PEPFAR Gender Technical Working Group Gender Special Initiatives

Addressing gender issues is essential to reduce risk of the vulnerability of women and men to HIV infection, to mitigate the impact of the epidemic, and to improve health outcomes. The President’s Emergency Plan for AIDS Relief (PEPFAR) proactively confronts the changing demographics of the HIV epidemic, integrating gender throughout prevention, care, and treatment activities with a focus on the five cross-cutting, gender strategic areas:

1. Increasing gender equity in HIV programs and services, including in reproductive health
2. Reducing violence and coercion
3. Addressing male norms and behaviors
4. Increasing women’s legal protection
5. Increasing women’s access to income and productive resources, including education.

In addition to dedicated PEPFAR resources for the integration of gender into prevention, care, and treatment programs at the country level, PEPFAR’s Gender Technical Working Group (GTWG) provides global technical leadership on pertinent gender and HIV issues. In 2007, the GTWG launched four initiatives to develop evidence for what works—at the individual, family, community, and national levels—to address factors contributing to HIV, such as adolescent girls’ vulnerabilities, harmful gender norms, and sexual violence. The four initiatives are:

  • Quebrando Barreiras. The Capable Partners Program (CAP) Mozambique decided to expand the HIV prevention tools available to local organizations facilitating community discussions about HIV. Among these tools was the Quebrando Barreiras (Breaking Barriers) series. Four short films, based on real-life situations, depict barriers that may prevent Mozambicans from adopting safe sexual behaviors. The barriers dealt with include multiple and concurrent partnerships, intergenerational sex, alcohol abuse, issues with interpersonal relationships (both familial and romantic), gender-based violence, disclosure of HIV status, and perceptions of masculinity.
  • The Male Norms Initiative (2007-2010). Implemented in Ethiopia, Namibia, and Tanzania, the initiative built the capacity of in-country partners to integrate male engagement (ME) strategies into their HIV programs through training, materials development, network development, and policy review. Some of the promising practices to increase ME that were identified by implementing partners include strategic involvement of partners and organizational leadership, investing in and strengthening the national advocacy networks, and linking facility-based activities with complementary community interventions.
  • The Initiative on Girls’ Vulnerability to HIV (known as the Go Girls! Initiative) (2007-2011). Implemented in Mozambique, Botswana, and Malawi, this initiative employed a multi-sectoral, integrated program adapted for each country. Program elements included: community mobilization; improving adult-child communication skills; use of reality radio; school- and community-based life skills; assisting teachers and principals to create a safe school environment; and girls’ economic strengthening activities. In all countries community leaders, adults, parents, and youth have recognized the value of girl-focused programming. The initiative was met with enthusiasm from community members, emphasizing the need for programming that gives adults the skills they need to build strong, nurturing relationships with their children and other adolescents in the community.
  • The Special Initiative on Sexual Gender-Based Violence (2007-2010). Implemented by 10 PEPFAR partners in Rwanda and Uganda, this initiative complements efforts to expand sexual violence services, improve service quality, increase service demand and uptake, and provides an evidence base for scaling-up such efforts in the future. Implementing partners use site-specific service delivery models based on the needs, preferences, and capacities within their health care setting and based on government policies and community practices. An evaluation of the initiative is ongoing.