HIV: Women and Girls

Jim Shannon Excerpts

Tuesday 12th April 2016 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to speak in this debate and I congratulate the hon. Member for Finchley and Golders Green (Mike Freer) on securing it. Many of us have an interest in this issue. I suspect that many more would be here if it was not for other duties and debates elsewhere, because the issue certainly resonates with us. We are here today because we want to highlight the issue for those in other parts of the world. We are taking steps here in the United Kingdom of Great Britain and Northern Ireland, but we need to encourage countries and Governments to take steps elsewhere.

Worldwide there are some 900 million adolescent girls and young women in the 15 to 24 age group. Despite being 12% of the entire population of the world, too often for cultural or political reasons those young women are left without a voice or any say or control over their own bodies. We are all aware of the issues across the world and the violence against women. Rape seems to be a method of violence and war that some soldiers inflict on women wherever they have the opportunity to do so. We have had many debates in Westminster Hall that have highlighted the rape of women and girls and the brutal, horrible violent acts that take place against them. We recently had a debate on Burma and the Rohingya people.

Across the Sahara and across Africa, rape seems to be a weapon of war and we must highlight this issue. I often say we have to be a voice for the voiceless, and so we do. In this House we have to be a voice for those who have no voice, who do not have anyone to speak up for them, and the debate today is an opportunity to do just that.

Women have limited access to healthcare in developing nations and little or no access to education. Systems and policies skewed against them in some of the more gender-oppressive nations combine to create obstacles that block adolescent girls and young women from knowing how to and being able to protect themselves against HIV. We need a loud awakening of some of the Governments across the world so that they understand what is going on.

Despite the fact that the world is becoming more global, there are still regions in the world where young women and adolescent girls remain at a much higher risk of HIV infection than their male counterparts. It is shocking that, despite this fact being known, there seems to be no real progress, and girls in the age group I referred to still account for a disproportionate number of new infections among the young people living with the infection. There are an estimated 340,000 to 440,000 new HIV infections among young women aged 15 to 24 each year. If that does not shock us, I do not know what does. Despite making up only 12% of the population, they accounted for 60% of all new infections.

Poverty plays a big role, but the elephant in the room, as so often, is that although it is a global issue, there are clear issues in particular regions that exacerbate the case. It is true that some cannot afford access to care, treatment and preventive measures, but more often than not it is the cultural or political treatment of women that means they are unable to access the treatment, care and preventive measures that they need. Fifteen per cent. of women living with HIV are aged 15 to 24, a shocking 80% of whom live in sub-Saharan Africa. We know that that is an extremely impoverished area of the world, but we also know that the culture and policy towards women there is a far cry from the relative gender equality we enjoy here in the west.

Indeed, up to 45% of adolescent girls in those poor regions reported their first sexual experience to be forced. That is another shocking statistic. It is estimated that around 120 million girls worldwide have experienced rape or other forced sexual acts at some point in their life. The magnitude of those figures should shock us all. They remind each and every one of us exactly what the issues are and it is why this debate is so important. From a collection of more than 45 studies from sub-Saharan Africa, it was revealed that such relationships were common between younger women and older male partners, and relationships with large differences in age are associated with unsafe sexual behaviour and the low use of condoms.

Women who experienced violence from a partner were 50% more likely to have contracted HIV than women who had not experienced such violence. In fact, of all the age groups, even married girls and women in the 15 to 24 age group are most affected by spousal physical or sexual violence. Some of the Members who have spoken already, including the hon. Member for Lanark and Hamilton East (Angela Crawley), who spoke just before me, mentioned DFID. Again, the background notes supplied for this debate are very helpful. I want to put this note on the record:

“DFID has committed to putting girls and women at the heart of its development assistance. As well as continuing a focus on women and girls in DFID’s bilateral HIV programmes, more work is required to capture, measure and maximise the HIV related benefits of DFID’s wider work with women and girls.”

