Empowering women and girls with the freedom to choose their HIV prevention methods is paramount. Our choices as women can evolve throughout our lives, but without robust political and financial backing, full access to safe and effective prevention options remains elusive.

The HIV Prevention Choice Manifesto for Women and Girls in Africa, launched early this month, advocates for choice in the HIV prevention options available for women and a commitment to expanding access to long-acting HIV health technologies. It was developed  by the African Women Prevention Community Accountability Board (AWCAB) and supported by the International Community of Women Living with HIV (ICW) East Africa and Advocacy for Prevention of HIV and AIDS (APHA). 

“As the programme director and AGYW HIV prevention lead in the SSLN, this manifesto speaks to a common vision - creating a future free of HIV for women in Africa. The evidence is clear; young women remain at the epicentre of the HIV epidemic in sub-Saharan Africa. The guidance is clear; we need to allow women to choose their preferred HIV prevention option. Funding, political will and accountability are lacking though. But... so long as we position African women at the centre of the response, and so long as we continue to lead as African women we can surely realise this manifesto. We don't have another choice.” - Kerry Mangold

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The Opportunity: Women’s voice’s can and should take centre stage

UNAIDS and partners are looking to eliminate HIV as a public health threat by 2030. Using a combination of prevention interventions - including both social-behavioural and biomedical interventions - provides women and girls with a more enabling environment for reducing their risk of contracting HIV. With policy, practice, and budgets adapting to research advancements, advocacy for choice for women and girls is now a top priority. Community-led organisations are at the forefront of this agenda, and central to promoting the voices and choices of women and girls. 

The Challenge: Removing Barriers

Women’s choices on which HIV prevention methods are available to them are often limited by social or cultural issues. As more biomedical approaches to prevention come on to the market, women’s choices should not be further curtailed by the decisions of medical personnel (especially when it comes to adherence), nor through a lack of access or lack of funding.

A Call to Action

The Choice Manifesto calls on sustainable financing for continued research and development into ways to enhance and promote women’s choices around prevention options, while also ensuring that community engagement continues to be the foundation of raising womens’ voices and driving ‘choice-based programming’. It also calls on partners to design programmes that deliver results. In particular, the call goes out to partners to ensure that structural barriers hindering access to prevention services to AGYW are addressed. This means removing cultural and traditional constraints that hinder negotiation for safer sex and adequate protection and combining HIV prevention into a broader offering of sexual and reproductive health.

Finally, the manifesto calls on National Governments, PEPFAR, UNAIDS and the Global Fund to walk the talk of a ‘people-centred’ approach, where funding priorities support choices through integrated primary HIV prevention, SRHR and attention to human rights. 

The SSLN is committed to finding good examples of the enactment of the Choice Manifesto and facilitating its documentation and sharing across the region. We will support experiential learning and build social capital around the notion of Choice and the principles that drive the Manifesto. Through activities like Link & Learns and regional workshops - including one on PrEP that is coming up in October - we will encourage South-to-South collaboration and accountability to the women of Africa. 

The manifesto’s creators and co-signatories stress that these options should be people centred, women-centred and women-led. As a co-signatory of the manifesto, SSLN, is calling on its extensive network to take steps to enact its vision. 

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Further Resources

https://www.prepwatch.org/wp-content/uploads/2023/04/BioPIC-ThinkTank-Report.pdf

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