• Gender inequalities
are a major driving force behind the AIDS epidemic. The different attributes
and roles societies assign to males and females profoundly affect their
ability to protect themselves against HIV/AIDS and cope with its impact.
Reversing the spread of HIV therefore demands that women’s rights are
realized and that women are empowered in all spheres of life.
inequalities overlap with other social, cultural, economic and political
inequalities—and affect women and men of all ages.
• A variety of
factors increase the vulnerability of women and girls to HIV. They include
social norms that deny women sexual health knowledge and practices that
prevent them from controlling their bodies or deciding the terms on
which they have sex. Compounding women’s vulnerability is their limited
access to economic opportunities and autonomy, and the multiple household
and community roles they are saddled with.
• Men, and especially
young boys, are vulnerable too. Social norms reinforce their lack of
understanding of sexual health issues and at the same time celebrate
promiscuity. This vulnerability is further increased by the likelihood
of engaging in substance abuse (such as alcohol and other drugs) and
of opting for types of work that can entail mobility and family disruption
(such as migrant labour or the military).
The impact on women
• In most societies,
girls and women face heavier risks of HIV infection than men because
their diminished economic and social status compromises their ability
to choose safer and healthier life strategies.
• The proportion
of women living with HIV/AIDS has risen steadily in recent years. In
1997, 41% of HIV-positive adults were women. Three years later, that
figure had risen to 47%. In sub-Saharan Africa alone, an estimated 12.2
million women carry the virus, compared to 10.1 million men.
• Women are often
infected at an earlier age than men. For example, in 1998 most HIV-positive
women in Namibia were in their 20s, while most men carrying the virus
were in their 30s. In some of the hardest hit countries, girls are five
to six times more likely to be infected than teenage boys.
• There is growing
evidence that a large share of new cases of HIV infection is due to
gender-based violence in homes, schools, the workplace and other social
spheres. In addition, in settings of civil disorder and war, women and
girls are often systematically targeted for abuse (including sexual
abuse). This dramatically increases their odds of acquiring HIV and
other sexually transmitted infections, and of experiencing unwanted
• Research has
shown that in up to 80% of cases where women in long-term stable relationships
are HIV-positive, they acquired the virus from their partners (who had
become infected through their sexual activities outside the relationship
or through drug use).
• Women also
find themselves discriminated against when trying to access care and
support when they are HIV-positive. In many countries, men are more
likely than women to be admitted to health facilities. Family resources
are more likely to be devoted to buying medication and arranging care
for ill males than females.
• All the while,
the burden of caring for ill family members is made to rest mainly with
women and girls. As the impact of the AIDS epidemic grows, girls tend
to drop out of school in order to cope with the tasks of caring for
siblings and ill parents.
Coming to grips
with the challenges
shows that controlling the epidemic depends in large measure on communities’
and families’ abilities to confront the gender-driven behaviour that
increases the chances of infection for girls and boys, men and women.
That, in turn, calls for strong and coherent national policies, strategies
• The Convention
on the Elimination of Discrimination Against Women (CEDAW) is a key
basis for legal reforms and other steps aimed at countering the violation
of women’s human rights and protecting women who are infected and affected
prevention and care programmes that take into account a wide range of
social, economic, cultural and political factors are more likely to
stem the epidemic. Such programmes should be marked by high-level political
commitment for steps that tackle the gender dimension of the epidemic
in a variety of ways (including legal reforms, as provided in CEDAW,
and national HIV/AIDS policies, plans and strategies).
• Such programmes
would also ensure that health information, care and other services are
improved and provided in ways that are culturally appropriate and gender-sensitive.
As important is the development of sex-specific, gender-balanced information
about HIV/AIDS and other sexually transmitted infections for different
audiences in different settings (for example, for young people in and
outside school, or for workers at home or in the workplace).
activities targeting boys and girls are needed to promote more equitable
and mutually respectful attitudes and behaviour, especially in sexual
relationships. Also needed are targeted anti-poverty programmes that
extend credit and other forms of support to both women and men in need,
as well as measures that address the special needs of widows and child-headed
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