Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697800502194.pdf (Dominica)
Prepared February 2003 by The Bureau of Gender Affairs The Globe Building 106 Independence Street, Roseau Commonwealth of Dominica Tel: (767) 448-2401 ext 3344/3023 Fax: (767) 4487855, Email: genderaffairs@dominica.gov.dm WHAT IS THE SITUATION OF HIV/AIDS LIKE IN DOMINICA TODAY?
TOTAL HIV POSITIVE BY SEX DOMINICA 1987-SEPT. 2000 0% 27% 73% Female Male Unknown TOTAL AIDS CASES BY SEX DOMINICA 1987-1999 34 100 Male Female TOTAL AIDS DEATHS BY SEX DOMINICA 1987-1999 28% 72% Male Female Reported Cases of STDs, AIDS and HIV from 1998 – 2000 STD AIDS HIV 1998 445 12 17 1999 353 15 20 2000 529 4 18 Poor communication between men and women concerning and reproductive health matters, result in inability to responsibilities in these important areas sexual foster shared Lack of an affordable, widely available women controlled method of prevention.
Using male condoms requires men’s cooperation, implying male control.

Female condoms that are not yet widely available and affordable in developing states also require male participation In the face of domestic violence or sexual assault women’s ability to protect themselves against HIV is highly reduced – are less able to refuse sex, insist on condom use or communicate effectively about sex.

RECOMMENDATIONS Interventions should both seek to empower women and transform gender relations.
Men programmes should also target gender inequality Empower women to take appropriate decision about the decrease; to learn skills in assertiveness to negotiate sex and resist sexual violence Work with both men and women in developing communication and relationship skills Coordinated response programmes should encompass various approaches such as service delivery, capacity building, research and advocacy and should be inter-sectoral Challenge the stigmatization and discrimination faced by those living with HIV/AIDS Partnerships between women’s rights activists, HIV advocates, Health workers and policy makers to provide a basis for action information and A focus on sexual and reproductive rights for women and men is an important corrective measure Help them reflect on the impact of negative/traditional ideas of male behaviour Utilize young positive men as facilitators in public education programmes.
Working with men is essential to change in behaviour and attitude Research have found out that young men who had more gender equitable attitudes were less likely to use violence and more likely to use condoms.

WOMEN ARE MORE SOCIALLY AND BIOLOGICALLY VULNERABLE TO HIV INFECTION BECAUSE: Sexual transmission from men to women is several times more efficient than women to men.
More so in younger women where tissue lining of the genital tract is not fully developed and also in the post menopause period when tissue lining again begins to thin out In comparison to men women hardly show any symptoms of STDs which increases their risk of contracting HIV Young women and girls are culturally vulnerable.

It is common for men to select much younger partners than themselves Women are more economic, socially and emotionally dependent on men.
It is harder for them to negotiate safe sex or refuse unsafe sex INEQUALITIES IN GENDER RELATIONS There are taboos and stigma in our society, which worsens the situation created by HIV/AIDS.

The denial, blame and stigma surrounding HIV has silenced open discussions at various levels, especially regarding like women and homosexuals.
The social particular groupings construction of sexuality where young persons, more so women based on societal norms and expectations do not feel free or are inhibited from openly discussing sex.

Decision making in relationships and reproductive health matters where men are expected to dominate and women passive is a barrier to wise choices.
Unequal parties are not in a position to negotiate as to: Double standards that encourage men to have many sexual partners, result in greater risk to HIV infection for their women  When to have sex partners Cultural expectations of female submissiveness and male dominance in sexual relations limits women’s ability to exert control over sexual and reproductive health Unequal power in gender relations at a personal, collective, institutional and broader societal level is neglected.
 How often and how to protect themselves from STDs.

The girl child, young women and now increasingly elderly women are more often the victims of rape/sexual abuse Insufficient open up debates around issues of sexuality and gender inequalities, provide opportunities to up drive HIV/AIDS pandemic.

The fact that women and young girls are more often the victims of sexual abuse/rape puts them more at risk.

The double standard of condoning multiple sex partners for men puts men and their partners at risk.
Reluctance to pay attention to their health needs This attitude also prevents men from seeking sexual advice.

Reports from health services show that generally less men than women access health care services.
Their use of violence against women Their resistance to using condoms RELATIONSHIP BETWEEN HIV, GENDER AND POVERTY These are therefore some of the biggest challenges to reducing HIV risk Inequalities such as poverty and economic dependence help to drive HIV pandemic Pressing concerns for short-term survival may lead poor women to engage in survival sex and be exposed to contracting HIV The “Sugar Daddy” relationship, young girls depend on older men for economic survival Women who are main caregivers, both as means of earning income and family support increasingly play this role as more HIV/AIDS patient require this caring service.
Women who are economically dependent may generally feel less confident in their ability to negotiate or discuss safe sex practices with their partner.

THE DOMINANT RISK FACTOR IS NOW HETEROSEXUAL SEX That is involving men and women in relationships - husband and wife or boyfriend and girlfriend, Globally 50% of those living with HIV/AIDS are women.

This seems to be increasingly the trend in Dominica as well.
This has implications for social roles of women as mothers and care givers This is especially critical in Dominica where we already have 38% female single headed households.
MEN’S BEHAVIOUR A DRIVING FORCE BEHIND THE HIV/AIDS Largely determine how and when sex takes place MEN NEED TO CHANGE THEIR ATTITUDES OR BELIEF THAT: Sexual health matters are women’s concern Violence against women is acceptable Men need sex more than women Quantity in sexual relationships is more important than quality Sexual intercourse with a virgin/child can cause venerial diseases WHAT WE NEED TO DO?
Convince men to: o Treat women with more respect o Negotiate sexual matters with women o Pay attention to their own and their partners health Encourage men to interact with male role models or mentors with more progressive ideas and belonging to groups that modeled or supported more gender equitable attitudes If he does not want to use and condom and I refuse, will he leave me?

What will I do to survive?

What about my children?