International Women's Health Coalition - Women and Risk of HIV/AIDS Infection

Women and Risk of HIV/AIDS Infection

Women and Risk of HIV/AIDS Infection

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WOMEN ARE HIGHLY VULNERABLE TO HIV/AIDS

Since 1995, women have constituted approximately half of all adults living with HIV globally. Today, women account for 15.4 of the 30.8 million adults (ages 15+) currently living with HIV.¹
In many of the world’s most affected regions, women are increasingly at risk. The number of women living with HIV globally increased by 1.6 million from 2001 to 2007.¹ In 2007, an estimated 2,900 new HIV infections occurred each day among women (ages 15+).²
Biologically, women are two to eight times more likely than men to contract HIV during vaginal intercourse.³
In sub-Saharan Africa, 61 percent of adults (ages 15+) living with HIV/AIDS are female.¹
In the Caribbean, 43 percent of adults (ages 15+) living with HIV are women, up from 30 percent in 1995.¹
In the United States (US), women represent 27 percent of AIDS diagnoses, up from eight percent in 1985. Of new AIDS diagnoses among women (ages 13 and older), African Americans account for 66 percent, Caucasians 17 percent, and Latinas 16 percent.⁴
In China, women constituted 39 percent of reported HIV cases in 2004, up from 25 percent two years earlier.⁵

YOUNG PEOPLE, ESPECIALLY YOUNG WOMEN, ARE DISPROPORTIONATELY AT RISK

There are 5.4 million young women and men (ages 15-24) who are HIV-positive, and 34 percent of all new HIV infections occur in young people (ages 15-24).²
In Lesotho, fewer than 10 percent of girls ages 18 and 19 are living with HIV, but by age 24, almost 40 percent of them will be HIV-positive.⁵
Forty-three percent of reported AIDS cases in U.S. teens (ages 13-19) are among young women. ⁶
Among young people (ages 15-24) worldwide, women are 1.6 times more likely than men to be HIV-positive.⁷ In Cambodia, three times as many young women (ages 15-24) are living with HIV as their male counterparts. ⁸
In sub-Saharan Africa, three young women are infected for every young man among 15-24 year-olds; in some countries in the Caribbean, young women (ages 15-24) are more than twice as likely to be infected with HIV than their male counterparts.⁷
Among young people (ages 15-24) in South Africa, 14.8 percent of young women are living with HIV/AIDS, compared to 4.5 percent of young men.⁸

MANY WOMEN AND YOUNG PEOPLE DO NOT HAVE ACCESS TO THE INFORMATION AND SERVICES THEY NEED TO PROTECT THEMSELVES FROM HIV INFECTION

Eighty percent of young women (ages 15-24) in low- and middle-income countries cannot correctly identify ways of preventing HIV transmission.⁹
Eighty-two percent of young South Africans (ages 15-24) said they would like to have more information about how to protect themselves from sexually transmitted infections, including HIV. Sixty-nine percent said they would like more information on how to discuss using a condom with a partner.¹⁰

THE BIGGEST HIV/AIDS RISK FOR MANY WOMEN AND GIRLS IS MARRIAGE

More than four-fifths of new infections in women occur in marriage or in long-term relationships with primary partners.¹¹
In India, some 90 percent of women living with HIV said they were virgins when they married and had remained faithful to their husbands.¹³
In Ghana, married women are almost three times more likely to be living with HIV than women who have never been married.⁵
In Africa and Latin America, more than 80 percent of young women ages 15-19 who have had unprotected sex in the last week are married.¹²

SEX WORK, INJECTING DRUG USE OR BEING A PARTNER OF AN INJECTING DRUG USER, AND BEING A STUDENT CAN ALSO PUT GIRLS AND WOMEN AT HIGH RISK OF INFECTION

Commercial sex without condom use carries a high rate of HIV transmission. Unprotected sex between sex workers and clients is a leading mode of HIV transmission in the Caribbean. HIV prevalence among female sex workers ranges from 3.5 percent in the Dominican Republic to 9 percent in Jamaica and 31 percent in Guyana.¹
In Thailand, 43 percent of new HIV infections in 2005 were among women, most of whom are believed to have acquired HIV from their husbands or partners who had been infected during unsafe paid sex or through injecting drug use, which leads to the infection of 30 to 50 percent of injecting drug users in the country.¹
Among primary school students in Malawi, more than 80 percent of students ages 9 to 13 and more than 30 percent of students ages 14 and older said they knew someone who had been sexually victimized by a teacher in return for good grades. Among students ages 14 and older, girls were more likely to know someone who had been sexually abused by a teacher than boys.¹³

