Monday , May 17 2021

The advocacy of safer sex is not enough to prevent HIV among women



By Magali Nelson, senior health advisor at Plan International Canada

HIV is on the rise for women around the world. Every week, 7,000 women are diagnosed with a positive status, and in 2016 women make up 52 per cent of all people living with HIV.

While the adoption of safer sex practices remains one of the most common ways to prevent HIV, the solution is not that simple. When it comes to women, gender inequality and unbalanced power relations are real drivers of transmission, asking us to look at HIV in women from social rather than purely health-based doctors.

Gideon Mandel through Getty Images

An educational poster for advocating safe sexual practices (such as holding one partner and using condoms) in a city on the border of Zambia and Zimbabwe,

Global HIV trends help to reveal some of the social, economic and legal consequences of gender inequality and its impact on women's health and well-being.

For example, in Malawi, where young people make up one-third of all new HIV cases, young women account for 70 per cent of them. In Zimbabwe, about 740,000 women reported living with HIV in 2017, representing 57 percent of all people living with HIV in the country. Adolescent girls and young women who are engaged in sex work are particularly vulnerable to HIV because of their exposure to gender-based violence and sexual partners who may already have the virus.

For many women, negotiations about the use of condoms with their sexual partner are simply not an option.

While much of the discussion about HIV prevention highlights the importance of safer sex, for many women, negotiations about the use of condoms with their sexual partner are simply not an option. Fighting power, isolation, and intimate partner violence play a major role in the way women move towards their sexual relationships and manage the risk of getting in contact with HIV. In Zimbabwe, only 69 percent of men consider that a woman has the right to refuse sex if she knows that her partner has sex with other women, and 23 percent of women consider that women have no right to ask their partner to use a condom if there is a sexually transmitted infection (STI). The threat of violence in consensual relationships limits women to make informed decisions about their sexual life and in cases of sexual violence, are completely robbed of their right to speak.

The lack of access to resources and information on AIDS also puts young women at risk. Globally, only three in every 10 adolescent girls have received comprehensive and accurate knowledge about HIV. Even when resources are available, deeply held beliefs about sexuality and a girls' agency over her body prevent many from seeking the health care they need.

GIANLUIGI GUERCIA via Getty Images

The challenge of gender norms and behavior is one of the key ways to address the increasing number of HIV cases among women. This requires us to approach preventive methods by understanding the unique barriers that young women face in expressing and demanding their sexual and reproductive rights. By tackling gender inequality in its root, we can weaken the network of social norms that prevent women from deciding their own future and leading lives.

Thirty-five years after HIV was first detected as a virus that causes AIDS, we are still discovering the complex network of risk factors that drove the epidemic. While we continue to expand our understanding of how the disease works, how it is transmitted and how to prevent it, we still have a lot to learn about how vulnerable groups, such as women, are only affected. Understanding the intersection between gender inequality and the systems that enable it will be one of the keys to ending HIV in women.

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In honor of the World AIDS Day, we will discuss the conversation, the one that talks about empowering women and all vulnerable groups at risk of HIV. Together we can help build a world in which everyone can freely withdraw from the margins and free up their full potential.

Magali Nelson is a Senior Health Advisor in the Global Fund team with Plan International Canada.

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