HIV/AIDS is a gender issue because men and women are vulnerable in different ways. Vulnerability is influenced by the interaction of a wide range of factors, including:

Personal factors
- Sexual history
- Ability to protect oneself and others
- Knowledge about treatment and support programs
- Skills to access and use them
Societal factors
- Cultural norms
- Laws
- Social practices
- Health and healthcare beliefs

Risk versus Vulnerability to HIV

Risk is different to vulnerability as it refers to the probability that a person will acquire an HIV infection. HIV risk reduction strategies refer to measures designed to address the immediate risk-taking action and environmental factors affecting it. HIV vulnerability reduction strategies are measures designed to address the underlying factors.

Women are biologically more vulnerable than men to HIV infections and other Sexually Transmitted Diseases

Women are two to four times more likely to become infected with the HIV virus after intercourse with their male partner because:

They have a larger surface area exposed to the virus.
The amount of the virus present in semen is greater than in vaginal secretions.
Semen may remain in the vagina for hours after intercourse.
Women are more likely to have an untreated STD since the area of infection is hidden and often unnoticed. Having an untreated STD puts women at a greater risk of contracting the HIV infection from an infected partner.
Women are more likely to be the recipients of blood transfusions due to anaemia and complications during childbirth.

Over 90% of women currently infected with HIV have been infected as a result of transmission through vaginal intercourse. [i]

Tearing and bleeding from "rough sex", rape or prior genital mutilation multiplies the risk of HIV infection. Throughout the world, women run a similar risk from unprotected anal intercourse. Sometimes preferred because it preserves virginity and avoids the risk of pregnancy, this form of sex often tears the delicate tissues and affords easy entry to the virus.

Young women - Vulnerable for many reasons

According to UNAIDS, 60% of new infections occur among girls and young women aged 15-24.
Girls are vulnerable because their genital tract is not fully mature and therefore more likely to become infected.

VULNERABILITY

Gender-related social norms can also increase women's vulnerability to HIV/AIDS. For example, women are expected to have only one lifetime partner, whereas men are encouraged to have more. This double standard puts women in a vulnerable position. Studies in Asia and Africa have shown that many married women contract the disease from their one and only sex partner - their husband.

Also pushing up HIV rates in girls and young women is age mixing. If the girls' sole sex partners were boys their own age, they would run little risk of becoming infected, as there are few HIV infections among boys before the late teens. However, girls are more likely to be raped or coerced into sex by someone older, who is physically and/or more financially powerful. Men often believe that young girls are free of HIV infection.

The high social value placed on virginity in unmarried girls may also pressure parents and the community to ensure girls are kept ignorant about sexual matters. Female ignorance of sexual matters is often viewed as a sign of purity and innocence. This emphasis on 'innocence' prevents young women from seeking information about sex or services relating to their sexual health. Sexually active young women are also discouraged from discussing sex too openly with their partners for similar reasons, making it difficult for them to communicate their need for safer sex.

"7 to 8 years ago, I married a man and I had no knowledge about AIDS. I did not know what my husband would bring to me. However, I got HIV from him. Now up to this point, I think that if the government or any relevant party created awareness or knowledge about AIDS, we women would not be in this situation of having AIDS."

Narumon Buayen, Women's Friendship Group, Chiang Mai Province, Thailand

Economic Vulnerability

In many situations around the world, women are economically dependent on men. More than two-thirds of the world's women are illiterate and 70% live in poverty. Due to their socio-economic conditions, some women do not have autonomy or resources of their own. Their fear that their husband may abandon them makes it difficult for many women to negotiate safe sex.

For many women, sexual intercourse is not a question of choice but rather a question of survival. As a result, they have very little control over how and when they have sex. In many cases, women are not able to negotiate safer sex practices with their partners because they do not want to jeopardize the relationship. Marriage provides forms of economic and social support that would not be available to them if they were to remain single.

Some women are forced into sex work by economic necessity. Prostitution is sometimes the only means of support for deserted, separated, divorced or unmarried women.

Due to such an economic imbalance, men have considerable power over women, especially when it comes to sexual relations between males and females.

"A women I know, whose child had been raped by her partner, could not prevent that man from visiting her because she had no other way of feeding her children"

Dr. Sunanda Ray
quoted in "Women, The HIV Epidemic and Human Rights"

[i] UNDP Issues Paper No.8 "Women, the HIV Epidemic and Human Rights". Global estimate.

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