Women now account for almost half of HIV infections worldwide and a majority of HIV infections in sub-Saharan Africa. This is due to women’s deep political, social, economic, and sexual subordination, which is inscribed in law and enshrined in culture and practice. Discrimination, stigma, and violence are also daily realities for many women living with HIV and AIDS.
- In many countries, national laws restrict women’s ability to own, inherit, or dispose of property. Women suffer inequality in access to education, credit, employment, and divorce. Legal and social inequality renders women economically dependent on their husbands, leaving them little choice but to remain in relationships where they cannot refuse sex or insist on condom use. Women often sink into poverty upon the death of their husband or the dissolution of their marriage, finding their choices and possibilities so diminished that they have to trade sex for survival, or rely on situations of lodging or work that expose them to sexual abuse or violence. Each of these factors places women at a heightened risk of HIV infection.
- Violence against women is itself a global epidemic that fuels high rates of HIV infection among women. Women face a higher risk of HIV infection through forced sex than consensual sex. Violenceand the fear of violence can deter women from seeking HIV testing, insisting on condom use, or disclosing their HIV status to their sexual partners. Many countries still refuse to recognize thecrime of marital rape. Even where laws prohibit violence against women, these laws are often not enforced. In many jurisdictions, survivors of rape and sexual violence have little hope of redress for such crimes due to inadequate police investigation, as well as bias and corruption on the part of the judiciary. Sexual violence survivors also rarely gain access to postexposure prophylaxis for HIV infection.
For many women living with and vulnerable to HIV and AIDS, health systems remain places of prejudice and discrimination,rather than treatment and care. Access to comprehensive reproductive health services, which is the core of HIV prevention for women and girls, remains woefully lacking and restricted by law and practice in every region of the world. Women encounter blame and abuse when they are found out to be HIV-positive, deterring them from seeking HIV testing or treatment services. Women who become pregnant while living with HIV or AIDS often face judgment and recrimination by health care workers, rather than being offered proven treatment to prevent mother-to-child transmission of HIV.