The Feminisation of HIV and AIDS

13 August 2018

 An Opinion Piece by Rejoice Nharaunda

Globally, women constitute over half of the population of people living with HIV. The trend is the same in sub-Saharan Africa where more than 57% of adults living with the infection are women - with heterosexual sex as the dominant mode of HIV transmission. Additionally, the result of a number of variables, sub-Saharan Africa has a peculiar prevalent phenomenon where young women (aged between 15 and 24) are recording the highest rates of new infections.

Why? Not only is poverty feminised in Africa, but alongside it, HIV is feminised too.In Zimbabwe, for example, a non-performing economy over a prolonged period has propelled poverty, which tends to impact women and girls more than it does their male counterparts. Due to opportunity limitations that girls and women find themselves bound in, transactional sexual relationships become an important survival mechanism for bread and butter, a meal and some sustenance. This ‘survival’ sex is often inter-generational, taking place between a girl and an older man, who is more likely to be living with HIV.

Due to the power dynamics that exist between women and men, women often find themselves in positions where they are unable to negotiate for safe sex. These power dynamics manifest on the domestic front as well in public places. On the domestic front, it is a taboo for a wife to negotiate for safe sex with a man to whom she is married. Married women are significantly placed at risk not just by the past behaviour of their spouses but even present and future behaviour, as males generally tend to have multiple concurrent partners. In addition to lack of power to refuse sex or to negotiate safe sex in their intimate relationships, education and the absence of awareness and information are further key determinants in the feminisation of HIV. School dropouts, inadequate information channels and access to lack of basic information on how to protect themselves further render women and girls unequipped. Additionally, harmful cultural practices such as female genital mutilation and levirate marriages also come into the fore and are a cause for heightened vulnerability.

While women’s health and survival are jeopardised by HIV, the epidemic further increases the care role that women play in their communities. Apart from their own self-care, women are often the ones who have to take care of the sick, which leaves them with barely any time to earn or learn new skills. This increase in domestic burdens is often passed onto the girls in the household, who in turn have to help their mothers, further exacerbating the cycle of poverty as girls end up staying home to help their mothers, which itself reduces education and economic opportunities. 

If the battle to eradicate AIDS in this lifetime is to be won, there is need for urgent transformation of the structural causes of inequality that render women vulnerable to infection. There is need for advancement of women’s rights, social and economic inclusion and removal of obstacles that limit women’s access to services.

Read the full article online here.