Vulnerability

Women make up about half of all people worldwide living with HIV. According to UNAIDS’ 2008 Report on the Global AIDS Epidemic, about 50% of the 33,2-million people living with HIV/AIDS globally in 2007 were women. The number of women living with HIV globally increased by 1,6-million between 2001 and 2007. Of these 15,4-million women, 77,4% lived in sub-Saharan Africa.

Across sub-Saharan Africa, women are disproportionately affected by HIV. The region itself accounts for over two-thirds (67% or 22-million) of all people in the world living with HIV; 61% of these are adult women. Young women (aged 15-24) are bearing the brunt of the disease: the prevalence for young women is 3,2% – against a prevalence of 1,1% among young (aged 15-25) males (global prevalence for women is 0,6% and for men, it is 0,4%). On average, there are 14 women for every 10 infected men in sub-Saharan Africa.

For more statistics global HIV/AIDS statistics, see “HIV and AIDS Estimates and Data, 2001 and 2007” (Annex 1 to the UNAIDS 2008 Report on the Global AIDS Epidemic). For more on gender and HIV/AIDS see the International Women’s Health Coalition (IWHC) website or the IWHC fact sheet on Women and Risk of HIV/AIDS Infection.

 

Biological Vulnerability

Heterosexual women can far more easily become infected through penetrative sex than heterosexual men, and vaginal and/or anal sex is much riskier than other modes of transmission because:

• The vagina and anus have larger areas of exposed and sensitive skin
• The virus can survive for longer in the vagina and the anus than on the surface of the penis
• There is a higher viral load of HIV in semen than there is in the fluids of the vagina or anus
• The vaginal and anal walls are much more likely to be ruptured during vaginal or anal sex, especially if the sex is violent or coercive or when a woman is very young and her cervix is not yet fully developed. Cuts, scrapes and bruises allow easy access for the HI virus into the blood stream.

 

Socio-Economic Vulnerability

Socio-economic vulnerability is based on gender inequality:

• Cultural and social norms often restrict women’s access to basic information about sexual and reproductive health.
• Even where women have access to this information, they may be unable to negotiate safer sex or the use of condoms in relationships as a result of gender norms that prescribe an unequal, passive role for women in sexual decision making. Marriage does not protect women from HIV infection. More than four-fifths of new infections in women occur in marriage or in long-term relationships with primary partners.
• Women are often economically dependent on their husbands or partners and fear rejection and/or violence if they insist on condom use or abstinence, or disclose their HIV status.
• Poverty undermines women’s opportunities to seek the knowledge, power or time to be concerned about safer sex.
• Practices such as “dry sex”, “widow cleansing” and female circumcision add to women’s vulnerability.
• Unequal property and inheritance rights also make women more vulnerable.
• Often women are expected to bear children to demonstrate their fertility and fulfil their roles as mothers.
• Because women are traditionally perceived as care-givers the “burden of care” that the HIV epidemic has created more frequently falls to women than men.
• Women and young girls may use sex as a commodity in exchange for goods, services, money, accommodation or even status. This transactional sex ‒ more often than not with older men ‒ is especially prevalent in sub-Saharan and South Africa.