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HIV prevention and protection efforts are failing girls, women

Existing HIV prevention and protection efforts are failing to stem infections among women and girls because they do not take into account such issues as gender relations and sexual behavior, according to the UN's AIDS program.

"All too often, HIV prevention is failing women and girls," said Dr Peter Piot, Executive Director of the Joint UN Program on HIV/AIDS (UNAIDS). Piot was speaking at the launch of the Global Coalition on Women and AIDS, a UNAIDS-initiated group of leading women and men committed to mitigating the impact of AIDS on women and girls worldwide.

"Because of their lack of social and economic power, many women and girls are unable to negotiate relationships based on abstinence, faithfulness and use of condoms. It is precisely to address these inequalities and reduce women's vulnerability to HIV that the Global Coalition on Women and AIDS has been created."

Women are particularly vulnerable to HIV, with about half of all HIV infections worldwide occurring among women.

This vulnerability is primarily due to inadequate knowledge about AIDS, insufficient access to HIV prevention services, inability to negotiate safer sex, and a lack of female-controlled HIV prevention methods, such as microbicides.

Women and girls are often powerless to abstain from sex or to insist on condom use.

They may be coerced into unprotected sex or run the risk of being infected by husbands in societies where it is common or accepted for men to have more than one partner. Women are also biologically more vulnerable to infection; male-to-female HIV transmission is estimated to be twice as likely as female-to-male. In some of the regions worst-affected by AIDS, more than half of girls aged 15 to 19 have either never heard about AIDS or have at least one major misconception about how HIV is transmitted.

While condoms have been proven effective in HIV prevention, their correct and consistent use rests with the male partner, making it more difficult for women to negotiate safer sex. In fact, most sexually transmitted HIV infections in females occur either inside marriage or in relationships women believe to be monogamous.

"The typical woman who gets infected with HIV has only one partner -- her husband or steady boyfriend," said Oscar-winning actress Emma Thompson, an ambassador for ActionAid International.

"Regardless of their relationship status women desperately need new HIV prevention tools that they can control."

A study in Zambia found that only 11 percent of women interviewed believed that a woman had the right to ask her husband to use a condom -- even if he had proven himself to be unfaithful and was HIV-positive. Studies in the US suggest that many women infected by male partners were unaware the men had had multiple sex partners.

Violence, too, increases the danger of HIV infection among women. In certain places -- Cameroon, the Caribbean, Peru, and South Africa -- between 20 percent and 48 percent of girls aged 10 to 25 reported that their first sexual encounter was forced. Fear of violence not only prevents women from accessing HIV/AIDS information, it prevents them from getting tested, disclosing their HIV status and receiving treatment and counselling, even when they know they have been infected. This is primarily due to the stigma and discrimination associated with HIV and AIDS.

"When women are infected with HIV, they often face physical and emotional violence. As a result, they can be abandoned by their families and ostracized by their communities," said Ludfine Anyango, a woman living with HIV and national HIV/AIDS coordinator of ActionAid Kenya.

Women's vulnerability to HIV and AIDS is further exacerbated by unequal property and inheritance rights. In many countries property is usually owned by men -- women only have rights through marriage. This radically reduces their economic security and can lead to women enduring abusive relationships or resorting to sex for economic survival. Women whose male partners die of AIDS are often left homeless.

"It is crucial that HIV prevention programs involve both women and men to effectively address gender inequality and reduce women's vulnerability to HIV," said Mary Robinson, former President of Ireland and executive director of the Ethical Globalization Initiative. "Women's rights must be fully respected and protected if we want a realistic chance at reversing the spread of AIDS."

Another promising HIV prevention option for women lies in microbicide research. Formulated as a gel, film, sponge, lubricant or time-released suppository, a successful microbicide could help protect women and couples who cannot or do not use condoms against HIV.

The Global Coalition on Women and AIDS aims to be a highly-visible group of men and women, including activists, government representatives, community workers and celebrities, that seek to stimulate concrete action on the ground to improve the daily lives of women and girls. Its efforts will focus on preventing new HIV infections among women and girls, promoting equal access to HIV care and treatment, accelerating microbicide research, protecting women's property and inheritance rights and reducing violence against women.

For more information about UNAIDS, please visit our website, www.unaids.org.
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