Intersections Between Gender and Disease: HIV/AIDS and Women

Acquired Immune Deficiency Syndrome, better known as AIDS, is a rapidly growing global problem. It is a problem which affects a disproportionately high number of women as opposed to men. According to an Amnesty International report, “Globally, young women are 1.6 times more likely to be living with HIV/AIDS than young men”(Women, HIV/AIDS and Human Rights 3) In the United States, AIDS is the leading cause of death among African American women. The overwhelming impact that the syndrome has on women can be partially explained by physical differences between men and women.  For the most part however, it is the result of socially constructed systems. Power disparity among men and women, manifested in a variety of ways puts women at a greater risk of infection and continues to negatively affect women at all stages of the disease. HIV should be seen as a virus whose large scale effects are extremely political. It feeds on the sickly forms of societal discrimination to further the impact it has on women and other marginalized groups. The result of these intertwining forces is to make the experience of living with HIV/AIDS not only more likely for a woman but more problematic and disabling. I will outline just some of the problems which uniquely impact the relationship between womanhood and AIDS

            In examining the relationship between gender and AIDS, it is important to look at the specific nature of the syndrome. Although it is not yet curable, AIDS is treatable. There are various antiretroviral medications (AVRs) which fight the virus. Additionally, its transmission is preventable. However, despite the existence of prevention methods and treatments, access continues to prove problematic and the disease continues to spread. We must examine the barriers individuals, specifically women, face in accessing these life-saving methods. 

It is important to first recognize that a sexual encounter with an infected partner of the opposite sex is more likely to result in infection for women. This is due to physiological differences such as the higher viral count in semen as opposed to vaginal fluid and the larger surface area of the vagina as opposed to the penis. However, these physical differences involved in the sexual act are not anywhere near fully accountable for the growing infection rate among women as compared to men. Socially constructed differences play a much bigger role.

The first difference is partially a physical difference but its presence in society is reflective of women’s lack of social power and agency. Disparate physical power between women and men puts women at a greater risk of violent abuse, a tragedy that has a deep, complicated relationship with HIV/AIDS. Amnesty International reports that “Because it is by definition non-consensual, rape has a higher risk of leading to HIV infection by virtue of physical injury to the woman’s genitalia or anus. Even in the absence of apparent physical injury, rape can cause micro-lesions in the vagina which can be a route of infection for the virus” (Women, HIV/AIDS and Human Rights 5). Intimate partner violence increases the risk for the women for the aforementioned reasons as well as the limitations it places on the woman’s ability to negotiate safe sexual practices such as condom use, testing etc (6). This holds true for any non-consensual sexual relationship including child sexual assault and forced first intercourse. Extending the danger is the psychological impact that those kind of experiences have on the victims. They are highly associated with behaviors which place the victims at a high risk of infection such as transactional sex (6).  Any time a woman is forced to have a sexual encounter she is simply unable to make decisions which might reduce or prevent transmission. A change in power dynamics in male-female relationships must occur socially. It must be reinforced by a legal system which explicitly condemns and punishes violence against women or other marginalized persons. 

            Education has a huge impact on women’s health issues. Globally, women are vastly underrepresented in education. Amnesty International emphasizes the importance of health education in “empower[ing women] to act more effectively in their own best interests” (Women, HIV/AIDS and Human Rights 14). Furthermore, studies link higher levels of education to making safer decisions regarding exposure to HIV/AIDS. In places where access to education is restricted from women, they are at greater risk of infection and then at greater risk of infecting others. This also holds true for places where there is a social stigma associated with seeking access to health information.   Access to health education impacts women infected with the disease as well as those at risk of infection. Lack of information about treatments translates into inability to seek those treatments. Furthermore, although mother to child transmission is preventable, the proper preventative measures must be taken. This can only be done if women know about and are able to follow a prevention program. 

Perhaps more importantly, education ways allows for social mobility. If women are restricted access to education, they are also largely restricted from areas of policy making. This means that their voices aren’t heard and the chances of someone addressing the specific problems they face is not guaranteed. Lack of incorporation into these decision making processes limits the extent that the decisions will be sensitive of women’s needs.

            Another obstacle that women face is limited economic independence or outright lack of it.   Wealth can have a huge impact on the prognosis of an infected individual. The best medical services available cost the most money which excludes those without economic resources. This is a problem which negatively impacts women more than men due to their average lower economic power.   If they are not financially able to buy medical help for themselves (which many aren’t) it becomes impossible for them to receive treatment without outside help. Although this help is sometimes available, women aren’t always aware of it. It might even be impossible for the woman to travel from her home to the treatment centers because of economic concerns.   Women who are financially stable but not financially independent also face obstacles. Fear of abandonment often causes women to hide their conditions from their partners/financial providers. This means that they do not access healthcare and their partners are unaware of their probable HIV positive status. Lack of independent economic power limits the options of thousands of HIV positive women globally

            The caregiving role associated with women often means that the burden of caring for sick relatives falls on them, regardless of their infection status. This has a number of different implications for those women taking on the task who are HIV positive. Perhaps the most pressing is that women facing overwhelming responsibilities in caring for others often neglect to take care of themselves. Stress, fatigue and undernourishment put individuals with HIV/AIDS at a greater risk of catching an illness that their weakened immune system might not be able fight off. HIV/AIDS makes even a common cold a potential killer so self care is truly vital among those with the syndrome. 

            Stigma is another huge issue which obstructs women’s access to care and puts them at risk of violence and persecution. Studies have shown that although women and men break sexual norms, the social consequences for women are much more severe. In some areas, sexual promiscuity is associated with being HIV positive or even with seeking reproductive healthcare. This means that the actions women must take to advocate for their own health are highly stigmatized. One study found that women were at a higher risk of serious forms of HIV/AIDS related discrimination including “being ridiculed, insulted or harassed,” “being physically assaulted,” “suffering exclusion from family members,” and “being refused entry to, removed from, or asked to leave a public establishment” among others. This social pressure behaves as a profound barrier in restricting women’s access to medical care.  The story of Sunita, an Indian woman who contracted HIV from an unfaithful husband provides just one account of how stigma can impact a life.

 http://www.youtube.com/watch?v=HBTcKkgTcqw

Unfortunately, her story echoes the stories of thousands of other women worldwide facing the same issues.

The intersections between gender and HIV/ AIDS are multifaceted and complex. In addition to broad based HIV/AIDS prevention programs, social programs are necessary. They must tackle these issues in ways which address the gender specific problems faced by women. They should be comprehensive and seek to change the social conditions which allow for widescale discrimination against women. Moreover, as most of the issues raised here reflect power differentials, efforts must be made to empower women and girls.  Accepting differential treatment should not happen, particularly when the stakes are so high.

 

"A Fact Sheet on HIV/AIDS, Women, and Human Rights." Amnesty International,

            Web. 10 Nov 2009.

            <http://www.amnestyusa.org/women/pdf/HIV_AIDS_Fact_Sheet.pdf>.

"Sunita." Youtube. Web. 10 Nov 2009.

            <http://www.youtube.com/watch?v=HBTcKkgTcqw>.

Women, HIV/AIDS and Human Rights. London: , 2004. Print.