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June 23, 2005 Before I begin, I would like to show a short clip from a documentary we filmed recently in Madagascar in partnership with VH1, The Global Fund and Friends of The Global Fight. It is called "Tracking the Monster," and shows how we work with young people to encourage abstinence. As an actress, I know the importance of setting the stage. Never in my career, however, have I had to set the stage for a drama as devastating and of such historic proportions as the AIDS epidemic that we now battle. There are currently 39 million people living with HIV, the virus that causes AIDS. 20 million have already died. Roughly half of the infected adults are women, and over two million children carry the virus. In 2004 alone, the last year for which we have reliable statistics, there were three million deaths due to AIDS, and nearly five million new infections. To what in recent memory can we compare this catastrophe? Approximately 50 million lives were lost during the darkness of World War II; that number will be surpassed by deaths due to AIDS when those now infected are laid to rest. Stalin's totalitarian regime in the Soviet Union took a toll of 20 million lives - roughly equal to the number that have already died of AIDS globally. The numbers are staggering. They are truly without precedent, and our words and actions in the face of this crisis will certainly be studied for generations to come. With the hope of doing more to save lives, this Committee has convened to hear testimony principally about AIDS vaccines as a strategy for prevention. Dr Fauci and Dr. Gayle, both leaders in the public health community, will address this important topic. I would like to focus my testimony on another critical aspect of AIDS prevention, and that is the urgent need to do more for young women around the world. In Africa, young women are up to six times more likely to become infected with HIV than their male peers. Little, if anything, is being done to address the problems that put young women at such high risk, and more must be done now if we honestly hope to stop the AIDS epidemic. To give you an idea how bad things are, let me tell you about a group of young women in Zambia. These young girls, age 15-19, met with PSI staff last year to talk about abstinence and their experiences growing up generally. I'll start with someone who I'll call Jane. Jane lived with her sister and brother-in-law. Jane's sister and her husband had a fight one night, and her sister left the house for the evening. At about 1:30 in the morning, Jane awoke in pain, and found her brother-in-law on top of her. Raping her. Family elders, after learning of the incident, decided this was something the family should take care of on its own. It was never reported to the police. Immediately after Jane finished telling this story, another young girl told how she was locked in a room and raped by her boyfriend. She kept the matter a secret for "fear of being mocked." After hearing these two stories, two other girls in the group of ten described how they had also been raped - one by her uncle, who pushed a cloth in her mouth and tied her hands; and the other by the 19 year old friend of her brother. One of the girls reported the case to the police, but the other did not because she was "ashamed" of herself. Five others in this small group reported how they were accosted, or barely managed to escape sexual violence. All this had happened well before any of the girls had reached the age of 19. What can we conclude from this group of young women who shared their stories of abuse? We can conclude that most of us in this room have no idea how difficult life is for young women in Africa and elsewhere in the developing world. Even though sexual violence happens in all corners of our planet, women in developing countries are at extremely high risk of abuse. Social norms and economic pressure are often at the root of the problem. Recent research confirms that these young women's stories are not isolated cases. A report published in 2002 concluded that nearly one out of three young women surveyed in South Africa had their initial sexual experience through rape. What more sordid and cynical rite of passage to adulthood could we imagine for a young woman? The abuse of women stretches beyond the sexual violence that I just described; I will now tell you about a degrading and common phenomenon called "cross generational sex." The social norms in many developing countries that determine what is "tolerable" (or at least not punishable) for a man to do to a woman have also created an environment in which girls as young as 15 are encouraged to seek financial or material gain by entering empty sexual relationships with men a generation or more older than them. These "cross generational" relationships are common across the continent of Africa, and result in young women exchanging their bodies for modest financial support -- such as lunch, a cell phone, plastic shoes, or half a liter of fuel. And while these relationships are fundamentally transactional, this is not commercial sex. These are young women - in both urban and rural settings - who have been persuaded by both peers and adults that having an older "sponsor," and sexual partner, is an acceptable and common way to acquire fashionable items or meet basic needs. Rarely do these young women seriously consider the possibility of becoming infected with HIV. But the risks are very real. Already at increased biological risk, such "cross generational relationships" are fueling the AIDS epidemic among young women. Two recent academic journal articles document how a young girls' risk of HIV infection increases significantly as a result of having an older partner. Both papers were clear that this practice of cross generational sex was an important factor which explained why young women are six times more likely to be HIV positive than young men in Africa. , And here I pause and ask you, honorable members of this distinguished
committee, if we are really doing everything we can to protect these
young girls from AIDS? We want them to abstain, or delay their sexual
debut, but it will be difficult for them to do so if they are not protected
from both sexual abuse, and from social norms that encourage sex with
older men in return for financial support. But if that is the case, why is nothing being done to address these problems? With all the research that has been conducted, it is certainly not because we don't know this is happening. And I would like to think it is not because we don't care that these young women are being violated or contracting AIDS. I believe it is because the problem is so pervasive, so deeply rooted, and so long standing that we simply don't know where or how to start. The long journey to decrease the vulnerability of women in the developing world to AIDS and sexual violence must begin, like all journeys, with first steps. Here is how we can start. First, we must acknowledge that preventing AIDS among young women will entail reversing the social norms which support their abuse. Societies must reject violence against women, as well as social norms which encourage young women to exchange sex for financial or material support. The Global Fund, thanks to its unique country level structures, could play an important role coordinating local partners. Second, acknowledge that the transformation of these unhealthy social norms must come from within. This does not mean that we should stand by idly waiting for something to happen. It means that international organizations and donors must work hand in hand with indigenous groups that are prepared to fight for change in their own communities. The African Union will be a key partner in this struggle, and they are eager to begin work. Third, honorable committee members, you could insist on legislation that would tie future foreign aid to a country's demonstrated commitment to enforcing laws that protect women from all forms of sexual violence, including statutory rape. And fourth, national campaigns promoting healthier gender norms and role models for men should be launched throughout Africa and in many other places in the developing world. Having an AIDS vaccine would be of great benefit to women of all ages because it could reduce their chances of becoming infected. As there can be no vaccine to prevent the abuse of women, however, there is nothing more important in the struggle against this disease than reversing destructive social norms that endanger women across Africa and in other developing countries. I thank you again, honorable members, for allowing me to contribute
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