Department of Gender and Womens Health Addressing gender in HIV/AIDS Indicators: Key issues to consider Department of Gender, Women and Health World Health Organization Geneva, October Avni Amin Eighth HIV/AIDS Monitoring and Evaluation Review Group (MERG) meeting

Department of Gender and Womens Health Caveats Not many gender and HIV/AIDS indicators, so extrapolated from gender indicators in broader health and development Where in UNGASS core indicators is there scope for integrating gender. Plus what are other areas for developing gender and HIV indicators Focused on brainstorming ideas, but methodology needs to be developed MERG meeting, Oct , 2004

Department of Gender and Womens Health Why address gender in HIV/AIDS indicators? Gender inequalities influence women and men's vulnerabilities to HIV/AIDS UNGASS declaration emphasizes gender equality in HIV/AIDS responses through articles 59, 60, and 61 Therefore, need to translate, monitor and evaluate gender- specific goals and targets in prevention, treatment, and care MERG meeting, Oct , 2004

Department of Gender and Womens Health MERG meeting, Oct , 2004 Opportunities to include gender in UNGASS core indicators Key message: Sex and age disaggregated data should be collected, analyzed, and reported (at all levels) for all relevant indicators

Department of Gender and Womens Health MERG meeting, Oct , 2004: Gender in the: Global commitment and action indicators 1. Amount of funds spent by international donors on HIV/AIDS (discussed Group B) Can the financial flows questionnaire track proportion of funds spent on women (e.g. SRH services, pMTCT, married women, female sex workers, adolescent girls)? Can use gender-budgeting tools to include: Proportion of HIV-related health expenditures allocated to women and girls, by institution (or donor) or Percentage of spending on HIV programmes targeting women and girls (preferred)

Department of Gender and Womens Health 2. Assessment of HIV/AIDS advocacy efforts (discussed group B) Additional indicator: Number of reports, pronouncements, declarations, conferences, policy statements on HIV/AIDS that specifically address or mention women, girls and/or gender inequalities (e.g. references to violence, disparities in education, lack of rights, customary practices and laws) Source: Review and analysis of media reports, public pronouncements of leaders, international declarations, conferences, policies and statements MERG meeting, Oct , 2004: Gender in the: Global commitment and action indicators

Department of Gender and Womens Health 3. National Composite Policy Index Country has strategy to integrate gender issues in HIV/AIDS programs (can be articulated different ways) Country has laws and regulations to prevent discrimination against women and girls in marriage, divorce, and property inheritance Country has laws and regulations to protect women and girls from rape and physical violence in all situations Country has strategy to ensure equitable access to treatment for women MERG meeting, Oct , 2004: Gender in the: National commitment and action indicators

Department of Gender and Womens Health 4.Percentage of people with advanced HIV infection on ART Needs to be sex and age disaggregated MERG meeting, Oct , 2004: Gender in the: National programme and Behaviour

Department of Gender and Womens Health 5.Violence Against Women: Prevalence Percentage women years, who ever had a partner, who have ever experienced physical violence by an intimate partner The WHO Multi Country Study measures emotional, physical and sexual violence by an intimate partner. The age range of years old is used as it covers violence during reproductive years including pregnancy-related Source: Special surveys WHO and CDC, VAW modules in DHS Frequency: every 4-5 years MERG meeting, Oct , 2004: Areas for further consideration

Department of Gender and Womens Health 5.Violence against women: Measurement issues There isn't a generally accepted indicator to capture trends Complexities related to: Use of a direct indicator like prevalence or use of a proxy (e.g. attitudes and norms – included in DHS)? What definition of violence should be used (physical, sexual, both, emotional)? How should prevalence be measured (special surveys, short module, surveillance, records)? Special issues related to confidentiality and safety? MERG meeting, Oct , 2004: Areas for further consideration

Department of Gender and Womens Health 6.Sexual negotiation – a UNAIDS indicator already developed (M&E guide, 2000) Percent of respondents who believe that if husband has STI, wife can refuse sex or propose condoms Source: Population surveys, DHS, Behavioural surveillance More widely applicable than violence because it will include women who not experience violence More relevant to generalized epidemic MERG meeting, Oct , 2004: Areas for further consideration

Department of Gender and Womens Health 7.MDG indicators for women's empowerment Ratio of girls to boys in primary, secondary and tertiary education Share of women in wage employment in non-agricultural sector Proportion of seats held by women in parliament Last two are not very good indicators for women's empowerment, however they are MDG indicators that could be used MERG meeting, Oct , 2004: Areas for further consideration