HIV infection in women: social inequalities as determinants of risk

Abstract

Social inequalities lie at the heart of risk of HIV infection among women living in poor countries and among poor women living in wealthy countries. As of December 1996, UNAIDS estimated that 12.1 million women have developed AIDS-defining diagnoses. These women have been disproportionately poor, and in the US, African-American and Latina. Their neighborhoods and villages have been burdened by poverty, civil unrest, structural adjustment, racism, drugs and violence. To explain which women are at risk and why, this article reviews the epidemiology of HIV and AIDS among women in light of four conceptual frameworks linking health and social justice: feminism, social production of disease/political economy of health, ecosocial, and human rights. The article applies these alternative theories to describe sociopolitical contexts for AIDS' emergence and spread in the US, and reviews evidence linking inequalities of class, race/ethnicity, gender and sexuality, as well as strategies of resistance to these inequalities, to the distribution of HIV among women.