WOMEN & HIV/AIDS

How HIV/AIDS is spread among women

• In many societies, there are cultural mindsets that promote different standards of empowerment between men and women.
• Males are expected to initiate relationships, whereas sexual assertiveness in females is often stigmatized or considered taboo.
• It is typical for women to marry or have sex with older men, who most likely have been sexually active for a longer period of time, hence have a higher probability of being exposed to HIV infection.
• Some societies expect women to have one life-long sex partner, whereas men are expected or even encouraged to be more adventurous. As a result, women are usually more monogamous compared to men. Reliance on monogamy can be misleading for these women as it can only protect against sexually transmitted diseases if their male counterparts abide by the concept.
• In some countries, women are not even permitted to talk about sex with their men, let alone negotiate safer sex practice.
• Males' resistance to condom use due to concerns about reduced sensitivity, ignorance regarding proper condom usage and fear of permanent infertility, put women at greater risk of HIV infection.
• Some countries employ age or gender-based statutory restrictions regarding access to knowledge about sexuality, contraception and disease preventions. As a result, young men and women lack adequate information and learned-skills to protect themselves against HIV/AIDS.
• Women are also vulnerable to threats of coerced sex (rape, sexual abuse, forced prostitution) from family members as well as outsiders.
• Cultures that enforce unsafe sexual activities such as ritual intercourse with a male relative after the death of a husband still exist. Traditional practices such as female genital mutilation, ritual scarification, tattooing and blood-letting using unhygienic utensils also multiply the risks of infection among women.

Economic subordination leads to HIV vulnerability

• Since the beginning of time, women have faced discrimination in obtaining decent education, employment and social status, which has contributed directly towards economic vulnerability in fending off HIV/AIDS.
• Financial dependence on male partners creates a barrier for women to negotiate safer sex practices.
• Some countries have laws that enforce women's economic dependence on men (e.g. laws that only permit property ownership and inheritance by men).
• Many women still rely on sex work for economic survival.
• War, famine, political oppression or poverty can result in migration. The phenomenon can increase a woman's vulnerability to HIV infection as she might get isolated from the familiar community structures and at the same time, cannot communicate effectively with the locals.

Biological vulnerability to HIV

• Women have larger mucosal surface area, which can pose more probability for exposure to the virus.
• Virus concentration in semen is relatively higher than in vaginal fluids.
• Immature cervix and low vaginal mucous production offer less protection for young women.
• Sexually transmitted diseases (STDs) that can cause ulcerative lesions encourage transmission of HIV. However, women with STDs are often without symptoms, which makes them less likely to seek treatment.
• Statistically women, as compared to men, do require more frequent blood transfusions for incidents such as childbirth complications or conditions such as anemia.

Impacts of HIV/AIDS on women

• Women are often stigmatized and blamed for causing HIV and other STD infections, when in fact the transmission rate from men to women is 3 or 4 times higher than vice versa.
• HIV positive women are often thought to be promiscuous, when in fact 90% of HIV positive women caught the virus from their husbands.
• Discrimination against women who are perceived to be at risk of HIV infection has resulted in termination of employment, denial of health insurance and subsequently divorce, abandonment as well as separation from children and family members.
• HIV positive women are sometimes pressured not to become pregnant or to get sterilized and, if they are already pregnant, to abort the conceived baby.

Most societies rely on women to be the voluntary caregivers of the family, as well as occupational caregivers for the community. This increases pressure on women, especially HIV positive women.

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*Info courtesy of Malaysian AIDS Council (MAC)