Gender Inequality and HIV

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• Women and young girls continue to be disproportionally affected by HIV.

 

• Financial disparities and intimate partner violence in relationships often hinder a woman’s ability to negotiate condom use and protect herself from HIV.

 

• Gender inequality in education and restricted social autonomy among women is directly linked to lower access to sexual health services, including HIV testing and treatment.

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Gender inequalities, including gender-based and intimate partner violence, exacerbate women and girls’ physiological vulnerability to HIV and block their access to HIV services. HIV is not only driven by gender inequality, but it also entrenches gender inequality, leaving women more vulnerable to its impact. 

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The gender inequalities result in an even starker difference between the way HIV affects men and women. The power imbalance between genders also means that many young women are not able to make decisions about their own lives. 

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These inequalities are more severe for marginalised women, including female sex workers, transgender women, women who inject drugs, who are also at a heightened risk of discrimination and violence.

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How does gender inequality increase women’s vulnerability to HIV? 

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HIV disproportionately affects women and girls because of their unequal cultural, social and economic status in society. 

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Intimate partner violence, inequitable laws and harmful traditional practices reinforce unequal power dynamics between men and women. These dynamics limit women’s choices, opportunities and access to information, health and social services, education and employment. 

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Women and girls were vulnerable to HIV in part due to laws and policies that maintain traditional gender roles - and that women in key populations had limited access to services.

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Discriminatory social and cultural norms are translated into laws which repress the autonomy of women. 

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Stigma and discrimination further exacerbate women’s vulnerability to HIV and undermine the response to the epidemic. In particular, women in key populations face numerous and specific challenges and barriers, including violence and violations of their human rights, in health care settings and from uniformed personnel.

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Intimate partner violence and HIV

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Intimate partner violence among married or partnered women remains high – affecting women’s decision on their own health and access to healthcare.

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The fear of intimate partner violence has been shown to be an important barrier to the uptake of HIV testing and counselling, to the disclosure of HIV-positive status, and to treatment uptake and adherence, including among pregnant women who are receiving antiretroviral treatment (ART) as part of services to prevent mother-to-child transmission (PMTCT). 

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Some of the intimate partner violence experienced by women occurs within the context of child marriage. Girls who marry as children are more likely to be beaten or threatened by their husbands than girls who marry later, and are more likely to describe their first sexual experience as forced. As minors, child brides are rarely able to assert their wishes, such as whether to practice safer sex. These factors all increase HIV risk.

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Women from key populations are especially vulnerable to intimate partner violence and the increased risk of HIV associated with it. 

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Cultural and social norms

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Intimate partner violence is typically underpinned by dominant cultural and social norms about masculinity, femininity, and sexuality. Researches shows that gender inequality results from the patriarchal nature of many societies, especially where control of women and male strength and power is highly valued. 

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Violence against women, including intimate partner violence and rape, is one consequence of gender inequality. However, such violence also reinforces and perpetuates gender inequality at both societal and relationship levels. 

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The meaningful involvement of women living with HIV in the global AIDS response

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Women living with HIV face a number of barriers to meaningful participation in HIV policy and decision-making. These include stigma and discrimination, economic insecurity, and a lack of access to information and resources, as well as insufficient opportunities for training and support. 

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There are also few institutional mechanisms to ensure women’s leadership or inclusion in the design, implementation, monitoring and evaluation of the HIV response. Even where opportunities exist, organisational and resource constraints hinder the participation of women living with HIV. 

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