What Works for Women and Girls

families and separated from their children than men are” (Hong et al., 2004: 2). A qualitativestudy conducted from 2001 to 2003 in rural and urban Ethiopia, Tanzania, and Zambia withstructured text analysis of more than 650 interviews, and 80 focus group discussions, and aquantitative analysis of 400 survey respondents found that “constraints are particularly acutefor young, married women with HIV who try to balance the stigma of being HIV-positive withthe reality that childbearing is often their only route to social status and economic support”(Nyblade et al., 2003: 51).In the words of an HIV-positive man who is an injecting drug user, “Men are forgiven.Women would not be forgiven. Women are blamed even if they are unlucky and sleep witha husband who used to sleep with many girlfriends or is an IDU and brought the disease tohis wife” (Nguyen et al., 2009: 146). An HIV-positive woman tested in a PMTCT program inMalawi explained that, “In the community few people accept HIV-positive mothers. They thinkyou are HIV-positive because you were just moving around and sleeping with a lot of men.They keep gossiping about you. Some even do witchcraft against you so you die faster. It is thusbetter that you keep your HIV status for yourself without telling others” (Bwirire et al., 2008:1197). A cross-sectional survey of 148 youth living with HIV/AIDS in Kinshasa, DemocraticRepublic of the Congo (DRC), of whom 79% were female, found that females reported morepersonalized stigma and stigma related to public attitudes compared to males (Mupenda et al.,2008). Yet, many studies of stigma and discrimination do not collect sex-disaggregated data,making it difficult to determine differential experiences that men and women face.Misconceptions About HIV Continue to Exacerbate Stigma and DiscriminationInadequate information about how HIV is transmitted adds needlessly to the stigmatizationand discrimination faced by people living with HIV. For example, findings from a qualitativeresearch study conducted in 2003 in Vietnam found that lack of detailed understanding of theroutes of HIV transmission led to isolation and rejection of people living with HIV and AIDS,avoidance of their goods and services, and secondary stigma against their family members andchildren. Further, many families of people who are HIV-positive or have AIDS take unnecessary‘preventive’ measures, such as eating separately, adding needlessly to the already significantemotional, economic and time-related burdens of care-giving (Hong et al., 2004). In Mali,“...the fact that social transmission (through sharing of food, bowls, latrines, blankets andclothes) was widely thought to be feasible is probably related to the perceived need to quarantinesuspected AIDS cases...” (Castle, 2004: 6). It’s critical to educate parents and teachers sothey can accurately educate young people as well. Interviews and focus groups in Mali foundthat three-fourths of the teachers in the study held mistaken beliefs about methods of HIVtransmission that they then communicated to their students (Castle, 2004).Interventions to combat stigma should include interventions for individuals, which createawareness of what is stigma and the benefits of reducing stigma, environmental interventions,i.e., meeting the need for information, supplies and training; and structural, i.e., addressingpolicies and laws (Nyblade, 2009). “Understanding the association of HIV and AIDS withassumed immoral and improper behaviors is essential to confronting perceptions thatWHAT WORKS FOR WOMEN AND GIRLS329