Women and HIV/AIDS
Women's Vulnerability to HIV/AIDS: An Overview
International Women’s Health Coalition
July 29, 2006
The Context: Women's Vulnerability to HIV/AIDS Worldwide
In January 2002, U.N. Secretary General Kofi Annan announced that for the first time, women represented half of HIV-positive individuals worldwide, and more than half in sub-Saharan Africa. HIV/AIDS had become a generalized epidemic in many African countries, moving from high-risk groups such as sex workers and injection drug users to the general population, largely because of pervasive gender inequality. The Secretary's rallying cry to the international community stressed that effective HIV prevention programs had to address the realities of women's lives.
The combination of gender inequality and severe poverty is lethal to women in the developing world, and creates the following risk factors for HIV:
-
Lack of comprehensive reproductive health services and information for women and girls. If the world community is serious about preventing transmission of HIV/AIDS in women, comprehensive reproductive health services should be a logical starting point for increased funding. But women's health education and services continue to be woefully underfunded. In India, for example, 70 percent of women and girls live in rural areas, and the only way many will learn about HIV and prevention is when they seek pre- or post-natal care, but these services are not considered priorities for HIV/AIDS funds in India or elsewhere.
- Economic
disempowerment. Pressure
to provide an income for themselves or their families leads many girls
to engage in "transactional sex" with older men ("sugar
daddies"), who give them money, school fees, or gifts in exchange
for sex.
- Lack
of basic education.
Of the 121 million children not in school worldwide, 65 million are
girls, and the highest concentrations are in sub-Saharan Africa. AIDS
is adding to the problem because girls are leaving school in increasing
numbers, much more often than boys, to care for sick relatives. Education
gives girls the skills they need to access information, enter the labor
force, and rise above the poverty that makes them all the more vulnerable
to infection.
- Migrant
husbands. Many
women, especially those in rural areas, are infected by husbands who
work as miners, truckers, or soldiers and engage in unprotected sex
while away from home. For example, in Cameroun, the HIV prevalence of
men who have been absent from home for more than 31 days is 7.6 percent,
compared to a rate of 1.4 percent among those who stayed home.
- Ignorance
and stigma around HIV/AIDS.
The unwillingness of too many governments and community or religious
leaders to talk frankly about sex prevents the dissemination of accurate
information about HIV/AIDS and fosters the spread of wildly inaccurate
information. Often, the effects are especially harmful to women and
girls. For example, the myth that having sex with a virgin can cure
AIDS only increases the number of young girls becoming infected.
- Child
marriage.
It is still common in many parts of the developing world for young girls
to marry before they are 18; 60 percent of girls in Nepal, 76 percent
in Niger, and 50 percent in India will be married by that age. All too
often, they marry older, sexually experienced men who may already be
infected, or who may be unfaithful, or both. These young girls often
know very little about sex, HIV, or how to protect themselves. Because
they are so young, they have little power in the relationship, and so
are unable to negotiate condom use. Additionally, girls and young women
who are married are more likely to drop out of school, underscoring
the need for innovative interventions to reach them.
-
Violence. One in three women worldwide will be raped, beaten, coerced into sex, or otherwise abused in her lifetime. A woman who experiences sexual violence is at a physically greater risk of contracting HIV, and if she is in an abusive relationship, she is rarely able to negotiate terms to protect herself from infection.
Policy
Implications
Prevention programs cannot succeed until women's health and rights are
placed at the very center of HIV/AIDS strategies. All young people,
male and female, must have access to full and accurate information about
their own sexual health, and how their sexual health affects the sexual
health of their partners. Men must learn at an early age to respect
women, and women must learn at an early age to respect themselves. Education
and empowerment are crucial.
A balanced,
scientifically based approach is fundamental to curbing the HIV epidemic,
as is a balance between prevention and treatment. As Uganda has shown,
approaches like Abstinence-Be Faithful-Use Condoms (ABC) can be effective,
but only if all three elements are emphasized and local conditions are
considered. Abstinence is not an option for a young married woman whose
husband is HIV-positive, but abstinence-only prevention programs operate
from the erroneous assumption that most women and girls have control
over their sexual lives. In order for HIV prevention efforts to be effective,
they must be based on the realities of women's lives.
Despite women's disproportionate vulnerability, few programs aimed at curbing the pandemic's spread target them or reflect the realities of their lives. If we want to stop HIV/AIDS—in Africa, in Asia, in Latin America, in Eastern Europe, and in Canada and the United States — we must do two things:
IWHC's colleagues worldwide are providing young people with the information, skills, and strategies to protect themselves against HIV/AIDS, and advocating for policies that mandate the gender-sensitive comprehensive sexuality education that will enable future generations to reach adulthood in good health. They are also working to erode the gender inequalities that fuel the epidemic's spread by advocating for women's sexual and reproductive rights and focusing attention on the realities of women's lives. For example:
- In Nigeria, the IWHC is supporting the Community Life Project (CLP), an organization founded in 1992 in the Isolo neighborhood of Lagos, Nigeria's largest city. By partnering with trade associations, churches, mosques, schools, hospitals, and families, CLP seeks to engage the entire community in the struggle to promote individual and family health and reduce the spread of HIV/AIDS.
Read more about CLP and IWHC's colleagues in Nigeria
- In Cameroun, the IWHC is supporting the Society for Women and AIDS in Africa – Cameroun Chapter (SWAAAC). Beyond providing diverse communities with basic, lifesaving information on HIV/AIDS, SWAAC is raising awareness on how gender inequalities and attitudes about sexuality fuel the epidemic's spread, rendering women disproportionately vulnerable.
Read more about SWAAC and IWHC's colleagues in Cameroun
- In Peru, the IWHC is supporting LUNDU, the only Peruvian group working on issues of gender, sexuality, and human rights with Afro-descendent young people, who face entrenched discrimination. LUNDU is currently training 30 peer educators to dispense vital information on sexuality, human rights, and HIV/AIDS in El Carmen, located in Peru's Ica province—the site of a growing sex tourism industry and the province with the second-highest rate of HIV/AIDS prevalence in Peru.
Read more about LUNDU and IWHC's colleagues in Peru
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