Türmen, T. “Gender and HIV/AIDS.” International Journal of Gynecology & Obstetrics 82, no. 3 (September 1, 2003): 411–18. https://doi.org/10.1016/S0020-7292(03)00202-9.
In this study published in the International Journal of Gynecology & Obstetrics, the relationship between gender and HIV is discussed in detail. The study starts by defining the difference between gender and sex, and explains that sex is assigned based on biological characteristics at birth, whereas gender is the more social context that plays into roles in society. In this study, gender is defined as “what is meant to be male or female, and how that defines a person’s opportunities, roles, responsibilities, and relationships.” While biological and gender differences are known, the study focuses on putting the two together to fully analyze the difference between women and men contracting HIV. Social aspects such as the fact that women do not have equal social status to insist on safe sex via condom use in many situations is a large contributor to the reason women contract the virus more. It is worth noting that the virus began with predominately male patients, but this has shifted dramatically since the early stages of the AIDS pandemic, with 48% of all new infections reported in 2005 being women. I have focused on the biological, cultural and social, and education aspects of vulnerability discussed in the study, though more are explained. I will also be looking at both prevention and treatment of care in women, as discussed after the vulnerability subheadings.
Biologically, women are more likely to be susceptible to HIV transmission, and young girls are even more likely than mature women. The study states that male to female transmission happens at a rate almost 4 times higher than female to male transmission. Additionally, if women have STIs (sexually transmitted infections) they are more likely to contract the virus. In women, STIs are often asymptomatic, so they are not diagnosed and treated with the same efficiency as in men. The reason that young girls are more susceptible to HIV than women is due to the lack of maturity in their physicality. The genital tract of young girls is more likely to tear during intercourse, which makes transmission likelihood increase dramatically.
Social and Cultural Aspects
In society, women are more often involved with older men with more sexual experience than them. Through this sexual experience, men may have contracted STIs or HIV. In developing countries with high poverty rates, young girls and women may be likely to have intercourse with older, wealthy men in order to get money or gifts out of it. Sometimes laws can perpetrate this occurrence, such as laws that permit child brides or prohibit women from asking for a divorce. In both of these scenarios, women are put at the disadvantage and cannot ask for safe sex practice and are often engaging in intercourse with older men.
It is worth considering that there are also societal aspects that increase the chances of men having HIV, such as celebrated promiscuity in society.
Education, Knowledge, and Skills
In many cultures, it is considered feminine to be naïve to sexual behavior, and it is up to the man to be educated about sex. In figure 3 of the study, the proportion of women who have heard about AIDS is contrasted with the proportion who know how to protect themselves. Men are less likely to ask for further explanation of things they don’t understand, and while that may increase their risk of HIV contraction, it inherently increases women’s chances as these men are their only source of information.
Gender in Relation to Prevention and Care
The majority of women who contract HIV do so through sexual contact with men. The primary mode of prevention efforts encourages condom use and reducing the number of sexual partners. These efforts are not as effective for women, as the biological aspect of women’s vulnerability needs to be considered. Health education regarding not only HIV but also STIs in general would probably be the most influential and productive mode of prevention. Because prevention methods are often focused on men, it again puts women at the disadvantage to protect themselves from infection.
Treatment and Care
Women are often paid less in the majority of societies, assuming they are paid at all. Because of this, it is harder for them to pay for treatment (though it is still extremely expensive for men too). The illness often goes ignored until day to day responsibilities cannot be carried out, such as caring for children or doing housework. Even in these cases though, they are often not the “breadwinner” of the family so their contribution is undervalued and ignored, which postpones treatment even further. Women are also deterred by the possibility that their health care provider may be male.
Conclusion and Connections
After reading this study, it appears as though almost every aspect of social life and the biology of women contributes to their contraction of the infection more easily. Unfortunately, these same factors prevent women from being treated as effectively if even at all. In order to change the narrative here, prevention measures need to be more personalized to women’s needs instead of accidently only benefitting men. After reading this study, I am interested in finding examples of HIV prevention methods that benefit men more, and would like to read more about what measures have been taken in the past that have helped or hurt women. I know that during the AIDS epidemic women were basically not tested, and I am interested in finding out when we eventually acknowledged women with AIDS and how long it has been that we have ignored this massive inequality.