Early in the epidemic, men vastly outnumbered women among people infected with HIV. In 1998, women made up 41% of adults living with HIV. Today, nearly 50% of adults living with HIV globally are women -- close to 60% in sub-Saharan Africa. Women are more physically susceptible to HIV infection than men and male-to-female transmission during sex is about twice as likely to occur as female-to-male ones.
| Key Facts |
- Since 2002, the number of women living with HIV has increased in every region. East Asia experienced the sharpest increase with 56% in two years, followed by Eastern Europe and Central Asia with 48%.
- Millions of young people are becoming sexually active each day with no access to prevention services. In sub-Saharan Africa, 76% of young people aged 15-24 living with HIV are female; young women are about three times more vulnerable to HIV infection than their male counterparts.
- In Russia, which has the biggest epidemic in Eastern Europe and Central Asia, the Russian Federal AIDS Center found that in 2003, 38% of people living with HIV were women, compared to 24% in 2001.
- In the United States, AIDS disproportionately affects African-American and Hispanic women, with AIDS ranked among the top three causes of death for African-American women aged 35-44 years (US Centers for Disease Control and Prevention).
|
Increasing Vulnerability
- In many parts of the world, marriage and long-term monogamous relationships do not protect women from HIV. In a study in Zambia, for example, only 11% of women believed that they had the right to ask their husbands to use a condom -- even if he had proven himself to be unfaithful and was HIV-positive.
- Many women and girls find themselves using sex as a commodity in exchange for goods, services, money, accommodation, or other basic necessities -- often with older men. This "transactional sex" is common in many countries in Asia, the Caribbean, and sub-Saharan Africa.
- For many girls, violence or coercion marks their first experience of sex. According to surveys, 24% of young women in rural Peru said their first sex had been forced, while a survey carried out in 2003 by the Reproductive Health Research Unit and Medical Research Council showed that in South Africa 10% of sexually active young women reported being forced to have sex.
- Fear of violence often prevents many women from accessing HIV information, getting tested and seeking treatment.
- Women's vulnerability to HIV is further exacerbated by unequal property and inheritance rights.
- For many women in developing countries, the "ABC" prevention approach (abstinence, being faithful or reducing the number of sexual partners, and condom use) is insufficient. Strategies addressing gender inequities are urgently needed. They should focus on violence prevention, property and inheritance rights, access to basic education and employment opportunities for women and girls, and microbicide research.
- The Global Coalition on Women and AIDS, spearheaded by UNAIDS, seeks to improve the daily lives of women and girls in developing countries by reducing their vulnerability to HIV.
Growing Burden of Care
- Generally, women and girls provide the bulk of home-based care, and are more likely to take in orphans, cultivate crops and seek other forms of income to sustain households. In Viet Nam, for example, women make up 75% of all caregivers for people living with HIV.
- As their time is absorbed by carrying out care duties, women's opportunities to advance their education, achieve some financial independence through income-generation, or build skills fade. Entire families are affected when women are diverted from other productive tasks. Research in Tanzania has shown that women spend up to 50% less time doing farm work when their husbands are ill.
- Possible options for resolving care economy issues include: cooperative day care and nutrition centres that assist women with their workload; nutritional and educational assistance for orphans; home care for people living with or affected by HIV, including orphans; labour-sharing and income-generating projects; and improving rural households' access to labour, land, capital and management skills.
- To reflect the global distribution of HIV by gender, which is nearly 50-50, women should constitute at least half of the millions of people in developing countries expected to gain access to antiretrovirals in coming years. Communities need to overcome barriers to women being tested for HIV, including the risk of violence they may face if they are found HIV positive.
