Women and HIV

Sub-Saharan Africa today has 60% of the world's HIV cases, despite having only 10% of the world's population. Of these, almost 60% are women and girls.

One explanation, according to experts, is that in some parts of Africa, efforts to promote condom use focused largely on women, instead of on both men and women.

Condoms are powerful weapons in curbing the spread of HIV, and in countries where women don't have the power to negotiate their use, it becomes much harder to stop the disease from spreading.

While female condoms exist, they are 10 times as expensive as male condoms and difficult to use. According to Debrework Zewdie, a World Bank HIV/AIDS specialist, there is still no widely accepted female-based method to prevent HIV.

Scientists are currently researching microbicides, which women can apply topically to prevent sexually transmitted infections such as HIV—but no safe and effective microbicide is yet on the market.

Gender Inequality Is Worsening the AIDS Epidemic

Experts say that inequality between men and women has fueled the AIDS epidemic. In many countries, women's lack of economic power, education, job opportunities, and rights to property often drives them into relationships in which they don't have the ability to ensure safe sex, says Elizabeth Lule, head of the Bank's AIDS Campaign Team for Africa (ACT Africa).

The risks are even greater for women who become commercial sex workers to survive. They receive clients who don't wear condoms and who in fact often pay more money for sex without condoms.

Even marriage has become risky. For instance, in Africa and Asia, girls as young as 12 are often married to men 10 or more years their senior. Older men have higher rates of HIV infection than younger men and often bring the disease home to their young wives.

Even so, these women are blamed for bringing HIV into the home, and suffer discrimination.

"Whichever way you look at this epidemic, women are vulnerable," says Zewdie.

Countries Can Fight HIV by Empowering Women

Today some experts believe that unless an AIDS vaccine is developed, empowering women may be the key to overcoming the disease.

So far, in battling AIDS, countries haven't addressed the reasons why increasing numbers of women and girls are being infected. Stigma and discrimination over the disease prevents open discussion about it.

But this must be overcome for women to have the information they need to protect themselves, and to negotiate condom use.

The World Bank and its partners are working with countries to address the causes of gender inequality and thereby combat HIV. They are focusing on legal and policy reform to strengthen women's property and reproductive rights, and also on providing access to education and livelihoods for women.

Lule adds that any discussion of gender and equality with regard to HIV/AIDS should not focus solely on women.

"There is a missing link—the other half of gender," she says. "The men are a part of the solution."

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