Factors_Contributing_to_the_Disparity_in_Hiv_Aids_Infection_Between_Males_and_Female_in_Subsaharan_Africa

B: FACTORS CONTRIBUTING TO THE DISPARITY IN HIV/AIDS INFECTION BETWEEN MALES AND FEMALE IN SUBSAHARAN AFRICA INTRODUCTION Gender inequalities are a major driving force behind the HIV/AIDS pandemic, and are not exclusive to women. They reflect widely held beliefs, expectations, customs and practices within a society about what it means to be a “man” or “woman.” Depending on society’s perspective on it, gender can increase an individual’s vulnerability to HIV and influence his or her ability to access information about preventive measures, care, support and treatment. Many factors account for why vulnerability and risk differ for men and for women, and for men and women at different ages. Some are physiological, where women’s risk of infection is higher. Others are socio-cultural, reflecting different norms, roles and expectations, and economic, reflecting differences in command over assets (including productive resources, employment, and education). Differences in power relations between men and women (largely grounded in culture, economic inequality, and vulnerability) have been identified as one of the major factors contributing to the spread of AIDS. Significantly, gender inequality contributes to the greater vulnerability to the spread of HIV in Sub-Saharan Africa. FACTORS CONTRIBUTING TO SPREAD OF HIV $AIDS IN SUB-SAHARAN AFRICA INCESSANT ARMED CONFLICTS In situations of conflict, the risk of sexual violence increases dramatically. There are large numbers of mobile, vulnerable and unaccompanied women who become easy prey for rapists. Children who survive wars often end up as orphans with no skills to face the challenges in life. Prostitution becomes the most likely way out, particularly for girls, and the vicious cycle of HIV/AIDS spread is thus perpetuated POVERTY Lack of economic security affects millions of women and girls, whose literacy levels are generally lower than men and boys'. Many women, especially those living with HIV, lose their homes, inheritance, possessions, livelihoods and even their children when their partners die. This forces many women to adopt survival strategies that increase their chances of contracting and spreading HIV. Educating girls makes them more equipped to make safer sexual decisions MULTIPLE SEXES In a cultural environment in which multiple sexual partners is considered normal for men, the vulnerability and powerlessness of married women deserves particular attention, especially as studies in Africa show that HIV infection levels are around 10 percent higher for married women than for sexually active unmarried girls. BIOLOGICAL NATURE Women are more susceptible to HIV infection on each sexual encounter because of the biological nature of the process and the vulnerability of the reproductive tract tissues to the virus, especially in young women. Men’s and women’s risks of acquiring HIV escalate in the presence of Sexually Transmitted Infections (STIs). STIs in women are less noticed and often go undiagnosed. The stigma of STIs in women also presents a barrier that discourages them from accessing adequate treatment. CULTURE In East Africa, Masaai men who were circumcised at the same time share everything, including their wives. All that is required is for the visiting comrade to put his spear outside the targeted hut to announce his presence and he is entitled to the same conjugal rights as the husband PROMISCUITY/UNFAITHFULNESS There is a large difference in attitudes towards men’s and women’s sexuality before or outside marriage. Promiscuity in men is often condoned and sometimes encouraged, while it is usually frowned upon in women. One of the consequences of this gender difference is that men expose themselves to an increased risk of infection by having multiple partners, and in turn become the vector for transmission of HIV/AIDS to their partners, even if the women themselves are not behaving promiscuously IGNORANCE AND STIGMA AROUND HIV/AIDS. The unwillingness of too many governments and community or religious leaders to talk frankly about sex prevents the dissemination of accurate information about HIV/AIDS and fosters the spread of wildly inaccurate information. Often, the effects are especially harmful to women and girls. For example, the myth that having sex with a virgin can cure AIDS only increases the number of young girls becoming infected LACK OF BASIC EDUCATION Girls are leaving school in increasing numbers, much more often than boys, to care for sick relatives. Education gives girls the skills they need to access information, enter the labor force, and rise above the poverty that makes them all the more vulnerable to infection. SOLUTIONS TO THE PROBLEM 1. Focus on women’s legal rights and protection. Expand access to legal and judicial services, legal literacy and education and gender-responsive reform of laws. In country dialogue, the focus should be on passage and effective enforcement of family laws (such as the Domestic Relations Bill and Sexual Offences Bill in Uganda), which criminalize rape and which provide women stronger legal rights relating to marriage, divorce, inheritance, and division of property. 2. Address gender-based obstacles to women’s economic empowerment and agency, and increase women’s effective access to productive resources (including land), and to entrepreneurship skills. Support in-country initiatives aimed at transforming gender relations, especially in relation to sexual behavior and reproductive health. 3. Identify and disseminate in MAP operations good practice in: (i) gender-differentiated analysis of risk/vulnerability, and impact; (ii) gender-appropriate targeting of prevention, care, treatment, and support programs; (iii) systematic age- and sex disaggregation of data; (iv) gender-inclusion in participatory processes at national and community levels. 4. Focus interventions on care tasks, with particular attention to the needs of AIDS orphans, in ways that specifically address gender-differentiated roles and responsibilities for care, and that reduce the substantial additional time burdens on women and girls. This requires targeted investment in household energy, water, and labor-saving technology accessible to women. 5. Integrate child- , and especially girl-headed households into the monitoring of households targeted for assistance by government or NGO actors REFFERENCES 1. UNAIDS. 1998a. Gender and HIV/AIDS:|UNAIDS Technical Update UNAIDS, Geneva 2. UNAIDS. 1999. Gender and HIV/AIDS: taking stock of research and programs, UNAIDS: Geneva