Gender-based violence, poverty and alcohol are the three main drivers of HIV infection that we need to address,” said Lebo Ramafoko, chairperson of the newly formed Social and Structural Drivers Technical Task Team of SANAC, in an address at SANAC’s last Programme Review Committee (PRC). The National Strategic Plan is clear that unless we address these social problems and unless our plan is comprehensive and employs both the biomedical and social responses, our efforts to address AIDS will be incomplete.
“There is evidence of the impact of the drivers of HIV incidence. Similarly, there are studies on existing interventions to address these problems. Various government departments also have strategies and policies to address these. Our work is to pull these together to make a concerted effort to prevent new HIV infections amongst key populations. Our work is to use these to devise programmes for provinces, districts, and so on.”
Ramafoko also pointed out that gender-based violence manifests itself in three different forms – intimate partner violence, sexual abuse of children and sexual abuse of adults – and added that interventions must include a focus on the prevention of gender-based violence and child abuse, strengthening women’s resilience and law and policy implementation. “We must do everything in our power to ensure that young girls remain in school. There is sufficient evidence to show that being in school has a protective effect from HIV infection for young girls.
“Key points of entry for gender-based violence prevention must look at building gender equity at all levels, critically changing constructions of masculinity, reducing childhood exposure to gender-based and sexual, physical and emotional abuse at home as well as improving relationship skills to manage communication and conflict and reducing substance abuse.
“South Africans are the heaviest drinkers in the world, with adult per capita consumption of 15 to 20 litres a years, according to a 2009 report by the Medical Research Council (MRC). There is a clear link between drunkenness and unsafe sexual behaviour and because of this we recommend policy that will ban advertising of alcohol. We recommend that a levy be imposed on the sale of alcohol to set up a health promotion foundation.”