Bringing Clarity to Gender Equity Programs
In the past decade, expanding resources have been devoted to fostering gender equity in a variety of social programs, including those dealing with HIV. This effort has been particularly urgent in sub-Saharan Africa, where female/male HIV infection ratios in young populations (aged 15-24) have reached 3-to-1 and sometimes higher. Programs addressing "gender and HIV" vary greatly with regard to target audiences, content, and measurable results. They range from microcredit programs for HIV-positive women to workplace programs seeking to change negative male norms and efforts to increase respect for diverse sexual and gender identities. A team of researchers, led by Population Council social scientist Nicole Haberland and policy analyst Judith Bruce, recently assessed a large subsample of the first generation of programs that address gender and HIV. They made recommendations to shape and improve the next generation of programs.
Girls' and boys' differential risks over the life cycle
The persistently high female/male HIV infection ratios among young people have numerous causes. Girls' biological and social puberty comes years before boys'. For girls, puberty results in less freedom and fewer choices, while for boys it leads to wider opportunities. This situation puts girls at a higher risk for harm related to restrictive, often exploitative, gender norms. A significant proportion of adolescent girls describe their first sexual experience as forced or tricked. In some countries, especially those in sub-Saharan Africa, the majority of girls aged 10-14 live in urban communities, often with only one or no parent. In some areas, 10 percent or more of girls live with neither parent and do not attend school.
"Although work to establish gender equity and safety is important for all," states Bruce, "we must focus scarce resources on those who are at the highest risk of the worst outcomes at the youngest ages. This frequently means girls in late childhood and early adolescence. 'Gender and HIV' programs are promising vehicles for this human rights and health equity investment."
The researchers examined 63 illustrative gender and HIV programs from across the globe, among them some of the largest and best-known initiatives. Data--about how programs selected their beneficiaries and targeted their interventions and whether, and to what degree, they address the distinct needs of females and males--were garnered largely through interviews. The researchers used several different scales to rate the strength of each program's approach to confronting gender issues.
Selection of female and male participants: Ships in the night
Of programs surveyed, more than half (64 percent) worked with both females and males, with a fourth working only with females and the rest working only with males. The vast majority of programs surveyed included young people; only 11 percent were for adults only. Forty percent focused exclusively on young people and very young adolescents (defined as those between ages 10 and 14). Strikingly, of the programs that work with both females and males, only 34 percent ever involved females in identifying appropriate male participants, that is, the males who have the largest impact on their lives with regard to the gender norms that the programs were meant to deal with. The researchers considered this a troubling use of scarce resources that arguably undermines program effectiveness.
Confirming behavior changes with the affected parties
The neglect of the female/male dynamic continues in monitoring and evaluation strategies. Of those programs that included males, 62 percent reported that they tried to assess whether men's gender attitudes or behaviors had changed as a result of their involvement in the program. A majority of these sought only males' self-reports (of being, for example, less likely to "abuse their partners" or more likely to "participate in household chores"). …