ABSTRACT
Planners, program developers, and activists encounter several paradoxes when they begin to formalize and conceptualize women’s role and needs in order to frame appropriate responses to the HIV pandemic. Some advocate for programs which address women as a special group, usually for the purposes of education and improving risk reduction strategies. Others seek removal of gender-based barriers to treatment or care, for example, lifting the exclusion of women from AIDS treatment drug trials, or including as diagnostic the range of gynecological complications of HIV, as recently occurred in the US. On one hand, women can benefit from claiming status as a special group, but on the other, designating women as a special group can fuel negative stereotypes and increase discrimination. Policymakers feel frustrated when special programs created for women are greeted with accusations of discrimination, or when ‘gender-blind’ programs are seen as insensitive by women who use or need information or services. Women’s dual social status as childbearers and as persons further complicates program and policy design. Women’s specific needs in relation to childbearing (which are perceived to be largely biomedical, but are also significantly social and cultural) are too often turned around to exclude women from other programs or social roles (for example, many societies do not recognize women’s desire for and right to education unrelated to their childbearing role).
