QUESTION: Why are women more vulnerable to HIV infection?
*** Larger mucosal surface; micro lesions (small cuts) that can occur during intercourse may be entry points for the virus; very young women are even more vulnerable in this respect.
*** The virus, when present, is more plentiful in sperm than in vaginal secretions.
*** As with Sexually Transmitted Infections (STIs), women are at least four times more vulnerable to infection; the presence of untreated STIs is a risk factor for HIV.
*** Coerced sex increases the risk of micro lesions.
*** Financial or material dependence on men means that women sometimes cannot control when, with whom and in what circumstances they have sex.
Socially and culturally
*** Women are sometimes not expected to discuss or make decisions about sexuality.
*** They sometimes cannot request, let alone insist, that a condom or any other form of protection be used.
*** If they refuse sex or request that a condom be used, they often risk abuse, as the request may imply a suspicion of infidelity.
*** The many forms of violence against women mean that sex is sometimes coerced, which is, itself, a risk factor for HIV infection.
*** For married and unmarried men, multiple partners (including sex workers) are sometimes culturally acceptable.
*** Women are in some cultures expected to have relations with, or marry, older men, who are more experienced and more likely to be infected. Men may seek younger partners in order to avoid infection and in the belief that sex with a virgin cures AIDS and other diseases.
Women as caregivers
*** Women are responsible for the health care of all family members.
*** Care is only one of the many productive and reproductive activities of women, which may include farming, food preparation, collection of firewood and water, child care, cleaning, etc.
*** During illness, women’s productive labour is lost; this has a serious impact on the long-term well-being of the household.
*** Care does not end with death of a husband/child/sister. Care of orphans then falls to grandmothers and aunts.
*** Women caregivers are often HIV-positive themselves.