1. HIV Response In Conservative Settings: Striking The Balance International Network of Religious Leaders living with or personally affected by HIV and AIDS Presented by: Rev. Phumzile Mabizela @ ICASA 2015

2. Outline 1.Introduction 2. Importance of psychosocial support 3. Cultural and social issues 4. Religious issues 5. Ethical issues ( health centres) 6. BEST PRACTICES

4. Introduction Just a few of the barriers that make it difficult for progress to be realised in conservative settings: Stigma Shame Denial Discrimination Inaction and Misaction

6. Cultural issues Patriarchy and Hierarchy Rituals: FGM, VT, Cultural Male circumcision Selective transformation Customary laws; Sexuality is taboo

7. SOCIAL ISSUES Socialization: Patriarchy Gender stereotypes: Boys and girls Gender inequality Stigma: Fear of the unknown leads to lack of testing and access to health services Legal Framework: Criminalisation of HIV transmission and sexual orientation

9. Religious issues Use of sacred texts Creation Story Human rights vs dignity Procreation and recreation Religious fundamentalism Marriage: vulnerability Faith Healing

10. Ethical issues Health professionals: further stigmatising Religious Leaders: promoting negative messages on PLWHIV Moralising HIV Forced sterilisation Response to key drivers of HIV, for example, Gender Inequality, Sexuality

11. Ethical Issues- continued Lack of monitoring of the private health sector Accountability and transparency – important values The faith healing debate Intergenerational relationships Legal Frameworks- Criminalization of sexuality Laws on SGBV

12. Recommendations Culture is dynamic Redefine cultural rituals Mutual faithfulness Eradication of homophobia and transphobia Intergration of CSE into all curricula Working with boys and men Holding teachers and health workers accountable Civil society should be involved in policy making - watchdogs

13. Importance of psychosocial support To reach the 90/90/90 – attitudes towards HIV have to change. Important pillar of care and support It promotes adherence and resilience Depression and lack of support - non- adherence Revive the Directly Observed Therapy(DOT) that worked for the treatment of TB

14. Conclusion Robert Frost: The Road Not Taken Two roads diverged in a yellow wood And sorry I could not travel both And be one traveller, long I stood………….. Two roads diverged in a wood, and I, I took the one less travelled by And that has made all the difference

15. TIME TO ACT Change begins with you and I. PLHIV must thrive and not just barely survive Getting tested is the first step towards life in abundance