 |
114
Stopping HIV Infection Before It Begins in Women
S Solomon
YRG Ctr for AIDS Res and Educ, Madras, India
|
Background: Over 40% (in India about 25%) of HIV infections now occur among women, and a very high proportion of them through sex. The prevention efforts of the first 20 years of the HIV epidemic have failed to meaningfully make inroads as women continue to be vulnerable to HIV, often from economic, social, cultural, and legal discrimination. That, in addition, women are biologically more vulnerable, adds to this. In India, the social construct of gender, which has evolved over several hundred years, places women in situations of very high vulnerability for HIV and other sexually transmitted infections.
Issues:
The lack of opportunities for young women to receive sex education and HIV information leads them to accumulate unverifiable myths.
Men foster a myth that sex with a virgin will clear their STDs. Social norms only encourage “innocent” women, e.g., who is sexually naive until marriage, does not seek pleasure from sex, one who would willingly and actively participate in sex only for the pleasure of her husband.
Women’s economic independence on men causes poor health-seeking behaviors. Reproductive tract infections are not promptly treated increasing their susceptibility to HIV. Women with poor social and job skills feel inclined to offer sexual services or to offer sex in return for social support. These women are more likely to stay within a marriage no matter how vulnerable they are to infection.
Motherhood, no doubt noble, also enslaves women. Fertility pressures force women to abandon caution when having sex with a known HIV-infected partner. Marriages are saved at the cost of HIV.
Women are taught to accommodate and be resilient in the face of violence. They pride in being able to live in the midst of violence. Violence directly enhances one’s vulnerability to HIV. Submission to violence encourages men to engage in irrational and unchallenged behaviors such as having concurrent multiple partners.
The impact of HIV on a woman is much greater than that on men. In most societies, women play the nurturing role, in predominant cases, naturally and voluntarily. However, when she is HIV infected, which may imply an infected partner, her burden doubles.
Strategies: We need longitudinal strategies to change the current imperfect HIV prevention program for women. Some of them are: 1) empowering women; 2) encourage men to admit that they are vulnerable; 3) gender sensitize the program; 4) engaging men in the process of changing gender norms; and 5) initiate structural changes.
Conclusion: There is no denying that HIV prevention among women is very important. A rapid sense of disappointment sets in when we witness preventable infections among women. It is equally important to recognize the barriers and limitations that impede safe sex options for women. It is not flattering that it takes a ruthless epidemic to awaken the world to the needs and condition of her women.
|
