Towards an Understanding of Gender and HIV/AIDS

If women had control over their bodies and were able to negotiate safe sex, would the HIV/AIDS epidemic have reached such vast proportions? It is unlikely. While the disease itself is a health issue, the epidemic is not. We know how the virus is transmitted and who is most vulnerable, but this knowledge fails to curtail practices that increase women’s rate of infection. Why? The answer lies, to a large degree, in understanding how values and traditions often prevent women and girls from saying "NO!" to unwanted and unprotected sex and being heard. These same values and traditions also prevent them from saying, "YES" to an expression of their own identities and sexuality.

Furthermore, sexual assault, including domestic violence, reduces women’s ability to protect themselves against HIV infection. In the face of violence, women are less able to refuse sex, insist on condom use or communicate effectively about sex. Women are both socially and biologically more vulnerable than men.

UNIFEM has undertaken pilot research to build a common understanding of the intricate interconnection between gender relations and HIV/AIDS. Some of the key results emerging from these community-based research initiatives have already had an impact on national policies and practices to stem the prevalence of HIV/AIDS.

Influencing policy is one of the key goals of the programme. Partnerships between women’s rights activists, HIV advocates and policy makers provide a basis for action and information: to empower women to take appropriate decisions about the disease; to learn skills in assertiveness to negotiate safe sex and resist sexual violence; and to provide women with economic resources to face the new challenges that are pushing them into poverty.

Mexico

The research team developed tools to assess HIV-infected women’s self-esteem, the incidence of violence in their lives and their ability to negotiate safe sex. They found that HIV-positive women had higher self-esteem than other women did. This appears to be because when a woman "comes out," she shows her empowerment, and her need for an income often enables her to become economically independent. Further, it was found that the official policy to distribute AZT to all who needed it in fact short-changed women. Delivery was through the social security system, but most women work in the informal sector. These findings are now being used to re-consider distribution policies.

India

Interviews with HIV-positive women revealed that, despite public information campaigns, they learned about the protection that condom use offered after they had become infected. Research findings are helping public health officials and AIDS organisations target information more effectively.

Senegal

Community research focused on cultural practices that promote HIV/AIDS. A key finding was that both literate and illiterate women were equally uninformed about unsafe sexual practices. Recommendations have been made to include a component on sex education in the school curriculum.

Zimbabwe

The research results have dramatically demonstrated how the burden of care falls largely on women, increasing their responsibilities as caregivers, food providers, nurturers as well as role models in the face of adversity. The findings point to specific services and social protections that could be formulated to provide greater support for women and girls.

Excerpt from UNIFEM’s presentation at the Commission on the Status of Women (CSW), 45th Session, 6-16 March 2001, New York