8 March is International Womens Day and in 2017 the chosen theme is: Be Bold for Change. Women’s Day can be viewed as a day to celebrate all things that women have contributed and achieved. However, historically Women’s Day is also a day put aside to stand up and challenge social and political norms that still keep women oppressed. It is a day to acknowledge that the fight for equality and fair treatment is not over; there are still many miles to go.
This misaligned power balance can still be seen starkly in three areas particularly relevant to South Africa:

  • In unequal economic opportunity: South African women need to work on average 2 months more every year to earn a man’s annual salary (1)
  • In the high rates of gender-based violence: almost half (45.6%) of women in Africa have experienced physical and sexual violence worldwide, which is much higher than the already shocking world average of 35% (2)
  • In the disproportionate incidence of new HIV infections where women are significantly more likely to contract HIV than their male counterparts (2)

We need to disrupt this. Tear down these statistics and transform them into a better, safer reality for our women. Unfortunately, this is not something that can be done quietly, behind closed doors as it fundamentally relies on the occurrence of a shift in public mindset and a change in common gender norms. This can only really be accomplished when it is gone about Loudly, Boldly and Strong.
This is why this International Womens Day we ask that you Be Bold for Change.
Bold Social Reform for Change:
The Desmond Tutu HIV Foundation has taken this to heart, and this year we will launch our biggest and boldest project yet, Zimele: a social and health intervention project for 20,000+ adolescents, predominantly young women and adolescent girls, in the Mitchell’s Plain/Klipfontein Sub-district of Cape Town. Zimele is in partnership with the Western Cape Government and will be funded by the Global Fund to fight AIDS, Tuberculosis, and Malaria. We are focusing all our efforts on this one community, because we believe that real meaningful change only comes when you intervene at all levels of education, healthcare, government, and community. If this model programme shows significant impact, it will have the potential to be rolled out to other communities nationally. To find out more click here.
Women of Worth is a single programme within Zimele that will focus specifically on empowering young women (aged 19-24 years). At this age, young women are stepping out of school and beginning the transition into adulthood. It is their choices and actions that will determine the future of women in the community, and that of the next generation as they become mothers. Women of Worth will offer unique and innovative monthly Empowerment workshops that challenge common gender norms and provide relevant life skills. Workshop themes will include CV writing and contraceptives; sexuality and self-defence; pregnancy and politics; mental health and making decisions. To get involved go here; to sponsor a woman through the program go here.
International Womens Day
Bold Biomedical Tools for Change:
A focus on social and structural change will not be fast enough to protect our women now. A key factor that puts young women at high HIV risk is the high prevalence of gender-based violence and regressive gender norms, which render women unable to negotiate the conditions of safe sex. In these cases, knowing about the need for condom does not offer protection and for this reason, we advocate PrEP (pre-exposure prophylaxis) rollout to South African youth. PrEP is a daily HIV-prevention pill for HIV-negative people. When taken consistently, PrEP prevents HIV infection from occurring and could be a real game-changer in preventing new infections. South Africa was the first African country to receive regulatory approval for PrEP, but national guidelines for its rollout have not yet been established.
In view of fast-tracking and guiding this process, the DTHF has conducted or is the process of conducting a number of PrEP studies. These studies focus on determining PrEP acceptability and uptake amongst high-risk South African populations, including adolescents (PlusPills Study) and men who have sex with men (Sibanye Project). Moving forward, the DTHF will be launching three new PrEP projects that test the acceptability of PrEP use in young South African women.

  • The POWER study (funded by USAIDS) will look at different delivery approaches, uptake and adherence to PrEP among young women (aged 16-25 years) in Cape Town. This project will attempt to tease out patterns of PrEP use and adherence, and identify which women are most likely to start PrEP and why they might stop taking it.
  • The 3Ps for Prevention (Prevention, Partner, Pills) study (funded by NIH) looks at how social marketing can be effectively used to stimulate demand creation around PrEP for young women. This project will also provide PrEP to 200 women (aged 16-25 years) in Masiphumelele to assess acceptability, adherence, and whether offering an incentive would help increase uptake.
  • A third project (funded by UNICEF/UNITAID) will look at PrEP use among predominantly female South African adolescents (aged 15-19 years) when delivered as just one part of a comprehensive prevention package, following WHO and SA national policies. This project will be conducted over a 5-year period in three different provinces (Kwa-Zulu Natal, Gauteng and Cape Town).

If these projects prove successful and show that young women are able to adhere to a daily PrEP regimen, this could go a long way in advocating the rollout of PrEP to public clinics for those at high risk.
Study results so far have shown a large obstacle to PrEP use is the need to swallow a pill every day, which has resulted in study participants having low adherence or leaving the study. A way to overcome this, as is the case with contraceptive pills, is to offer different longer lasting routes of administration such as a three-monthly injection or a vaginal ring. The DTHF is involved in a number of clinical trials that are assessing the feasibility of such an alternative.
This International Womens Day we would like to say thank you to all the women who have taken part in our research so far. You are deeply appreciated and it is your participation that makes our work possible.

This Women’s Day: Be Bold for Change.

1. Bosch A. 11 Aug 2015. Women are still paid less than men in SA companies. Mail & Guardian. [Online] available:  https://mg.co.za/article/2015-08-11-women-are-still-paid-less-than-men-in-sa-companies.
2. WHO 2016 report. [Online] available: http://www.who.int/mediacentre/factsheets/fs239/en/