Hon. Members who have spoken have expressed some disquiet over the DFID policy in relation to its ever being successful. The Minister always responds in an energetic and knowledgeable way, so I am sure he will be able to indicate and reaffirm DFID’s response. If there is a shortcoming—I perceive that there is—DFID must address that as well.

The note continues:

“Global progress on reducing new infections in women and girls remains a priority for DFID.”

I hope that that is the case. Negative gender stereotypes and harmful norms are equally damaging. Adolescent girls and young women face significant barriers in accessing health services or protecting their own health. Lack of access to comprehensive and accurate information on sexual and reproductive health means that adolescent girls and young women are not equipped to manage their sexual health or to reduce potential health risks. Furthermore, they are less able to negotiate condom use. They have limited access to HIV testing, modern contraception and family planning, and are less able to adhere to HIV treatment. Those facts cannot be ignored.

Queen Nana Adwoa Awindor of Ghana, who chairs the African Queens and Women Cultural Leaders Network, has underscored the important role that cultural and traditional leaders have to play in the fight against HIV and AIDS, saying:

“It is our responsibility to ensure that harmful traditional practices that promote the spread of HIV such as early marriages and female genital mutilation are eradicated”.

What she is saying is, “Change traditions and protect the people.” I hope that today’s debate will in some way do that.

ln sub-Saharan Africa, only 26% of adolescent girls possess comprehensive and correct knowledge about HIV, compared with 36% of adolescent boys. In that context, according to UNICEF, among girls aged 15 to 19 who reported having multiple sexual partners in the previous 12 months, only 36% reported that they used a condom the last time they had sex. There are basic, simple issues that must be addressed by DFID and through the Minister’s Department, but also by the Governments responsible for the countries where HIV and AIDS are epidemic. There is a need for relentless pressure to be exerted, using the international bodies at hand, such as the UN, on the Governments of the countries in question. The things I have talked about are not acceptable in the UK, and we are addressing them; they should not be tolerated anywhere else in the world.

[Patrick Grady (Glasgow North) (SNP)]

It is a pleasure to serve under your chairmanship, Ms Buck. I congratulate the hon. Member for Finchley and Golders Green (Mike Freer) on securing what has been a considered and useful debate on tackling HIV and AIDS in women and girls. I congratulate him too on his work as chair of the all-party group on HIV and AIDS, of which I am a member. There were useful contributions from the hon. Member for Harrow West (Mr Thomas), who brings considerable experience to the debate, my hon. Friend the Member for Lanark and Hamilton East (Angela Crawley)—I shall reflect in particular on some of what she said—and the hon. Member for Strangford (Jim Shannon), who spoke of being a voice for the voiceless. I do not think there is any question of his voice not being heard. He spoke with his usual commitment and passion.

This debate is timely, as has been mentioned, taking place as it does in the context of the adoption of the sustainable development goals. Indeed, some of us will be back tomorrow for a debate on the implementation of those goals in the round. However, today’s debate is a useful opportunity to reflect on the particular issue of tackling HIV and AIDS, for all the reasons that we have heard, in particular the need to make rapid progress now that the goals are agreed. The number of people around the world living with HIV and AIDS continues to rise, despite the progress being made, and indeed partly as a result of it, given the enhanced longevity from treatment—an HIV infection need not be a death sentence per se. Nevertheless, transmission continues to increase and, as we have heard, in particular parts of the world that may affect women and girls disproportionately.

Three themes arise from what we have heard in the debate: general issues and challenges, such as those I have touched on; the steps and strategies needed to tackle those challenges; and the ways in which we fund and prioritise those steps. I will reflect briefly on those, making sure, of course, that the Minister has plenty of time to respond to all the questions that have been asked.

