Gender Role In The Epidemiology Of Hiv Infection

GENDER ROLE IN THE EPIDEMIOLOGY OF HIV INFECTION. DR.ADDAH A.O. INTRODUCTION. . 38.6 Million adults infected(2002) . 19.2 Million women (nearly 50 %) . Percentage not equity but gender inequality. . Increasing infection rate among women.

Definition:  .Gender refers to societal beliefs about

the roles and responsibilities that are appropriate for women and men.  Gender dynamics – different roles, expectations, identities, needs, opportunities and obstacles that society assigns to women based on sex.  Sex is biological, gender is socially ascribed.

HIV/AIDS, GENDER AND RISK.  Social inequalities and power relations

have impact on HIV transmission.  Poverty, migration, urbanisation,  Social background, age, race, gender and sexuality.  Prevailing relationship within and between sexes or gender relations also affect the epidemic.  Interplay of variables.

Sex differences in HIV/AIDS.  Efficiency of male – female infection is

more than two times that of female – male.  Biological reasons –  large

mucosal surface of vagina,  High concentration of the virus in semen.  Langerhans’ cells of the cervix may provide a portal of entry for HIV.  Vulva and vaginal inflammation/ulceration  STI.

 Initial infection in women by multiple variant of

HIV virus while men are not.  Women develops AIDS at lower CD4 count than men and also show a faster rapid decline.  Women are likely to experience significant weight drop than men. .More prone to HPV infection – cervical cancer. .Women metabolizes zidovudine faster than men.

Gender roles  Increases risk of HIV.  Three areas of influence of gender role

in epidemiology of HIV infection.  Knowledge (sexual knowledge), Sexual passivity/aggression and promiscuity.  Some gender roles are incompatible with safe sex eg child bearing.

Knowledge  Insufficient or incorrect information is a risk

factor.  Many young people lack adequate knowledge about transmission, prevention and risks associated with HIV/AIDS eg the virgin myth.  Improper in most societies for a woman to demonstrate sexual knowledge.  Young women are hesitant to seek information on sexual health.

Sexual passivity/aggression  In most societies women should display sexual

passivity/  Women tacitly discouraged from taking active steps to defend themselves from infection.  Women unable to negotiate sex in cultures that permits male superiority.  For men sexual stereotype is aggression. Many partners.  Dominance, physical strength, virility and risk taking.  Drug/alcohol.  Sexual violence – increased HIV EPIDEMIOLOGY. 

Promiscuity  Cultural permissiveness for men while chastity      

for women is valued. Male experimentation. Double standards puts both male and female at risk. Anal sex where virginity is valued. Older men may seek young girls. Male – male sex. Popular notion that HIV is for promiscuous people leads to stigmatization.

Women social/ economic background.  Women economic, political and social

positioning forms the backdrop.  Healthy choices limited.  Low economic and social indicators – literacy level, income, education.  Difficulty controlling when, where, and how sex takes place.  Most HIV + women got infected through heterosexual sex – husbands.

Enabling environment for HIV transmission.  Economic factors – affects mostly the

most impoverished.  HIV/AIDS can lead to poverty.   



Poverty Too expensive drugs Economic status of women influence when to have sex. Migrant labourers especially men

Cultural/societal factors.  Traditional practices – bed sharing, dry

sex, FGM, marrying of virgins to older men.

Changing social structures of families.  Children as bread winners of the family  Grand parents taking care of children.

Political factors  War. Armed conflict  Women access to political power.  Political will to establish HIV/ AIDS

POLICIES.

Men and HIV epidemic  Too much critisms for men.  Many gender equality programmes

geared only towards women.  Difficult for women alone to persuade men to use condomes.  Change of terminology from ‘women in development to gender development.

Gender and masculinity  Gender roles are not ‘natural’ but are

culturally produced – no consensus on what causes them.  Links between gender roles and broader sexual inequalities had not been fully explained.  Effort to explain position of men difficult as ‘sets of ideologies governing thoughts, actions and behaviors’ are constituted and reproduced over time.