|African Women and AIDS: Scope, Impact and Response (UNESCO, 1999, 59 p.)|
The Impact of HIV/AIDS on African Women as Socio-Economic Agents within the Communities
By Brigitte Quenum
(A Public Health Medical Doctor, Counsellor in Community Responses, Regional Project on HIV and Development for Sub-Saharan Africa, UNDP)
Even though prevention strategies are effective, the current high levels of HIV infection and the long incubation period prior to AIDS indicate that the economic impact of the disease will represent a major impediment to development for many years to come.
AIDS of course affects the population at large, but women are more specifically affected. This is due to a number of reasons which are biological and social, including the various roles that women play as mothers, wives, and providers.
WOMEN'S VULNERABILITY TO THE HIV INFECTION IS BIOLOGICAL, SOCIAL, AND ECONOMIC
· Biological vulnerability: women are at major risk of infection; they are more prone to HIV contamination than men. The risk of being infected during unprotected sexual intercourse is twice to four times higher among women than men. Women are also more vulnerable to other sexually transmitted diseases, which represent an important factor in the transmission of the virus. Those STDs cause serious or chronic genital lesions among women and represent an additional infection risk factor. Moreover, when women are infected with STDs, they generally are not aware of it or are poorly treated. Inadequate treatment is often due to lack of financial resources or a lack of understanding about the necessity to treat the disease. Anaemic conditions and complications related to pregnancy and childbirth often require blood transfusion, which are more likely to expose women rather than men to infection. Finally, it is easier for women than men to cause mother-fetus transmission due to the simple fact that the woman gives birth. This situation in turn, seriously affects women in their capacity as progenitors and mothers, which is quite valued in Africa.
Social and economic vulnerability: Women's condition aggravates their exposure to HIV/AIDS. Although the condition varies from one country to another within the continent, we generally notice that family and social systems place women in a subordinate role to their partners, in particular, and men in general. This is in view of the fact that men hold the economic and political power, be it at the family, lineage, or village levels. Some changes have of course occurred over the last several decades, especially with women attending school. However, female school attendance is still below males' although it has improved over the past few years. Increasingly more women are running households, namely in urban areas. This evolution may be perceived as some form of emancipation for women, yet it often places them in difficult situations. Many women are compelled to develop survival strategies because they often have to take care of their children's education, and sometimes meet the needs of parents. This leads them on a continuous search for jobs, particularly in the non-formal sector, which results in repeated home changes and in many instances prostitution.
The consequences of AIDS are all the more significant for women as they often attend to many duties in the family. The epidemic affects them disproportionately, not only as persons infected by the virus, but also as carers of other affected members of the family. Whether it is the woman or her husband who has AIDS, important changes occur in the distribution of roles within the family and in ways of caring for the children. When women fall sick or are overloaded with work due to the husband's sickness, they call upon other members of the family (especially grandparents) for care to the children and, sometimes, pay for their schooling. This is not new but AIDS has the capacity to boost the phenomenon.
Moreover, when a relative falls sick, women are the ones to extend care both at home and at the hospital. This task is all the more difficult when it comes to AIDS, as it may affect women's own productive capacities. Indeed, it is women's responsibility, especially in rural areas, to care for the family and take on related domestic chores such as fetching wood and water, cooking, etc., as well as providing most of the food for subsistence. With the advent of AIDS, task distribution within the household, where men used to produce cash crops for export (coffee, cotton, cocoa, etc.) changes. In fact, if the woman falls sick, she can no longer ensure production of subsistence crops. If in order to replace her affected husband, she is compelled to channel her activities more toward cash-generating ventures to meet family needs, in particular health expenses, the family may therefore be exposed to food shortages Other production arrangements will be necessary which, contrary to the first scenario, may cause the dropping off of cash crops in favor of subsistence production. However, those arrangements may also call for the use of additional labor, namely child labor. Finally, when the husband dies, many women who were already deprived of the right to land inheritance and are additionally stigmatised by the community, are compelled to adopt personal survival strategies that put them at risk of expanding the epidemic. Due to some traditional inheritance laws, a widow can find herself separated from her children and denied access to family resources.
WHAT STRATEGIES COULD POSSIBLY HELP REDUCE WOMEN'S VULNERABILITY TO THE HIV INFECTION?
A vulnerable woman has neither the means nor the power to control or reduce the risk of being HIV-infected. However, because she is biologically, socially, and economically vulnerable does not necessarily imply that she cannot be protected or provided with the means to protect herself.
Reducing vulnerability could be achieved through the following:
· improving girl's access to the formal school system;
· developing prevention methods that women can comprehend;
· Reinforcing women's financial independence, i.e., multiplying and strengthening training opportunities for women, credit programs, savings mechanisms and women's co-operatives, and combining such initiatives with AIDS prevention activities. For instance, UNAIDS is supporting an initiative of women fish sellers in Zambia which is about to set up a co-operative that will extend interest-free loans to the women. Thus, they will not need to offer sexual favours to fishermen or truckers to get their fish or transportation, as was previously the case.
· Developing prevention, counselling and appropriate care services: availability of condoms and STD care in places and in an environment that is comfortable and supportive to women.
In order to reduce vulnerability, policies have to change, i.e., there is a need for an environment that strengthens women's capacity to protect themselves and their communities from the virus. This presupposes some reforms at the community and national level, in order to safeguard women's basic rights and to improve their economic autonomy.
- African Populations and AIDS. Supervised by JACQUES VALLIN, Editions La Decouverte/CEPED, 1994, pages 195-198.
- Reducing Women's Vulnerability to the HI V infection. Viewpoints. UNAIDS.
- AIDS and the Development of Africa. World Bank publication, Africa Region.