OneWorld.net (U.S.)

HIV infection is the most devastating new disease to have emerged in recent history. Although, worldwide, approximately as many women as men suffer from HIV, this aggregate figure conceals marked differences in the implications of the disease for men and women. Some of these result from biological differences in sex between men and women, but more result from socially defined gender differences.

* Women are probably more susceptible than men to infection from HIV in any given heterosexual encounter, due to biological factors – the greater area of mucous membrane exposed during sex in women than in men; the greater quantity of fluids transferred from men to women; the higher viral content of male sexual fluids; and the microtears that can occur in vaginal (or rectal) tissue from sexual penetration. Young women may be especially susceptible to infection.

* Gender norms may also have an impact on HIV transmission. For example, in many places, gender norms allow men to have more sexual partners than women, and encourage older men to have sexual relations with much younger women. In combination with the biological factors cited above, this means that, in most places where heterosexual sex is the main mode of HIV transmission, infection rates are much higher among young women than among young men.

* Forced sex, which all too many women (and some men) experience at some point in their lives, can make HIV transmission even more likely, since it may result in more trauma and tissue tearing.

Women may remain ignorant of the facts of sexuality and HIV/AIDS because they are not “supposed” to be sexually knowledgeable, while men may remain ignorant because they are “supposed” to be sexually all-knowing.

Women may want their partners to use condoms (or to abstain from sex altogether), but often lack the power to make them do so.

Women (who are often more socially, economically and physically vulnerable than men) may be unwilling to learn and/or share their HIV status for fear of violence and/or abandonment if the results turn out positive.

Female family members already do the majority of caretaking for those afflicted with HIV, and for those negatively affected by the disease in other ways, such as AIDS orphans. Healthcare systems (perhaps especially those undergoing reforms to lower costs) may add to this burden by depending more and more on such unremunerated caretaking, on the assumption that this is a role that women “naturally” fill.

Prevention of mother-to-child-transmission (PMTCT) efforts may fail if they focus narrowly on women and their biological role in passing along the illness. Beyond their roles as fathers, many men may effectively control both family finances and their wives' ability to use health care. Failure to engage men may thus leave women unable to participate in PMTCT programs even if they, themselves, are convinced. Furthermore, PMTCT programs that treat women only as the bearers of children, and not as individuals who are themselves deserving of treatment, risk both violating women's human rights and failing to attract as many participants as possible.

Due to the importance of HIV/AIDS as a public health problem, and the many gender issues that surround it, the Department of Gender and Women’s Health has made focusing on gender and HIV a priority. The following is a list of recent GWH work on gender and HIV/AIDS:

In collaboration with WHO's Department of HIV/AIDS and UNAIDS, GWH developed a policy brief on ensuring equitable access to anti-retroviral treatment for women.

For details