Gender-Based Violence and HIV

Emerging Lessons from the PEPFAR Initiative in Tanzania

The dual global epidemics of HIV/AIDS and gender-based violence (GBV) exert a destructive and disproportionate impact on women and girls, especially in high HIV-prevalence countries in Africa. Yet despite bipartisan political consensus on the intersection between HIV and GBV, efforts to address this area have not attracted the attention or resources necessary to drive the program innovation that could demonstrate progress. However, new momentum is now being brought to this agenda with the U.S. President’s Emergency Plan for AIDS Relief’s (PEPFAR) GBV initiative. Although still early in implementation and facing many challenges, the GBV initiative has the potential to yield important lessons about synergies and cost-effectiveness in reducing GBV and HIV, with clear implications for U.S. global health investments.

This paper examines how the GBV initiative is being introduced in Tanzania, one of the GBV focus countries, based on interviews in Tanzania in April 2012 with U.S. government officials, nongovernmental organizations, and implementing partners, as well as interviews in Washington, D.C. It describes the importance of this initiative for the work of PEPFAR and the Global Health Initiative (GHI), impediments to progress, why this program has the potential to provide valuable and timely lessons for achieving HIV-related goals and for improving health outcomes for women and girls, and priority steps for getting the best results in the future.

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Janet Fleischman
Senior Associate (Non-resident), Global Health Policy Center