Women with HIV/AIDS in context

M.A.The headlines scream of HIV/AIDS being a global pandemic and it is true that HIV has reached every corner of the globe. Never in history has there arisen such a widespread and fundamental threat to human development. Yet it is sub - Saharan Africa that is the hardest hit region and mainland southern Africa that experiences the most severe HIV/AIDS epidemic in the world (Jackson, 2002). Countries like Botswana and South Africa have the highest infection rates with as many as one in three adults affected (Clark, 2002). Millions of children are being orphaned in these regions and years have been knocked off life expectancy. AIDS threatens food security, productivity, human resource availability and development (Jackson, 2002). It severely leaves its mark on the individual and the family, but its impact reaches through to the macro-economic level as well. This is a long term development disaster on a scale never witnessed before and sub -Saharan Africa is bearing the brunt of it. The global pandemic as it is called, is looking more and more like two distinct epidemics – one global and one regional (Jackson, 2002). Two dominant HIVtransmission patterns are described by UNAIDS (2000) today: heterosexual sex throughout sub-Saharan Africa and intravenous drug injecting, together with some sexual transmission among men who have sex with men, everywhere else. It is to be understood though, that these are not exclusive patterns of course, but it matters that these are the predominant modes of transmission. The devastating fact about African HIV/AIDS scenario is that women are several times more likely to be infected than men. Gender inequality is a fundamental driving force of the AIDS epidemic (Women’s Health Weekly, 2000). Biological and social factors make women and girls far more vulnerable to HIV/AIDS than men. Women are anatomically and physiologically much more susceptible and penile penetration puts women at great risk. Socio -culturally, women in (South) Africa tend to wield little power in heterosexual relationships. The socialisation process of both men and women right from childhood, as well as the stereotyping of their roles in society, has exposed women more to HIV infection as compared to their male counterparts (Henderson, 1996). The term gender refers to the widely shared expectations and norms within a society about appropriate male and female behaviour, characteristics and roles. It is a social and cultural construct that differentiates women from men and defines the ways in which women and men interact with each other (Gupta, 2001). In sub-Saharan Africa this very often means that it is unacceptable for a woman to say no to unwanted and unprotected sex unless they want to risk abuse or even violence (Esu-Williams, 2000). Both men and women are socialised to believe that men have a right to have sex regardless of their wives’ consent, even if he had been demonstrably unfaithful and was infected with HIV (Urdang, 2001). This state of affa irs is further exacerbated by the fact that very often the women is economically dependant upon the man. The fact that women are so vulnerable is a vital issue in the spread of HIV/AIDS in sub-Saharan Africa. Women’s rights and needs have to be taken seriously if any kind of slowing of the epidemic is to occur. Equity in all fields – health, education, environment and the economy – are essential if women are to act to protect themselves when it comes to HIV/AIDS (Women’s Health Weekly, 2000). Issues surrounding women and poverty, education, training, health matters, violence, economy, power and decision-making, are issues that will have a major impact on the spread of HIV and AIDS