We have heard that HIV/AIDS is the No. 1 killer of women of reproductive age around the world. In our part of the world it is sometimes difficult to comprehend that, because it is not necessarily true in every individual country, or in developed countries such as ours. However, in developing parts of the world it is of particular concern. During the recess I was in Zambia with the Westminster Foundation for Democracy. The overall prevalence of HIV/AIDS in the country is 12.4% of the population—some 500,000 women. Yesterday I welcomed Jacqueline Kouwenhoven, who is Dutch born but is a Member of the National Assembly of Malawi. She is the Member of Parliament for the Rumphi West constituency. In Malawi the prevalence of HIV/AIDS among men is 8.1%, but among women it is 12.9%. That is a pretty stark demonstration of the disparity, and the disproportionate impact that HIV/AIDS has on women, which is reflected in other statistics we have heard in the debate. I think others have discussed how 74% of new HIV infections in 2014 among adolescents in Africa were among girls and women. That is 12,500 new infections every week, and it gives us a sense of the scale of the challenge.

There is a challenge in two respects. First, there is a challenge for the individuals, as HIV/AIDS limits their life chances and lowers their life expectancy, limiting their ability to work, contribute to society and live flourishing, dignified lives of their own. However, there is also a broader development challenge, in the form of a barrier to societal and economic development, starting at household level, because younger children may be taken out of school to provide care or take up income-generating activities. That has a knock-on effect on whole societies. My hon. Friend the Member for Lanark and Hamilton East quoted Scotland’s First Minister, Nicola Sturgeon, on the importance of empowering women fully, as the simplest way for countries to increase their productive potential sustainably. Interestingly enough, the quotation came from a speech given to the Chinese Friendship Association in Beijing in July 2015. As we have come to expect, Nicola Sturgeon is not afraid to be a voice for the voiceless and to speak out, without fear or favour, around the world on issues of gender equality. That goes to the heart of the point made about the need for political leadership—both an holistic response to a holistic challenge, and political leadership to drive that response forward.

The steps needed to tackle the spread of HIV and AIDS among women and girls in particular fall into two key areas. The first is prevention, in its broadest sense. We have heard a lot in the debate about education, including education specifically for awareness—of status, safe practices and cultural barriers. All those things are important, and we have heard about some of the support that the Scottish Government are providing. A particularly interesting example came about through the small grants scheme, which allows the funding of small, innovative programmes. The Yes! Tanzania programme conducted a feasibility study on using its sports facilities to educate young people about the transmission of HIV and AIDS, and used the study to put the lessons into practice. It will deliver both sport and sexual health training to more than 60 community sports coaches, teachers and peer leaders, and through that method will reach more than 2,000 young people in Arusha in Tanzania. Hopefully it will go on to measure the impact of the work.

Using small grant funding can be a useful and innovative way to try out new techniques and to reach young women and men in particular, through forums where they might not traditionally have expected to receive such education. It would be useful to hear the Minister reflect on whether there any lessons he can learn from that kind of thing.

[Jim Shannon]

I would like to reiterate what the hon. Gentleman has said. The Elim Church in my constituency—to give just one example—does fantastic work in Swaziland with young boys and girls who have HIV/AIDS. Some of the good work that the hon. Gentleman has been discussing, and that he asks DFID to do, is also being done by church groups throughout the United Kingdom. I mentioned the Elim Church, but the Presbyterian Church, the Church of Ireland, the Methodists, the Baptists and the Roman Catholic Church all do it as well. It is good to recognise some of the good work that other groups do.

[Patrick Grady]

I am sure we can all give examples from our constituencies or broader areas of interest of specific projects or programmes that have made a difference. An issue relating to some of the broader questions that have been asked about DFID is to do with its different priorities: the way in which it is leveraging the 0.7%, which we all welcome, and how that can be done as effectively and as holistically as possible. Having some flexibility to try to innovate in new areas and support small, dynamic projects is definitely one area for consideration.

There is the important question of education specifically about HIV/AIDS, which we have heard about, but there is a broader question of education as well. Although it is true that, as I have said a number of times—my hon. Friend the Member for Lanark and Hamilton East said it too—there is no silver bullet to global development, educating women and girls is about as close as we can get. Broader access to education—not just education on HIV/AIDS but, more broadly, education that trains and empowers women with the skills they need to take into society—can reverse the negative spiral that I spoke about at the beginning of my remarks. That economic empowerment is crucial.