Official Bank Sites Related Information August 11, 2006—Soon, more women than men will be living with HIV, if current trends continue. It’s the kind of equality women can do without. As AIDS turns 25 this year, 48 percent of people living with
HIV are women, according to the United Nations global report on AIDS. That’s some 17.3 million women. The disease is now the leading cause of death in both men and women 15 to 59. And young women aged 15 to 25 are at least three times (and in some places five or six times) more likely to become infected as men in the same age group, even as the epidemic eases in some countries. - AIDS has driven female life expectancy below men’s in four countries: Kenya, Malawi, Zambia and Zimbabwe
- 60 percent of those living with HIV in Africa are women
- In India, almost 90 percent of HIV-positive women were infected by their husbands
The reasons are biological, cultural, and economic. The worsening epidemic is related to inequality in gender, education, and socio-economic status, say World Bank experts. “Whichever way you look at this epidemic, women are vulnerable,” says Debrework Zewdie, Director of the Bank’s Global HIV/AIDS Program. Young women are especially vulnerable and disproportionally affected in many countries, says Elizabeth Lule, head of the Bank’s AIDS Campaign Team for Africa (ACT Africa). Physiologically, young women’s reproductive tracts are not fully developed, making it easier for the virus to enter their bodies. Culturally, inter-generational sex and marriage of young girls to much-older men is accepted and common. Older men seek out young women as sex partners partly in the belief young women are less likely to be infected with HIV. But older men have higher rates of HIV infection than younger men and often bring the disease home to their young wives, says Lule. Economically, young women are at a disadvantage, with generally less education and opportunity. They suffer legal or cultural barriers to owning land and property, earning a livelihood, or even access to health care, says Lule. They are also often victims of domestic violence and rape, she says. In some cases, young women have sex with older men to help pay school fees or simply for survival, she says. These kinds of “Sugar Daddy” relationships are unequal make it difficult for young women to negotiate safe sex even in marriage, says Lule. And she says the World Bank is supporting efforts to address the underlying causes of gender inequality and thereby combat HIV—such as legal and policy reform to strengthen women’s property and reproductive rights, and maintain their rights to education and livelihoods. In some countries, there are good policies that aren’t implemented, or laws against rape that aren’t enforced, and “good laws” that allow women to inherit land, but they’re also not enforced, says Lule. “It doesn’t happen overnight. I think we have laid a good foundation. But much more needs to be done,” says Lule.
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