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Gender inequality and HIV

  • Gender inequality drives the HIV epidemic. Achieving gender equality is essential for ending AIDS. 
  • The link between gender inequality and HIV is visible in many ways. This includes the effects of gender-based violence, expectations about how women and men should behave, restrictions on access to services, harmful traditional practices and unequal access to education. 
  • There are many ways to  move towards gender equality, including supporting women to take part in decision-making at all levels, tackling harmful gender norms, keeping girls in school, and initiatives to develop skills and reduce poverty.  

What is gender?

Gender is different from biological sex. It relates to the ideas and expectations that societies and individuals have about being a man (masculinity) and being a woman (femininity). It affects how people are perceived and how they are expected to think and act.  

What is gender inequality?

When men and boys have more power, status, opportunities and resources than women and girls. 

Gender inequality also affects people who do not conform to society’s ideas about how men and women should behave, such as lesbian, gay, bisexual, transgender and intersex (LGBTI) people, women who sell sex, and women who use drugs. 

What links HIV and gender inequality?

Gender inequality is one of the things that drives the HIV epidemic. HIV also fuels gender inequality because women and girls in countries with large HIV epidemics are more affected by HIV than (heterosexual) men and boys. And gender non-conforming people face harsh laws, stigma and discrimination that increases their HIV risk while keeping them away from services. 

HIV and gender inequality is linked through: 

Gender-based violence

Gender-based violence is violence linked to someone’s gender. One of the most common types of gender-based violence is intimate partner violence.  This stops women and girls accessing sexual and reproductive health (SRH) services, using condoms, testing for HIV and starting or staying on treatment. In places with high HIV prevalence, women who experience intimate partner violence are 50% more likely to get HIV than women who do not. 

There is also a direct risk of HIV transmission through sexual violence and rape. This includes rape within marriage, homophobic rape and rape in conflict situations, when rape is used as a weapon of war. 

Gender norms and stereotypes

Some commonly-held views of feminine gender roles encourage women to be passive when dealing with men, including in decisions relating to their sexual and reproductive health. The view that younger people should obey older people mean young women have even less say over their bodies.  

Restrictions on access to services

In some countries women need their family or partner’s permission to access sexual and reproductive health (SRH) services, which means they often miss out. While laws that criminalise people who do not conform to gender roles, such as LGBTI people or women who sell sex, make it hard for them to access services.

Child marriage

Girls who marry as children (under 18) are more likely to experience intimate partner violence, including rape, than girls who marry later. They are also less likely to have access to information about HIV and sexually transmitted infections (STIs) and SRH services. 

Education and poverty

A lack of education means women are more likely to be poorer than men. This means women are more likely to be dependent on men and have less decision-making power within relationships, families and societies. 

A combination of lack of education and poverty has many consequences that increase the risk of HIV. Women who are less educated are more likely to get married at a young age, exchange sex for money or gifts or rely on a partner for money. This means they may have less of a say over their sexual health choices (like using a condom), and have limited knowledge on HIV and sexual health. 

What can we do to tackle gender inequality?

Involve women and girls in decision-making

Women and girls should be at the heart of programmes that aim to reduce gender inequality. This includes the use of female peers, and services designed and delivered by women. It is also important for women and others affected by gender inequality to take part in decision-making, from parliaments to village committees.  

Accept and respect women’s rights and choices

Enabling women to be aware of their rights and to make choices about their own lives is key to achieving gender equality.  

Offer comprehensive sexual and reproductive health and rights services

Programmes should address women and girl’s sexual and reproductive health and rights beyond HIV to meet a variety of needs.

Economic empowerment

Initiatives, like jobs training schemes and small business loans, can support women and girls to develop skills and knowledge so they have more money and resources, and more control over their lives and bodies. 

Keep girls in school

Increasing education levels among women and girls is linked to better sexual health, including lower rates of HIV. Making education free for girls, supporting orphans and other vulnerable children to stay in school, and providing cash transfers to parents who keep their daughters in school can all help.

End child marriage

It is important to work with parents and families to understand the harms child marriage brings and find alternative ways for households to raise income and resources. Doing this can help parents reject higher bride prices from older men to marry their young daughters. 

Teach young people about sex and gender rights

Comprehensive sexuality education (CSE) that focuses on gender rights and power dynamics is effective in reducing unwanted pregnancies, HIV infections and other STIs.

Include men and boys

Working with men to reflect on the ways households and communities are unequal, and building skills to approach intimate relationships in fairer ways, helps to reduce gender inequality. These approaches can focus on whole communities, couples or just on men. 

Tackle unequal laws

Changing laws on parental and spousal consent will increase women and girl’s access to HIV and SRH services.  

Hold governments to account

There are many international commitments to address gender inequality. These are a good basis to advocate for changes to policies and laws.

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