Women are increasingly affected by AIDS epidemic, report shows

The proportion of women and girls with HIV has increased in every region of the world since 2002, a new report from UNAIDS, the joint United Nations programme on HIV and AIDS, shows.

A girl sits at the bedside of her dying mother in Tanzania

Credit: PANOS/SEAN SPRAGUE

The report says that nearly half of the estimated 39.4 million people in the world infected with HIV today are female: the proportion in 1998 was 41%.

The proportion is highest in sub-Saharan Africa, which has three quarters of all women infected with HIV in the world. Fifty seven per cent of adults with HIV in this region are women. Among people aged between 15 and 24 years in this region there are on average 36 HIV positive women for every 10 affected men.

The sharpest increases in the proportion of women to men with HIV, however, have been seen in eastern Europe, Asia, and Latin America, says the report. In Russia, for example, the ratio increased from 24% in 2001 to 38% in 2003. With an estimated 860 000 people with HIV at the end of 2003, Russia has the largest epidemic in Europe.

The report indicates that women may be benefiting less from current efforts to prevent HIV infection than men. According to UNAIDS this may be because most HIV prevention strategies assume an idealised world and fail to acknowledge the discrimination many women still face.

“Strategies to address gender inequalities are urgently needed if we want a realistic chance at turning back the epidemic,” said Dr Peter Piot, executive director of UNAIDS. “Concrete action is necessary to prevent violence against women, to ensure access to property and inheritance rights, and to enhance basic education and employment opportunities for women and girls.”

Not only were women biologically more vulnerable to HIV, but—driven by poverty and the desire for a better life—they commonly found themselves engaging in “transactional sex” in exchange for basic necessities such as money or accommodation, often with many and considerably older male partners.

The authors also say that society has to move away from the belief that long term monogamous relationships are protective. Increasing numbers of infections within marriages reflected the fact that many men with previous or current other sexual partners transmitted the virus to their wives. Often women had no say in taking precautions against infection. As a recent study in Zambia shows, only 11% of women believed that they had the right to insist on condom use, even if they knew that their husband was HIV positive.

Abuse of any kind against women is strongly correlated with the risk of women contracting HIV infection, as various studies have confirmed. Choosing to abstain or have safer sex is not an option for the millions of women around the world who endure rape and sexual violence, the report says.