UC Atlas: HIV/AIDS and Gender

Africa is the only continent where HIV Prevalence is higher for women than men. For every 15-19-year-old boy that is infected, there are five to six girls infected in the same age group. Of Africa's 28.1 million people living with HIV/AIDS, 15.5 million (or 55%) are women, constituting 88% of the world's women with HIV/AIDS. Figure 1 (below) shows the rates of HIV prevalence rates by age difference in 25 African Nations. Note the marked difference in infection rates between men and women.

Figure 1: HIV Prevalence Rates by Age (15-24) and Gender, SSA Countries. Retrieved from: World Bank 2001

Three Critical Factors Place Gender Issues at the Center of the HIV/AIDS Epidemic in Africa

Gender analysis is essential in understanding the social, cultural, economic, and resulting behavioral underpinnings of the spread of HIV/AIDS, key elements of which are summarized in Table 1 below.

Men	Women
Different perceptions of, and responses to, risk and vulnerability
Behavioral and Physiological Factors
Usually infected at later age (>30)	Usually infected 5-10 years earlier than men, especially aged 11-29.
Multiple sex partners as norm.	High-risk behavior of regular sexual partner.
Lower physiological risk/vulnerability for men.	Physiology: women four times more likely to contract HIV and other STDs than men. Transmission to unborn child (20% - 40% risk).
Socio-Cultural Factors: Prevailing Norms and Expectations
Sexual domination	Emphasis on virginity and value of marriage and motherhood
Presumption of knowledge (prevents seeking information/contraception/treatment)	Culture of silence on sexual matters (inappropriate to be aware of sexuality or to suggest condom use)
Violence (incl. associated with drugs/alcohol)	Cultural practices: female genital cutting, ritual cleansing, widow inheritance
Frequency of drug abuse, including by injection Link between socializing and alcohol use.	Link between substance abuse and exchange of sex for drugs or money.
Imbalance of sexual power (incl. violence) Lack of responsibility for own sexuality	Vulnerable to coerced sex, including rape and other sexual abuse, practice of "dry" sex.
Stigma attached to HIV/AIDS discourages testing, knowledge sharing, and leads to ostracism
Economic Factors
Economic power	Economic dependence/insecurity
Command over resources	Less access to and control of economic assets, and fewer options for income/asset creation, leading to greater vulnerability (exchange sex for money/favors) Lack of legal recourse and discrimination in legal rights and protections.
Male occupations (e.g., truck driving, military) involve mobility and family disruption	Resort to sex work by migrant or refugee women when families are disrupted

'Strategies to prevent the spread of HIV have focused on the promotion of condom use, reduction of the numbers of sexual partners, and treatment of STDS. Many of these responses have failed to address, social, economic, and power relations between women and men, among men, and among women. These relationships, together with physiological differences, determine to a great extent women's and men's risk of infection, their ability to protect themselves effectively and their respective share of the burdens of the epidemic' (World Bank 2001: 1).