列的数据的能力也大大提高。通过联大特别会议报告系统监测妇女在艾滋病毒应对方面的进展情况，提供了重要的见解，但还应辅之以数据，以加强对战略实际执行情况的了解。
Background: The Declaration of Commitment of the United Nations General Assembly Special Session on HIV/AIDS (UN-GASS), in 2001, sets out several policy and programmatic commitments that pertain to women and the gender aspects of the HIV epidemic. Some of them are general, whereas others are more specific and include time-bounded targets. This article summarizes data on policies and strategies affecting women and men equity in access to antiretroviral treatment and other HIV services, as reported by countries but do not address other issues of gender, such as men having sex with men.Methods: The analysis includes data from the National Composite Policy Index as reported by 130 countries in response to 14 questions relating to progress in creating an enabling policy environment for women. Additional data on gender equity in knowledge of HIV and access to HIV testing and antiretroviral treatment is obtained with other core UNGASS indicators. The review aggregates countries according to regions.Results: A total of 147 countries provided national reports in which 78% of relevant UNGASS indicators were either completely or partially disaggregated by sex. However, 16% of countries did not report any HIV indicators by sex (with a range of 0%-29% across regions). A total of 82% (108 of 130) of countries report having policies in place to ensure that women have equal access to HIV-related services, but 14% of reporting countries also had laws and policies in place that hinder their ability to deliver effective HIV programs for women. About 80% of countries report having included women as a specific "sector" in their multisectoral AIDS strategies or action frameworks. However, only slightly more than half (53%) of those countries report having a budget attached to programs addressing women issues. As of the end of 2007, antiretroviral therapy reached 33% of people in need, and women represent a slight majority of those on treatment. The gender gap on HIV knowledge has narrowed, but overall levels of knowledge on how to prevent HIV remains at low levels, with only about 40% of young men (aged 15-24 years) and 36% of young women with correct comprehensive knowledge about HIV prevention.Conclusions: Since 2001, a large majority of countries have integrated women-related issues into their national HIV policies and strategic plans. However, countries and regions with low-level or concentrated HIV epidemics lag behind countries with generalized epidemics in integrating women-focused policies into national frameworks. The lack of budget support for women-focused programs in half of the countries indicates that those policies have not been sufficiently translated into multisectoral activities. The engagement of development, ministries in women's social and economic empowerment is largely still lacking, which raises the concern that strategies to reduce gender inequality may also be lacking in broader development plans. The apparent attainment of gender equity in HIV testing and the delivery of antiretroviral treatment is an important achievement. There has also been a significant increase in countries' abilities to collect and report data disaggregated by sex and age. The monitoring of women's progress in HIV responses via the UNGASS reporting system provides important insights but should be complemented with data that strengthen understandings of the actual implementation of strategies, as well.