Mail and Guardian (Johannesburg) - August 4, 2000

In many parts of the world, especially in the developing world, cultural, religious or other impediments prevent girl children and women from receiving education and thus becoming informed about their sexual and reproductive rights and options.

There is also a close correlation between gender violence and the spread of STDs, which increase women's vulnerability. Two years ago, at a conference organised by the Aids Law Project and the Tswaranang Legal Advocacy Centre found that violence against women, including domestic violence and rape, was strongly linked to their exposure to sexually transmitted infections like HIV/Aids.

Sexual violence like rape can increase women's susceptibility to the virus due to the likely presence of blood.

Moreover, men who refuse to wear condoms may even turn violent against a partner insisting on their use a problem prostitutes often encounter.

There have been several indicators to suggest that HIV/Aids has placed an enormous psychological burden on women who are inevitably the ones who have to care for the sick and the dying. In some cases women who are themselves sick have to care for family and/or community members who are dying from opportunistic infections like tuberculosis. There is an urgent need not only for trauma counselling for women in such positions, but adequate training for women who are involved in home-based care for people with Aids.

The increasing prominence of pharmaceutical companies jostling for a place to test and market anti-Aids drugs has also placed women in a position of vulnerability. Many countries in the developing world have become fertile ground for researchers conducting clinical trials into drug therapies, as well as for drug companies to market patented, often costly, drugs.

The issue of standards of care for participants in clinical trials, as well as the high cost of anti-Aids drugs in the developing world they are considerably cheaper in the developed world have particular consequences for indigent, poor, uneducated rural women who are often recruited into clinical trials.

The ethics around Aids research and testing of anti-Aids drugs in the developing world was a less prominent but vital issue raised at the 13th International Aids Conference.

This was in response to speculation that researchers in the developed world are trying to amend the Helsinki Declaration (an established protocol that sets international guidelines relating to clinical trials) to introduce the notion of relativity in standards of care.

This would basically mean that participants in developing countries are not entitled to a standard of care above and beyond what is generally available. This has particular consequences for trials involving mother- to-child transmission of the virus.

A central principle being promoted by the women's movement with regards to tackling HIV/Aids is that women have the right to control over their own bodies a matter which has not been promoted vigorously enough by several governments in the developing world.

Following on this, women should have access to fully informed choice and consent concerning medical interventions, particularly when therapeutic alternatives are presented to women for Aids treatment.

Women are still not adequately informed of the full range of risks and benefits outlined, on alternatives available, and on the consequences of refusing treatment or therapy.

All these raise the potential human rights questions arising from the testing and treatment of women for infections both indirectly and directly related to HIV/Aids.
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