VIOLENT OR COERCIVE SEX MAKES WOMEN MORE VULNERABLE TO HIV

One in three women around the world will be raped, beaten, coerced into sex, or otherwise abused in her lifetime.¹⁴
Fearing violence or rejection, 58 percent of South African girls avoid discussing condom use with their partners.¹⁵ Yet in couples where only one partner is infected with HIV, consistent and correct condom use provides the HIV-negative person with a near-zero risk of infection.¹⁶
A study among high school students in Swaziland found that almost one in five sexually active females had been coerced into their first sexual experience;⁶ a study in South Africa found that close to half of sexually experienced young women had been coerced into their first sexual encounter.¹⁷
Violence can be both a cause and a consequence of HIV infection. Women in some studies report not obtaining an HIV test, not disclosing test results, or not requesting that their partner be tested, use condoms, or remain faithful because of a fear of being beaten or abandoned by their partner.¹⁸

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References
1 UNAIDS, AIDS Epidemic Update 2007, December 2007.
2 UNAIDS, AIDS Epidemic Update 2007: Epidemiology Slides, December 2007. http://www.unaids.org/en/KnowledgeCentre/HIVData/Epidemiology/epi_slides.asp
3 Cummins JE, Dezzutti CS, “Sexual HIV-1 Transmission and Mucosal Defense Mechanisms,” AIDS Review 2000; 2: 144-154, cited by amfAR, The Foundation for AIDS Research, “Fact Sheet: Woman and HIV/AIDS,” March 2008.
4 Kaiser Family Foundation, “Women and HIV/AIDS in the United States,” May 2008. http://www.kff.org/hivaids/upload/6092_05.pdf
5 UNAIDS, 2006 AIDS Epidemic Update, December 2006.
6 CDC, Slide Set: HIV/AIDS Surveillance in Adolescents and Young Adults (through 2005), June 2007, cited by Kaiser Family Foundation, “The HIV/AIDS Epidemic in the United States,” March 2008.
7 UNICEF, “The State of the World’s Children 2008,” 2008.
8 IPPF/UNFPA/Young Positives, “Change, Choice and Power: Young Women, Livelihoods and HIV Prevention,” 2007.
9 UNAIDS, 2006 Report on the Global AIDS Epidemic, May 2006, cited by Kaiser Family Foundation, “The Global HIV/AIDS Epidemic,” November 2007.http://kff.org/hivaids/upload/3030-103.pdf
10 Kaiser Family Foundation and South African Broadcasting Corporation (SABC), “Young South Africans, Broadcast Media, and HIV/AIDS Awareness: Results of A National Survey,” March 2007.
http://kff.org/southafrica/upload/7614.pdf
11 UNFPA, "State of World Population: The Promise of Equality: Gender Equity, Reproductive Health and the MDGs," 2005.
12 Clark, Shelley, Bruce, Judith, and Dude, Annie, "Protecting Young Women from HIV/AIDS: The Case Against Child and Adolescent Marriage," International Family Planning Perspectives, June 2006.
13 Burton, Patrick, “Suffering at School: Results of the Malawi Gender-Based Violence in Schools Survey,” Malawi National Statistical Office, 2005. 14 Heise L., Ellsberg M. and Gottemoeller M., “Ending Violence Against Women.” Population Reports, Series L, No. 11., cited by UNIFEM, “Not a Minute More: Ending Violence Against Women,” November 2003.
15 Vetten L and Bhanna K, “A preliminary investigation into the links between violence against women and HIV/AIDS in South Africa,” Center for the Study of Violence and Reconciliation, 2001.
16 Women’s Coalition for ICPD, “Condoms and Disease Prevention,” 1999.
17 Maharaj P. and Munthree C., "Coerced first sexual intercourse and selected reproductive health outcomes among young women in Kwazulu-Natal, South Africa," Journal of Biosocial Science 39(2): 231-244, 2007.
18 World Health Organization, “Gender Dimensions of HIV Status Disclosure to Sexual Partners: Rates, Barriers and Outcomes: A Review Paper,” 2004.