Moving forward on women's gender-related HIV vulnerability: The good news, the bad news and what to do about it

Abstract

The global response to AIDS has triggered unprecedented attention to gender inequality and the role it plays in shaping the vulnerability of women. Tragically, however, this attention has not yet led to wide-scale transformations in gender roles, or reductions in gender-related risk. This paper reviews both knowledge and action on the impact of gender inequality on women in the context of HIV prevention, and argues that, while much is known, and while effective strategies do exist, impact on a population level will not be achieved unless gender considerations are integrated into an evidence-informed comprehensive national strategy. Such a strategy must be implemented by national governments within an enabling policy and legal environment for change; be driven and owned as much as possible, by communities who are empowered with skills and resources to put their own ideas and capabilities into action; and include people living with HIV as equal partners.

Keywords:

• HIV
• gender
• women
• vulnerability
• integrated programming

Notes

1. This paper draws heavily from Rao Gupta (2009).

2. It is not just women and girls who are made more vulnerable to AIDS by gender inequalities. Unequal gender norms also increase the vulnerability of men in a number of ways, and recent scholarship (e.g., Peacock et al. 2010, Higgins et al. 2010, Stephenson 2010) has explored this issue – underlining the importance of ensuring prevention programming involves and targets men more effectively.

3. Issues of gender-related HIV vulnerability also affect heterosexual men, and same-sex practicing men and women across gender lines. This paper focuses primarily, however, on the vulnerability of women and girls.

4. A simpler explanation could be that men with greater wealth are more likely to spend money on leisure pursuits that could include alcohol and concurrent sexual partnerships. This is a pattern observed in a number of African countries where the relatively better off in a community are those most likely to be living with HIV.

5. Similar findings were made by Wamoyi et al. (2010) in Tanzania, and Masawure (2010) in Zimbabwe.