Overview and abstracts from UNESCO's upoming publication:

Introduction

The HIV and AIDS pandemic is both fuelling and being fuelled by inequalities across gender, race, ethnicity, class and age. e patterns of impact vary across different settings and regions of the world and are also shaped by demographic crises, armed conflicts, natural disasters, environmental degradation, state incapacities, famine and poverty. e pandemic’s refractory impacts on women and girls – and humanity writ large – are nothing short of catastrophic. In the third decade of the HIV pandemic, women and particularly young women and girls have become a growing proportion of those affected and infected. Nearly half of the 40.3 million people living with HIV are women between the ages of 15-49.1 Gender disparities in HIV prevalence are more extreme among young women between the ages of 15-24, globally 1.6 times more likely to be living with HIV and AIDS than young men. And in sub-Saharan Africa overall, young women between 15 and 24 years old are at least three times more likely to be HIV-positive than young men.

Until recently, the epidemiology of the pandemic has been explained largely in biomedical and behavioural terms. More attention is now being given to the social, political and economic factors that shape individual behaviour and the effectiveness of responses. But without understanding the deeply rooted social and cultural norms which increase risks for girls, young women and other at-risk populations, the impact of HIV prevention will continue to diminish as the pandemic unfolds over generations. Addressing the gender dimensions of the pandemic – and the implications for policy makers and practitioners – requires a far deeper understanding about how to support families and communities as they mediate the epidemic’s repercussions for household restructuring, gender and intergenerational relations, reproductive decision making, livelihood choices, education planning, economic status and civic participation. Equally urgent is the need to develop the knowledge necessary to strengthen national response capacities so those most affected by HIV and AIDS do not also have to shoulder its associated burdens.

Background
Launched in 1998, the joint UNESCO/UNAIDS project ‘A Cultural Approach to HIV and AIDS Prevention and Care’ supports the development of policy and planning principles which are gender-responsive, human-rights-based and built on thorough analysis of the cultural and social specificities of those communities concerned. Recognizing the severe limitations of prescribing a single formula, the project takes ‘cultural approaches’ to generally encompass tailored strategies grounded on the traditions, beliefs, values and practices specific to a particular group, which also mobilize the group’s cultural resources and assets as a basis for social engagement and development. It is within the framework of this project that UNESCO
commissioned the Social Science Research Council to carry out a review of literature addressing the cultural dimensions of HIV and AIDS to identify the gaps in linkages between theory and practice and to propose ways in which they could be addressed. e review, published in June 2006 and distributed at the XVI International AIDS Conference in Toronto2, included thousands of citations covering academic, UN, NGO and policy reports published in English, French, and Spanish.

While the review revealed a heartening increase in research into socio-cultural factors shaping the pandemic, it also exposed a lack of attention to gender issues, to the culture of response, and to comparative and interdisciplinary approaches. The review identified a great deal of project-focused literature attempting to assess the impact of specific responses but found much less that addressed the role of culture in shaping these responses or the broader cultural context in which they occur.

The vast majority of literature addressing the intersections of gender, culture and the pandemic continues to focus on specific groups of women or specific practices rather than on how gender organizes communities, institutions, and culture in everyday life. HIV and AIDS risks are still assessed largely in terms of ‘risk groups’ and ‘risk behaviours’, rather than on the socio-structural environmental factors that shape behaviour and place particular groups at disproportionate risk. Both the physiological and social risk factors associated with sexual violence, for example, have been vastly underrepresented in the literature on HIV and AIDS risks. And, although a confluence of factors – HIV and AIDS, crisis, poverty – underpin various risk ‘behaviours’, HIV and AIDS policies and programmes have yet to adequately distinguish among and respond specifically to these varied circumstances and groups.

A singular and defining question emerged from the UNESCO-SSRC review: How and why is the response to the HIV epidemic failing women?

Understanding the Fourth Wave

To respond to these gaps in awareness, understanding and response, UNESCO’s Division for Gender Equality in collaboration with the Division for Cultural Policies and Intercultural Dialogue commissioned the SSRC to co-publish an edited volume addressing what will be termed the ‘Fourth Wave’. The volume brings together nearly 30 accomplished authors, senior policy makers and young scholars to offer original insights and empirical analyses of socio-cultural factors shaping the gendered course of the pandemic and responses to it. It poses provocative questions and challenges conventional theories and methods used to explain the pandemic’s brutal effects on women and its tragic consequences. The volume does not treat gender as an additive variable, nor does it focus on women to the exclusion of men. Rather, it identifies explicit ways in which the global AIDS pandemic is, and has always been, ‘gendered’ and shows how increased understanding about these dimensions can shape more effective responses.