More women than men are now HIV-positive; in South Africa, the infection rate in the 15 - 24 age group is an estimated 20 women for every 10 men.
This is partly due to the fact that women usually become infected at a younger age than men. Many young women have sexual relations with older men, who are more likely to be HIV-positive, with the result that far more young women than young men in Africa are infected. The younger age groups contain the highest numbers of people; also, individuals who are infected younger tend to live for longer.
However, HIV is also more common in women because they are at higher risk for infection. The reasons for this are both physical and socio-cultural:
Heterosexual intercourse carries a higher risk of infection for women. During sex semen enters the vagina, where it can stay for several hours, increasing the risk of infection. The virus enters the bloodstream via tiny abrasions that form in the sensitive lining of the vagina during intercourse.
Certain sexual practices between men and women, such as dry sex (a common practice in South Africa, where the vagina is expected to be small and dry) and anal sex, carry an even greater risk of HIV because they cause more severe vaginal or anal abrasions.
Unequal power relations between men and women, particularly when negotiating sexual relations, increases women’s vulnerability. In South Africa, and throughout Africa, male-dominated culture socialises men to feel that they are superior to women and should control them, and women to relate to men in a submissive manner. Women’s inferior status means that they often have little or no power to negotiate for safer sex.
Lack of economic power often results in women being dependent on their male partners for basic needs for themselves and their children, especially where state support is lacking.
This dependence means women are often not in a position to question or challenge their male partners for fear they will be denied financial support. Many women feel they cannot risk losing their partners by denying them sex, even if it is unsafe, and fear not being able to survive financially should they themselves leave an abusive relationship. Poor women are at greatest risk.
Studies show that women who are economically independent are far less likely to be abused by male partners. Preventing women from working is a fairly common act of abuse by their male partners that increases women’s economic dependence and reduces their ability to resist other abusive acts.
Physical and sexual violence against women, a major problem in South Africa, is linked to the male-dominated nature of society.
Violence is often used by men to maintain their societal status, and prove that they are “real men” by keeping women under their control. Sexuality is one of the most common areas in which men exert power over women through violence: women may be beaten for refusing a sexual advance, wanting to end a relationship, or having or being suspected of having other partners.
Many men still do not want to use condoms, and some become violent in order to force women to have unprotected sex. Women may not even raise the issue of safer sex for fear of a violent response.
South Africa, where an estimated 147 women are raped every day, has the highest rape statistics in the world. In the past, rape survivors risked unwanted pregnancy and other sexually transmitted infections; now they also risk being infected with HIV.
The risk of HIV transmission through rape is considered to be higher than through consensual sex, and very much higher if there is associated trauma (injury). Forced sex frequently causes abrasions to the vagina, which increases the rate of infection. When virgins and children are raped, the trauma is even more severe, and risk of infection even higher.
Although violence against women occurs throughout society, the most affected areas include working class and poor African communities, as women in these areas have less access to financial resources and limited means to secure legal rights. Female sex workers are another group of women at high risk for physical and sexual violence.
Women who have been sexually abused are more likely to risk unsafe sex, have multiple partners, and trade sex for money or drugs. Men who are violent to their partners are also more likely to have STDs. All these factors put women who suffer sexual violence at higher risk of HIV infection.
Many women lack access to accurate, relevant information on HIV/Aids and sexuality, and are therefore unaware of the risks. Women have high rates of illiteracy in Africa, and many girls do not complete basic education. Also, women may be unaware of risks because their time is taken up with tending the home, and they have limited links with the outside world. Some men isolate their female partners by preventing them from seeing family and friends, speaking to other men, or working.
Migratory labour practices put rural women at risk. Men who work as migrant labourers frequently become infected at their place of work, most notably the mines, and then carry the infection back to their wives at home.
Stats on gender infection ratios from the AIDS Foundation of South Africa
Stats on rape in South Africa from Rape Crisis
- Health24, updated October 2006