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Gender and HIV/Aids


Men should be a primary focus

It is a biological fact that women, and especially younger women, are more vulnerable to HIV/AIDS than men.

These biological factors are exacerbated by the gender roles and expectations that society places on women and men –and the economic, social and political factors that create an “enabling environment”for the pandemic.

Biological facts

 Women are far more likely to become infected through heterosexual intercourse than they are through any other means of transmission.

  The vagina and anus have larger areas of exposed, sensitive skin.

  The virus has an easier time surviving in the vagina and anus than it does on the surface of the penis.

  There is a higher presence of the virus in a man’s semen than in the fluids of the vagina or anus.

  More cuts and scrapes occur during vaginal or anal intercourse. Cuts and scrapes are especially likely during violent or coerced sex or when a woman is very young, since her cervix is not fully developed.

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Gender roles

  Women are often not able to negotiate safer sex with their partners, especially in marriage.

  Traditional practices such as “dry sex” and Female Genital Mutilation (FGM), aimed in the one instance at maximising men’s sexual pleasure and in the other minimising women’s sexual pleasure, add to women’s vulnerability.

  Women bear the majority of the responsibility of caring for the sick as one of the many forms of unwaged work that they perform.

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Gender expectations

 In many countries, women are under great pressure to demonstrate their fertility and become mothers. Women who seek to become pregnant may have no real options to protect themselves against HIV/AIDS.

  Poor men may be unable to provide for their families, an important gender role that they feel obliged to fill. This may lead to alcoholism, violence, or seeking to exert sexual control over those whom they perceive to be weaker.

  Diagnosis of TB in HIV-infected patients is therefore more difficult. TB patients who are early in their HIV disease with intact immune systems will present with a similar clinical picture as those who are not infected with HIV.

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Gender dimensions of the enabling environment


o  Facilitate collaboration between TB/HIV public and private stakeholders at district level.

o  Increase access to voluntary HIV counselling and rapid testing (VCT).


o  Women are poorly represented in decision-making structures at all levels. Their voices are not heard where policies regarding HIV/AIDS are being made.

o  War and social upheaval can result in the disintegration of the family, the loss of local social systems and mass migration, creating an enabling environment for the transmission of HIV. Rape and atrocities often accompany the violence of war.


Many laws contribute wittingly or unwittingly to the "enabling" environment. These include:

o  Prevention and suppression of commercial sex work.

o Homosexuality, categorised under sodomy, that is punishable by law.

o  Laws that reduce women’s access to property and economic security.

o Policies regulating sex education in school.

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Men should be a primary focus

The promotion of behaviour change is an important element in preventing the spread of the epidemic as well as minimising impact. The tacit and explicit acceptance in many societies that men should have multiple sexual partners contributes to the spread of HIV/AIDS to women.

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Gender and AIDS Almanac: UNAIDS

Gender, HIV and Human Rights: A Training Manual: UNIFEM

The HIV/AIDS Epidemic: An Inherent Gender Issue: Commonwealth Secretariat



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