Commentary: Global Spread of AIDS Victimizes Women
download image
by Wendee Wechsberg, Ph.D.
As people around the globe pause on World AIDS Day to raise awareness of the public health threat caused by the spread of AIDS, too many still judge those with HIV as the damned and deserving.
The fact is that HIV incidence around the world is occurring among poor women with little choice in power relationships with men or in vocation. Such ignorance about the inequality, lack of opportunity for prevention and public misperceptions about HIV remain the reasons that, 25 years after this disease was identified, HIV has been feminized worldwide.
Two-thirds of people living with AIDS in sub-Saharan Africa are women, and 2005 estimates show that about 2.4 million women are living with HIV in Asia, more than two-thirds of whom live in India, and the problem is getting worse.
Studies have shown that during heterosexual sex, women are about twice as likely to become infected with HIV from men as men are from women.
World AIDS Day serves to remind us that we must do more to prevent the spread of HIV/AIDS, particularly among women, who are not only increasingly at risk for contracting AIDS themselves but, as child bearers, are increasingly spreading the disease to their children.
At the end of 2005, there were an estimated 2.3 million children living with HIV, most of whom were infected with HIV at birth and many of whom will not live to adulthood. Reducing AIDS among women will also reduce the transmission of AIDS to their children.
Class, race, ethnicity, religion, descent and citizenship status contribute to the subordination and vulnerability of women around the world. This vulnerability leaves women as victims of rape and sexual coercion. Poverty often gives women few options other than prostitution as a vocation, leaving them at severe risk of violence and disease.
Violence against women, particularly rape, increases women's vulnerability to HIV infection and often limits a woman's ability to negotiate safe sexual behavior. Women's relationships with male partners are still subservient, often due to economic dependency. Even more dramatic today are the reports of women and girls being raped and even murdered as part of the pillage of war.
Myths and lack of knowledge also contribute to the spread of HIV. For example, many men in developing countries believe that having sex with a virgin can cure this disease, which in turn leads to the rape of young women and children by men with HIV.
However, the spread of HIV/AIDS among women isn't just a problem overseas; it's an increasing problem here at home, too. In 2001, teenage girls accounted for more than half of the new HIV infections reported in the United States. New trends among American youth of substance abuse at parties and the practice of "trains," which is the coercion of a young woman to have sex with her boyfriend's friends, are added risks contributing to the rapid spread of disease.
Fear of violence and the stigma of HIV/AIDS, both in the United States and abroad, dissuade women from seeking information on HIV/AIDS, getting tested for HIV, disclosing their HIV status and seeking treatment and counseling.
Earlier this week, a report projected that AIDS will become the world's third-leading cause of death in the next 25 years. More than 25 million people have died from AIDS since 1981, an estimated 40 million people around the world are living with HIV/AIDS, and each year more than 5 million more are infected by the disease, many of those women.
In order to alter this dangerous course, we need to provide women with opportunities for an education to help them emerge from poverty and unemployment. Most importantly, we need to empower women around the world, providing them with the knowledge and skills to reduce harm and have greater control in their lives.
Implementing hands-on interventions that encourage healthy outcomes and lead to positive changes in sexual risk behavior, substance use, and violence prevention will help reduce the exposure and transmission of HIV around the world.
Many of the interventions being used to address the HIV/AIDS epidemic in countries like South Africa, Russia and India that are currently experiencing or showing signs of an emerging epidemic of HIV among undereducated and underemployed women, are being developed, implemented, and evaluated here in Durham.
We need to adapt, translate and tailor HIV/AIDS prevention interventions to ensure a large-scale effort to reach disempowered women around the world, reducing the transmission of HIV.
We need to engage, unite and act to empower women, change belief systems of men, and influence policies to change the course of the disease and reduce the incidence of HIV around the world.
Wendee Wechsberg, Ph.D., is director of RTI International's Substance Abuse Treatment Evaluation and Interventions program.
rti.org