HIV Prevention and Protection Efforts Are Failing Women and Girls
More Young Women Are Becoming Infected by Husbands and Long-Term Partners -- Female-Controlled HIV Prevention Methods Urgently Needed
February 2, 2004
-- Existing HIV prevention and protection efforts are failing to stem infections among women and girls because they do not take into account such issues as gender relations and sexual behaviour, according to the United Nations AIDS programme.
"All too often, HIV prevention is failing women and girls," said Dr Peter Piot, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS). Dr Piot was speaking at the launch of the Global Coalition on Women and AIDS, a UNAIDS-initiated group of leading women and men committed to mitigating the impact of AIDS on women and girls worldwide. "Because of their lack of social and economic power, many women and girls are unable to negotiate relationships based on abstinence, faithfulness and use of condoms. It is precisely to address these inequalities and reduce women's vulnerability to HIV that the Global Coalition on Women and AIDS has been created."
Women are particularly vulnerable to HIV, with about half of all HIV infections worldwide occurring among women. This vulnerability is primarily due to inadequate knowledge about AIDS, insufficient access to HIV prevention services, inability to negotiate safer sex, and a lack of female-controlled HIV prevention methods, such as microbicides.
Women and girls are often powerless to abstain from sex or to insist on condom use. They may be coerced into unprotected sex or run the risk of being infected by husbands in societies where it is common or accepted for men to have more than one partner. Women are also biologically more vulnerable to infection; male-to-female HIV transmission is estimated to be twice as likely than female-to-male. In some of the regions worst-affected by AIDS, more than half of girls aged 15 to 19 have either never heard about AIDS or have at least one major misconception about how HIV is transmitted.
While condoms have been proven effective in HIV prevention, their correct and consistent use rests with the male partner, making it more difficult for women to negotiate safer sex. In fact, most sexually transmitted HIV infections in females occur either inside marriage or in relationships women believe to be monogamous. "The typical woman who gets infected with HIV has only one partner -- her husband or steady boyfriend," said Oscar-winning actress Emma Thompson, an ambassador for ActionAid International. "Regardless of their relationship status women desperately need new HIV prevention tools that they can control."
A study in Zambia found that only 11% of women interviewed believed that a woman had the right to ask her husband to use a condom -- even if he had proven himself to be unfaithful and was HIV-positive. Studies in the US suggest that many women infected by male partners were unaware the men had had multiple sex partners, sex with other men or that they injected drugs.
Violence, too, increases the danger of HIV infection among women. In certain places -- Cameroon, the Caribbean, Peru, and South Africa -- between 20%-48% of girls aged 10- 25 reported that their first sexual encounter was forced. Fear of violence not only prevents women from accessing HIV/AIDS information, it prevents them from getting tested, disclosing their HIV status and receiving treatment and counselling, even when they know they have been infected. This is primarily due to the stigma and discrimination associated with HIV and AIDS. "When women are infected with HIV they often face physical and emotional violence. As a result, they can be abandoned by their families and ostracised by their communities," said Ludfine Anyango, a woman living with HIV and National HIV/AIDS Coordinator of ActionAid Kenya.
Women's vulnerability to HIV and AIDS is further exacerbated by unequal property and inheritance rights. In many countries property is usually owned by men -- women only have rights through marriage. This radically reduces their economic security and can lead to women enduring abusive relationships or resorting to sex for economic survival. Women whose male partners die of AIDS are often left homeless as the property rights are passed on to relatives instead.
"It is crucial that HIV prevention programmes involve both women and men to effectively address gender inequality and reduce women's vulnerability to HIV," said Mary Robinson, former President of Ireland and Executive Director of the Ethical Globalization Initiative. "Women's rights must be fully respected and protected if we want a realistic chance at reversing the spread of AIDS."
Another promising HIV prevention option for women lies in microbicide research. Formulated as a gel, film, sponge, lubricant or time-released suppository, a successful microbicide could help protect women and couples who cannot or do not use condoms against HIV. Researchers at the London School for Hygiene and Tropical Medicine estimate that a microbicide could prevent more than 2.5 million new HIV infections in only three years, even if it is 60% effective. To date, microbicide research is severely underfunded. Of the US$775 million needed to test existing products in the pipeline, only US$343 million is available.
The Global Coalition on Women and AIDS aims to be a highly-visible group of men and women, including activists, government representatives, community workers and celebrities, that seek to stimulate concrete action on the ground to improve the daily lives of women and girls. Its efforts will focus on preventing new HIV infections among women and girls, promoting equal access to HIV care and treatment, accelerating microbicides research, protecting women's property and inheritance rights and reducing violence against women.
Women comprise about half of all people living with HIV/AIDS. In Sub-Saharan Africa, 58 percent of those living with HIV were women as of end 2003 and young women aged 15 to 24 were 2.5 times more likely to be infected than young men.
For more information, please contact: Dominique De Santis, UNAIDS, London, mobile (+41 79) 254 6803 or Geneva (+41 22) 791 4509, Louise Coward, Ogilvy PR Worldwide, London, tel. +44 (0)207 309 1085. For more information about UNAIDS, please visit our website, www.unaids.org.
This article was provided by UNAIDS. Visit UNAIDS' website to find out more about their activities, publications and services.