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The gender dimensions of HIV/AIDS By Arlette Campbell White, World Bank Institute `

The gender dimensions of HIV/AIDS By Arlette Campbell White, World Bank Institute `. A RH issue that crosses all sectors. In this brief presentation we will define the gender dimensions of the HIV/AIDS pandemic;

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The gender dimensions of HIV/AIDS By Arlette Campbell White, World Bank Institute `

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  1. The gender dimensions of HIV/AIDS By Arlette Campbell White, World Bank Institute`

  2. A RH issue that crosses all sectors • In this brief presentation we will define the gender dimensions of the HIV/AIDS pandemic; • We will identify gender–related interventions addressing the needs and concerns of both men and women to (i) reduce vulnerability to HIV/AIDS & (ii) mitigate the impact of HIV/AIDS, drawing out non-health sector implications

  3. 2. Why a gender approach? Men and women face : • Different prevalence rates; • Different risk factors; • Different impacts of the pandemic; This has implications for care, strategies of prevention, and coping mechanisms

  4. Worldwide: • The proportion of adults with HIV/AIDS who are women has been steadily increasing: 41% in 1997, 47% in 2000; • In 2000: 52% of all AIDS death and 46% of all adults newly infected were women; • AIDS ranks as a leading causes of death among women aged 20 to 40 years in several cities in Europe, SSAfrica, and North America; • Women are increasingly infected at younger ages than men.

  5. Eg: In SSA, HIV/AIDS affects men and women differently: • Women are more frequently infected than men; • Women are more vulnerable than men; • Women are more affected than men; and • Existing strategies are more male oriented.

  6. In SSA, more women than men are infected : • Out of 24,5 million people living with AIDS, 53% are women, representing 82% of the world’s women with HIV/AIDS; • 5 to 6 times more girls than boys are infected between 15 and 19 years of age.

  7. HIV Prevalence rates by Age (15-24) and Sex 40 35 30 25 20 WOMEN 15 MEN 10 5 0 CAR MALI CHAD NIGER GABON KENYA GHANA ZAMBIA MALAWI NIGERIA NAMIBIA LESOTHO RWANDA S. AFRICA TANZANIA ETHIOPIA DR CONGO ZIMBABWE BOTSWANA CAMEROON SWAZILAND EQUATORIAL GUINEA MOZAMBIQUE BURKINA FASO COTE D'IVOIRE

  8. Why are women/girls more affected than men? • Physical and emotional burden of caring for sick family members and for orphaned children; • Dropped out of school due to AIDS-related demand; • “Managing” to find food, medicines…; • And then, more vulnerable to AIDS.

  9. 3. For women and girls, risk factors to HIV/AIDS are different from men and boys.

  10. Vulnerability of women and girls is multi-dimensional: • Biological vulnerability; • Social and cultural vulnerability; • Economic vulnerability.

  11. Biological vulnerability: • Risk of becoming infected during vaginal intercourse as much as 2-4 times higher for women than men; • Unrecognized and untreated STDs; • Bleeding during intercourse from prior FGM, or due to early marriage…

  12. Socio-cultural vulnerability: • Society imposes different rules on both men and women which increase women’s vulnerability to AIDS. Example of SSA

  13. Domination over women ; Sexually active; Control decision-making concerning sex; Multiple partners essential to men’s nature; Have to prove their manhood Defer to male authority: lower social status; Ignorant about sex; No control on when, how, with whom… to have sex; Virgin; faithful; have to stick to one man; Have to prove their motherhood How men and women are supposed to interact:

  14. “Real men” take risks: expected to use drugs, alcohol; Supposed to have the relevant information about sex; Supposed to be strong, daring and virile;”Real men” don’t get sick... Risky behavior to please men; Little information concerning their reproductive roles Supposed to be fragile...

  15. Then, gender norms contribute to women’s vulnerability: • Cannot negotiate safer sex, nor behavior change of their partners; • Have limited ability to seek and receive care & support when infected; • More exposed to stigmatization in seeking out treatment and care; • More exposed to HIV through rape, sexual violence...

  16. Gender norms contribute to men’s vulnerability too: • See themselves as invulnerable to illness or risk: don’t seek for health care; • Bisexual/homosexual; • Less informed than expected...

  17. Economic vulnerability of women due to: • Unequal access to education/ employment, land, property, credit... • Increase of female-headed households; • Economically-motivated migration; • Coping with AIDS impact in the context of high prevalence setting (Stress on food security, lost incomes, medicines…)

  18. And then, women : • Not able to avoid risky situations; • Often pay for “life opportunities” as an alternative to dire poverty: “Sugar daddies”, Transactional sex, Sex trade... • Lack of money to pay for prevention and treatment...

  19. In conclusion, women’s vulnerability is: • Associated with factors that are not within their control; • Determined by social, and economic relationships; • Determined by power relationships.

  20. Economic vulnerability of men due to: • Special circumstances: war, male environments; • Worked related male migration; • Male occupations: truck drivers, fishermen, soldiers, miners…

  21. 4. What can we do to tackle the gender issues that stand in the way of effective prevention, care, and coping mechanisms ?

  22. Develop gender sensitive strategies: • Raise awareness among women and men as well as girls and boys about the ways gender differences affect them; • Question definitions of femininity and masculinity; • Question whether policies address the specific needs of both men and women.

  23. Develop messages which promote: • Sex education and basic information about reproductive health (anatomy and physiology) for girls and boys as well as for women and men; • Access to a technology women can control and use to protect themselves (female condom); • Sexual behavior that respects both men and women;

  24. Access to women-friendly AIDS prevention services; • Target different stakeholders in ways to increase gender sensitivity of AIDS interventions; • Diversify the channels to inform different target groups; • Target women’s groups, teachers, parents, youth’s groups… at school or elsewhere;

  25. Create an enabling environment by: • Creating awareness of the fatal economic impact of AIDS for the entire community; • Pushing for policy changes that improve socio-economic status of women; • Promoting a better dialogue between girls and boys at a very early age.

  26. Sensitizing men and women to the changeable nature of social roles in general and to sexual roles in particular; • Empowering youth to protect themselves, to speak up and to have access to a much better controlled technology; • Promoting behavior change.

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