Useful notes on the linkage between gender, sexuality and HIV/ AIDS

In most societies, adults act as gatekeepers to young people’s access to information about sex and health. Yet many adults access to information about sex will lead to early sexual initiation. The protection of virginity is a key message in young girls’ sexual socialization in many cultures. Where virginity among girls is highly valued, young women are inhibited from seeking out sexual and reproductive health information and services.

If they do so, they risk being perceived as sexually active, with server consequences, including expulsion from the home. The adoption of alternative and unsafe sexual practices, including unprotected anal sex, sometimes results from the desire to protect virginity. In many places, unmarried women do not have access to family planning or STD services.

Many young people, especially girls, are also vulnerable to HIV as a result of their desirability to adults who perceive them as “clean” and therefore free from disease. Coupled with this perception are circumstances which compel young people (especially girls) to trade sex for money or goods.

The males are also often encouraged by adults and peers to demonstrate their masculinity through early sexual initiation and multiple sexual “conquests,” including visiting sex workers as a first sexual encounter.

HIV prevention messages that promote abstinence or the delay of sexual initiation among boys without addressing broader gender expectations of masculinity may often simply create conflict and confusion.

Promote gender awareness

HIV prevention programmes for young people and adults that focus exclusively on modes of transmission and safer sexual practices should include discussions of gender roles, sexuality, and relationships. They should also focus on developing skills to identify and change gender related norms that act as barriers to HIV prevention.

Create school – and community – based opportunities for women and men, and girls and boys, to discuss and share experiences and personal prevention strategies. While mixed sex groups may be appropriate in some settings, separate groups are best for allowing men and women to identify gender – related norms that support behavioural change and challenge those that inhibit such change.

Females are particularly affected by the HIV epidemic, not only because of increased biological vulnerability, but also because of structural social and economic inequities. Various factors are responsible for increasing female’s vulnerability and susceptibility to HIV and AIDS. Among the most important factors are gender differences in socialization of young people.

Roles that are assigned to boys and girls in matters regarding freedom of mobility, time use, types of education, and decision – making responsibilities within the home. This includes the early assignment of sexual ‘privileges’ for young men, including those that introduce and subsequently reinforces the idea that sex is a male ‘necessity’.

In contrast, a set of sexual ‘responsibilities’ are assigned to young women, including the maintenance of virginity, responsibility for birth control, or exhortations that passivity and ignorance about sex is the best ‘protection’ a girl can have from sexual interactions.

Gender norms often determine what women and men are supposed to know about sex and sexuality. This limits their ability to accurately determine their level of risk and to acquire accurate information and means to protect themselves from HIV.

In many societies, it is inappropriate for women to seek out or have extensive knowledge about sexuality or reproductive health. Men, in contrast, are expected to be well informed about matters related to sex, although many are not.

Masculinity norms can make it especially difficult for men to admit this lack of knowledge. In both cases morns may be based on incorrect information or myths.

• Although HIV and AIDS affect both men and women, women are more vulnerable because of biological, epidemiological and social reasons.

• The epidemic is fuelled by situations where macro policies have led to an increase in gender disparities.

• The rapidity of the spread of HIV and AIDS among women can be slowed only if concrete changes are brought about in the sexual behaviour of men.

• The underlying causes and consequences of HIV and AIDS infections in men and women vary, reflecting differences in biology, sexual behaviour, social attitudes, economic power and vulnerability.

• Inequality between the sexes limits women’s access to care and – services. It also reduces both men and women’s opportunities

to acquire knowledge about safer sexual practices, and to develop skills to protect themselves from HIV.

• There is a large difference in attitudes towards men and women’s sexuality, both within and outside marriage. Promiscuity in men is such more acceptable. This exposes men

to an increase risk of infection, and increases the possibility that they will transmit HIV and AIDS to their partners. In most societies, girls and women face heavier risks of HIV infection than men because their diminished economic and social status compromises their ability to choose safer and healthier life strategies.

The proportion of women living with HIV and AIDS has risen steadily in recent years. Women are often infected at an earlier age than men. In some of the hardest hit countries, girls are five to six times more likely to be infected than teenage boys. The burden of caring for ill family members is made to rest mainly with women and girls.

As the impact of the AIDS epidemic grows, girls tend to drop out of school in order to cope with the tasks of caring for siblings and ill parents. The feminisation of poverty is a key characteristic of the socio­economic impact of HIV and AIDS.

Women forcibly exposed to HIV infection, for example by rape, are being denied their right to life.

Many social, cultural and economic factors restrict women’s right to health and right to access to healthcare, further increasing their vulnerability to HIV.

Some women infected with HIV are suffering further denials of human rights through the deprivation of their right to bear children and their right of freedom of reproductive choice.

For women blamed for the spread of the HIV infection, the right to freedom from discrimination has a powerful meaning. Women are still seen by many as the vectors of HIV infection, suffering stigmatisation, rejection and expulsion from family and community structures.

Women’s right to knowledge has also been transgressed in a number of ways during the course of the HIV epidemic. The recognition of women’s right to knowledge is essential to their informed choice and action.

All over the world, there are social pressures to ensure that women and girls remain ignorant about gender, safer sex, sexuality and relationships as well as HIV and AIDS.

They lack access to relevant information, resources and opportunities to develop skills needed to apply that information to avoid HIV infection. HIV and AIDS has become a major challenge to gender equality and the advancement of women. Yet the same gender roles and

relations that enhance women’s vulnerability to HIV and AIDS also increase some of the risks for men. Prevailing views about masculinity and .manliness encourage men to demonstrate sexual prowess by having multiple sexual partners, and by consuming alcohol and other substances that may lead to risk- taking and violences.

• An HIV-related illness in the family affects men and women differently, and its impact also varies depending on whether the person who falls ill is female or male. In many instances, when a man falls ill there is likely to be a drop in disposable household income.

• Women have found it difficult to overcome these barriers of silence and have not been able to open up communication with clinicians and counselors – the two critical pillars to assist a women to overcome the impact of the epidemic.