Sleeping with the enemy: Women more vulnerable to HIV/AIDS

Christine, a 27-year-old woman, got married five years ago; her husband did not disclose that he was HIV-positive and was privately on ARV’s. When Christine showed the medicines he took to one of her sisters, she was urged to take an HIV test. Although her 4-year-old daughter tested negative, Christine was positive. “When my doctor asked me if I knew about my disease I couldn’t believe him,” Christine says. Today, Christine’s story is a story shared by so many women world-wide. The majority of HIV-positive women are faithful house-wives who never get out of their houses but are infected by their husbands. According to information from the Global Coalition on Women and AIDS, over the past two years, the number of women and girls infected with HIV has increased in every region of the world, with rates rising particularly rapidly in Eastern-Europe, Asia, and Latin-America. In sub-Saharan Africa, women and girls already make up almost 60 per cent of adults living with HIV. UNAIDS (2008) estimates that globally, the percentage of women among people living with HIV has remained stable (at 50 percent) for several years, although women’s share of infections is increasing in several countries. According to UNAIDS, Southern Africa is the area worst affected by HIV/AIDS in the world, and women are withstanding the worst of the disease. The crisis is disproportionately affecting women. Females in the 15-24 age groups are four times more likely to be infected as males in this age range. Recently it was reported, in The New Times, that girls aged 20-24 are five times more likely to be infected with HIV than boys of the same age, revealed health surveys done in 2005. And according to Dr. Agnes Binagwawo, the executive secretary of the National AIDS Commission (CNLS ) the highest rate of HIV infection was found among men aged 40 -44 years which is believed by epidemiologists to be an indication that young women may get infected by older men, rather by boys of their age. Conversely, it should be noted that not only are young girls more vulnerable but the whole female gender. And also high prevalence among women is not unique to Rwanda but globally especially in poorer regions. But why are women and girls shouldering such a heavy burden of pain? Cultural or social norms often restrict women’s access to basic information about sexual and reproductive health. Even if women have access to information and commodities (e.g. condoms), there are gender norms that prescribe an unequal and more passive role for women in sexual decision-making. They also undermine women’s autonomy, expose many to sexual coercion, and prevent them from insisting on abstinence or condom use by their male partners. Most women in this part of the world do not have equal rights with men particularly to make choices about their sexuality. Women are poor despite the huge burden as household heads. Female headed households today are familiar in the Rwandan setting as a result of the horrible 1994 Tutsi genocide. The genocide left many women and young girls vulnerable as heads of households. Despite the huge responsibility most of these women have a low status in the community that is exacerbated by illiteracy, lack of employment and poverty. All these factors increase women’s risk of infection. The lower social status of women and girls also makes them easy targets for rape, and limit their ability to cope with violent households. The death of one or both parents during the war was also and is still catastrophic for their children. The girls are particularly vulnerable to exploitative sexual relationships. Women and young girls pushed into relationships built on unequal power relationships are hard pressed to negotiate their sexual activity. Most women do not have easy access health care facilities while others can not afford to meet their health bills. Infections like STDs often go untreated hence increasing their vulnerability to HIV/AIDS. Traditional customs make women more vulnerable to infection, and discourage them from learning about and defending their rights and demanding social change. Denying women basic rights lowers their status in society, makes them dependent on men for economic survival, and increases their chances of being abused and infected with HIV. Religious beliefs, customs, and cultural traditions sometimes place women and young girls directly in the path of HIV/AIDS. The paying of bride price which used to be modest gifts intended to promote links between families is now seen as an income-generating opportunity by families with the co modification of the girl-child. Lack of respect towards women, and especially arranged marriages of young girls, increases the likelihood of HIV infection through sex with older men. Traditional healers consulted by desperate men are also been reported to advise sex with virgin girls as a cure for HIV. This is leading to rape, and increased infection rate of young girls. Fear of abuse discourages women from being tested for HIV and getting treatment. Fear of violence can be a barrier to HIV disclosure. Bringing news about their status to their partners or larger community opens them up to violence. Women in abusive relationships are less empowered to negotiate their sexual activity, and advocate for condom use. As long as women are considered inferior, and society assigns them lesser rights and allows them to be abused and discriminated against, they will continue to suffer the brunt of HIV/AIDS. Contact: ubernie@gmail.com