Our AIDS Response Must Acknowledge and Bridge Gendered Digital Inequalities

By Anne Githuku-Shongwe and Eva Kiwango
JOHANNESBURG, Mar 7 2023 – Recent crises have pushed the gender inequality gap even wider and new technology has brought new threats to women’s autonomy and safety. This year’s International Women’s Day celebrated under the theme “DigitALL: Innovation and technology for gender equality” is an opportunity to strengthen efforts to uplift and empower women and girls’ digital participation to ultimately improve their lives.

Sima Bahous, UN Under-Secretary-General and Executive Director of UN Women has described it as “digital poverty”: the digital divide which “disproportionately affects women and girls with low literacy or low income, those living in rural or remote areas, migrants, women with disabilities, and older women”.

From a health perspective, excluding women and girls from digital participation restricts their access to life-saving information. That can have dire consequences in a region such as eastern and southern Africa where young women and girls carry the burden of HIV

On a continent that contributes only 13% towards global internet users, nearly 45% fewer women than men have access to the internet in sub-Saharan Africa.

That means alarmingly high numbers of African women and girls are left out of digitally-enhanced opportunities such as employment, mobile money transactions and banking.

From a health perspective, excluding women and girls from digital participation restricts their access to life-saving information. That can have dire consequences in a region such as eastern and southern Africa where young women and girls carry the burden of HIV.

In our region, women and girls continue to be disproportionately affected by HIV, accounting for 63% of the region’s new HIV infections in 2021. HIV infections are three times higher among adolescent girls and young women (aged 15 to 24 years) than among males of the same age.

The factors fueling this reality are power, deep-set inequalities and limited access to information among other factors.

Our report Dangerous Inequalities highlights that sexual reproductive health rights (SRHR) barriers, lack of quality comprehensive sexuality education (CSE) and restrictive and contradictory policy frameworks make it difficult, if not impossible, for adolescent girls and young women to access essential SRHR and HIV prevention and treatment services.

Furthermore, sociocultural norms, stigmas, discrimination, perceptions and age of consent laws impede young women and girls from accessing HIV testing and SRHR services.

Such barriers discourage young women and adolescent girls from approaching healthcare centres for their sexual reproductive needs.

This leaves girls with insufficient knowledge and skills to protect themselves from unsafe and unhealthy sexual practices, leading to HIV infection and sexually transmitted infections, teenage pregnancies, unsafe abortions and sexual violence.

The UNFPA “Seeing The Unseen” report highlights that 13% of all young women in developing countries begin childbearing while still being children themselves. In eastern and southern Africa, the overall weighted pregnancy prevalence among adolescent girls and young women (10-24 years of age) is alarmingly high at 25%.

We have completely normalised the abnormal. That is a crisis in itself. However, closing the gender equality gap will give us the opportunity to change the inequality trajectory for women and girls.

Technology and the digital space should be made more inclusive and accessible in our region and beyond. Virtual medical consultations, SRHR apps and searchable information should be options our young women and girls should be able to explore in a shame-free, destigmatised environment.

We applaud African developers who have created multiple free apps such as In Her Hands developed by the Southern African Development Community with the support of UNAIDS. Such apps work to empower young women and girls with SRHR information as well as expand HIV prevention outreach.

However, all our efforts to make the digital world accessible and inclusive should also be safe. Unfettered access to information and unscrupulous persons leave women vulnerable to misinformation on the very health issues they would seek to treat.

Furthermore, while the virtual world gives us a space to create boundaries and interact at a seemingly safe level for school, work and socialization, online violence against women is proving to be pervasive.

A UN brief shares physical threats, sexual harassment, stalking, zoombombing and sex trolling as examples of some of the attacks women face online.

It is therefore important to accelerate internet literacy for women and girls and equip them with precautionary and reactionary measures to ensure their digital safety before online violence permeates the physical world leading to serious challenges such as physical stalking, abduction and trafficking.

In spite of the challenges and safety concerns, the digital world can be an empowering space when harnessed correctly. Safe digital spaces hold the potential to disseminate life-saving, evidence-based information on SRHR, HIV prevention, treatment, GBV reporting and related support mechanisms at the click of a button.

Initiatives addressing SRHR and HIV ought to be framed with an inclusive digital lens at the fore. Multi-stakeholder collaboration is key, particularly with the private sector, internet service providers and data hubs.

At UNAIDS, we have partnered with UNESCO, UNICEF, UNFPA and UN Women to launch the ‘Education Plus’ Initiative. The initiative accelerates actions and investments to prevent HIV by ensuring adolescent girls and young women in Africa have equal opportunities to access quality secondary education, alongside key education and health services and support for their economic autonomy and empowerment.

Furthermore, the Transforming Education Summit is a key initiative of Our Common Agenda launched by UN Secretary-General, Antonio Guterres, in September 2021. It works to recover pandemic-related learning losses and sow the seeds to transform education in a rapidly changing world.

If harnessed effectively, connectivity and openly accessible digital teaching and learning resources can contribute to the transformation and democratization of education.

As we work to end AIDS by 2030, access to new prevention technologies such as long-acting PrEP to be rolled out in Botswana, Uganda and Zimbabwe should be expanded to the entire region. That should be rolled out without disparity between rich and poorer countries.

Emerging technologies such as the vaginal ring, an important feminist option, need to be supported to increase efficacy and accessibility. Furthermore, the preventive benefits of antiretroviral treatment need to be promoted and understood. Platforms such as social media should be considered powerful and accessible tools to raise awareness of HIV prevention and care in our region.

Technology is a game changer in access to health information and enabling young people to break taboos around sexual health and HIV and feel empowered in their bodies.

We need to urgently level the digital space, use it to end gender inequalities and safeguard our women and girls from the scourge of HIV. There is no price on human life: Ending AIDS is a promise that can and must be kept.

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Anne Githuku-Shongwe is the UNAIDS Regional Support Team for Eastern and Southern Africa Director and Eva Kiwango is the Country Director of UNAIDS South Africa