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Wednesday, August 5th, 2009 - 10 comments

The Status of Women is The Real Culprit

It is an almost universally held belief that the biggest factor in the spread of HIV/AIDS is poverty.  If that were true, poverty should correlate with higher HIV/AIDS rates but, as Steve Kraus, HIV/AIDS Branch Chief for UNFPA, the United Nations Population Fund, reminds me:  HIV/AIDS and poverty do not correlate elegantly.

If you look at global national data, the fact is that the world’s poorest nations do not have the highest HIV/AIDS prevalence rates.  While true that two-thirds of the people living with HIV/AIDS are in sub-Saharan Africa – the poorest region in the world – the rates by African country do not neatly match up to the poverty index.

Some of the highest prevalence rates are in South Africa and Swaziland, two of Africa’s comparatively richest nations (and middle income countries by global standards). Yet prevalence rates are less than 2% in Niger and Mali, among the poorest nations in the world.

What’s going on?

The truth is that cultural norms, particularly as they relate to sex and marriage, women’s status and women’s economic power, have more to do with the spread of HIV than poverty.  The primary drivers of HIV/AIDS are major social problems: gender inequality and stigma. A woman cannot control her own risk factors if she has no power in her relationships with men.

We will never get a handle on the spread of HIV unless the view of women in much of the world is transformed. Will there be a day where it will not be a bold, out of the box idea that elevating the status of women alone, would hugely impact the spread of HIV?

I hope so.  And I hope that the dawn of such a day occurs soon.

The views expressed in this blog-post are solely those of the author.

Comments (10)

Thursday 6th August, 2009, 12:40pm

I read recently that roughly 8.3 million people are living with HIV in Asia; and over a quarter of the total number of people living with HIV in Asia are adult women – 2.4 million. What is influencing the rampant spread of HIV/AIDS amongst women in Asia?

Thursday 6th August, 2009, 2:48pm

So interesting. And to expand on the cycle that traps women who are in the societies where they are least valued:

The feminization of AIDS and poverty are linked in a cycle that practically ensures the spread of the disease, even if a vaccine were developed.

For the 51 million of girls around the world who were married off as children, marriage is risky sexual behavior. A girl who is married off at 12 or 13-years-old is regarded as a commodity by her family – property to be traded to feed the other children or to repay debts. Or she is property taken in exchange for a dowry.

She has no ability to negotiate condom use with her husband. And as he is likely to be 10 or more years older than his child bride, the chances that he is already infected can be huge.

It is in these societies where the stigma of AIDS tends to remain so great that women breastfeed their children even if they know they are HIV positive rather than risk being ostracized and abandoned.

When this woman who lost her childhood to marriage eventually dies of complications of AIDS, she is likely to leave daughters. In desperation some of them turn to sex work to survive.

We will never get a handle on the spread of HIV unless we put an end to early marriage and keep girls in school. Educated girls marry later and tend to have more economic stability. These are big challenges and they will take time but the alternative is to wait for a vaccine and that will only combat AIDS. The underlying problems will remain.

Thursday 6th August, 2009, 3:04pm

Interesting facts. As a young woman raised in the west- how can I help? What can young women like me do to change the false notions, and cultural misconceptions that surround HIV/AIDS, be they at home or abroad?

The lack of knowledge surrounding women and HIV/AIDS seems to be only one example of how women's health is on the back burner- for developing and developed nations.

Thursday 6th August, 2009, 3:55pm

Countries also miss out on 50% of their intellectual capital by failing to allow women to self-actualize. This lack of opportunities has untold consequences that affect the whole nation for decades.

How do countries (like the US) promote women's rights in other countries without seeming to be imperialist?

Thursday 6th August, 2009, 4:16pm


What you are talking about is a problem that has already exploded in sub-Saharan Africa and is starting to happen in Asia. In sub-Saharan Africa, women represent more than half (57%) of all adults living with HIV/AIDS. The feminization of HIV/AIDS is expected to spread in Asia, particularly in India and China. The root causes of this trend are gender inequalities in social and economic status, limited access to prevention and care services and sexual violence. Remember, women are more biologically susceptible to HIV infection than men.

Friday 7th August, 2009, 12:59am

As a returned peace corps volunteer who recently spent the last two years working n HIV education and prevention in rural Zambia, I have seen first hand how and why it is that HIV is exacerbated by gender inequalities. On a daily basis I talked to women and girls, in school, women's groups, and around the village. What surprised me most about my conversations with women was how much they already knew about HIV and how it was spread and how to protect themselves. The problem wasn't a lack of knowledge, it was a lack of power in decision making.

One of the most sobering moments I encountered in Zambia occurred after I had finished an HIV lesson and condom demonstration with a women's group. When I asked for questions, one women raised her hand and said the only question she had was, what was she supposed to do when she asked her husband to wear a condom and he beat her up simply for asking? I didn't have an answer for that then, and i still don't now.

Mitigating the spread of HIV isn't going to happen by preaching condoms, abstinence, or being faithful. It is going to take a change in cultural practices that have been around in many places for hundreds if not thousands of years.

I think Americans need to stop worrying about being culturally imperialist and realize there are some core rights and values that we all deserve as human beings, that are a part of HUMAN culture.

I agree with Deni that the most important step we can take in this direction is through education of girls and women. Every year a girl is educated she becomes more and more empowered, which makes her more likely to marry a more tolerant and educated man who will respect her and protect her against HIV.

Friday 7th August, 2009, 6:35pm

As much as the status of women is a primary culprit in the AIDS problem, it is also a major factor in the source of our many environmental crises; population growth and excesses. It has been shown repeatedly that when women are able to exert more power in a society, the birth rate comes down.

It is not apparent to most people than the only true long-term solution for our environmental crises is the lowering of the causative factor in virtually all of them. The world seems consumed with technological "solutions" which offer, at best, only a temporary respite from continuing worsening of the many crises. If the effort to achieve population stabilization and reduction does not begin very soon, the environmental crises will achieve it for us, but in a very unpleasant way.

Thursday 27th August, 2009, 11:05am

Alma and Rajeeve: Great questions! The fact is that there are now activists, community leaders and organizations in every country in the world working to promote women’s rights and equality. A country like the US can support such local initiatives. Moreover, by providing financial and political support for fundamental issues such as girl’s education and equality, a country like the US can make a huge difference.

Thursday 27th August, 2009, 11:06am

Aleta, you are absolutely correct that cultural roles, expectations and practices lie at the root of so many of our problems. We need to work on the development of societies and norms that respect both genders and allow each person to grow and develop freely. Sadly, women are so powerless in so many societies and situations that it will take us a long time to work toward the ideal of a egalitarian society. However, I believe that we must all engage in the struggle to take small steps towards that vision.

Thursday 27th August, 2009, 1:27pm

Investing in women will have many dividends, many of which we probably cannot even foresee today. Raising the status of women is expected to reduce poverty (since women are often concerned about their families and communities), create more stable societies and result in more planned pregnancies. The impact of these choices on the world, in environmental terms as well as political, would be enormous. Women are the key to changing the world.

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Guest Editor

Anika Rahman

President, Americans for UNFPA


Anika Rahman, a well-known international advocate for the rights of women, is the President of Americans for UNFPA where she is responsible for building American legislative and financial support for the promotion of women’s health and rights globally. For more than fifteen years, Ms. Rahman has monitored and analyzed United States and international policies that affect the health and rights of women.

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