IWD 2011: Culture & Women’s Vulnerability to HIV and AIDS

As we celebrate 100 years of International Women’s Day, we recognize that women have fought for and achieved greater gender equality over the years. Today women hold senior level positions all over the world, are welcome into secondary education and contribute to democratic processes.

However, social and cultural behaviours and norms are slow to change. Despite the progress seen in the women’s movement, in many patriarchal cultures, women are treated as second class citizens. Cultural barriers are a significant contributor to the vulnerability of women to HIV and AIDS.

The global HIV epidemic has had a considerable impact on developing countries where the virus is widespread. In these countries, women often bear the brunt of the HIV and AIDS burden as they exhibit a higher prevalence and are less likely than men to have access to HIV and AIDS prevention, treatment and care.

In developing countries, where resources are limited and access to HIV prevention, treatment and care are scarce, gender inequality has a profound impact on women’s ability to care for themselves.

Since the beginning of the HIV epidemic the global community has made strides in its systematic approach to increasing HIV and AIDS competence, reducing the spread of the virus and providing care and treatment to those affected and infected. However, gender inequality remains widespread, and cultural norms are often barriers to women’s access to prevention, treatment and care with HIV and AIDS.

International legislations, such as the Convention of the Elimination of All Forms of Discrimination against Women, have been ratified by many countries to further advance gender equality. Yet reviews conducted have shown that there is often inadequate knowledge of the statutory laws in place; even lawyers are sometimes unaware of how the law applies to women’s inheritance and other key issues. In addition, customary law is the dominant legal code in many parts of the world. Under some customary law, male superiority is promoted and women’s rights undermined, increasing their vulnerability to harmful sexual practices and HIV infection.

Women are often perceived as the property of their fathers, husbands or other male relatives. Consequently they are unable to purchase, own or sell land and are reliant on their male relatives for financial support.

In societies where women are economically dependent on their male relatives, women are often forced into marriage, often at a young age. Many countries have laws prohibiting marriage below the legal age of 18. However, girls are frequently married off at a much younger age. Statistics show that, globally, approximately 82 million girls, often from poor families, will marry before their 18th birthday. They are statistically more likely to become infected with HIV due to the often advanced age of their spouse and aligned advanced sexual history as compared with their unmarried peers.

For men in patriarchal societies, monogamy is not considered a fundamental part of marriage. In fact, as sexual promiscuity is perceived as a sign of ‘manhood’, they continue to engage in sexual practices with other women, and later infect their young wives. It has been estimated that 60–80% of women who are HIV positive have only had sexual relations with their husbands. For women it is also difficult to suggest condom use because it is perceived as lack of trust or promiscuity.

Once a woman’s husband dies, she is not able to claim rights over the land she has tended to. Instead, cultural practices such as widow cleansing, a traditional practice in which widows are expected to have sexual relations, often with a relative of their deceased husband to secure property are enforced. If a woman refuses, she is often banished from the land without her dowry, forcing her to return to her parents, who often times cannot financially support her.

Cultural norms have informal yet powerful mechanisms of enforcement. If an individual opposes a tradition and refuses to participate in it, they are often ostracised from the community. For women living in patriarchal societies, this is a strong deterrent as they are financially reliant on their male relatives. Due to the difficulties of opposing young marriage, unsafe sexual practices and widow cleansing, among other cultural traditions, they do not frequently challenge these practices.

However, the continued involvement of the international community and active engagement of national governments has achieved success in eliminating many harmful cultural traditions.

The Commonwealth Secretariat acknowledges the importance of addressing women’s issues through gender mainstreaming. A central premise of the mandate of the Commonwealth Plan of Action for Gender Equality 2005-2015 (PoA) is that empowering women is an essential element to achieving economic, social and political development.

Education is one of the most effective tools of social change. A continued emphasis on education will greatly reduce the cultural barriers women face in accessing HIV prevention, treatment and care. The education system should be used to change social norms that increase vulnerability to HIV for men and women. School curricula can be used as a tool to remove gender stereotypes, promote girls’ leadership and self-esteem, and include age-appropriate information on sexual and reproductive health, HIV and AIDS.

Furthermore, a greater emphasis on educating policy makers, opinion and traditional leaders, on reducing women’s vulnerability in the context of HIV is an important step to an effective response.

Dr Anie is Director of Social Transformations Programmes Division at the Commonwealth Secretariat. She has served as a member of the Monitoring and Evaluation Reference Group on HIV and AIDS, UNAIDS, Geneva. Her last appointment was as Director of Policy and Planning at the Ghana AIDS Commission.

In This Story: HIV

The human immunodeficiency viruses (HIV) are two species of Lentivirus (a subgroup of retrovirus) that infect humans. Over time, they cause acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive.

Without treatment, average survival time after infection with HIV is estimated to be 9 to 11 years, depending on the HIV subtype. In most cases, HIV is a sexually transmitted infection and occurs by contact with or transfer of blood, pre-ejaculate, semen, and vaginal fluids. Research has shown (for both same-sex and opposite-sex couples) that HIV is untransmittable through condomless sexual intercourse if the HIV-positive partner has a consistently undetectable viral load.

Non-sexual transmission can occur from an infected mother to her infant during pregnancy, during childbirth by exposure to her blood or vaginal fluid, and through breast milk. Within these bodily fluids, HIV is present as both free virus particles and virus within infected immune cells.

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