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close this bookGender and HIV (Best Practice Collection - Technical Update) (UNAIDS, 1998, 12 p.)
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Open this folder and view contentsThe Challenges
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At a Glance

· Whereas sex is biological, gender is socially defined. Gender is what it means to be male or female in a certain society as opposed to the set of chromosomes one is born with. Gender shapes the opportunities one is offered in life, the roles one may play, and the kinds of relationships one may have - social norms that strongly influence the spread of HIV.

· For women, risk-taking and vulnerability to infection are increased by norms that make it inappropriate for women to be knowledgeable about sexuality or to suggest condom use; the common link between substance use and the exchange of sex for drugs or money; and the resort to sex work by migrant and refugee women and others with family disruption.

· For men, risk and vulnerability are heightened by norms that make it hard for men to acknowledge gaps in their knowledge about sexuality; the link between socializing and alcohol use; the frequency of drug use, including by injection; and predominantly male occupations (e.g. truck-driving, seafaring, and military) that entail mobility and family disruption.

· For young people, norms that discourage access to information and services for safer sex; prescribe the preservation of female virginity (which may encourage alternative practices such as anal sex); and that pressure young males to have early and repeated sexual “conquests” also increase the risk and vulnerability to infection.

· In cultures where HIV is seen as a sign of sexual promiscuity, gender norms shape the way men and women infected with HIV are perceived, in that HIV-positive women face greater stigmatization and rejection than men. Gender norms also influence the way in which family members experience and cope with HIV and with AIDS deaths. For example, the burden of care often falls on females, while orphaned girls are more likely to be withdrawn from school than their brothers.

· Hence, responses to the epidemic must build on an understanding of gender-related expectations and needs, and may need to challenge adverse norms.

· For example, people should be assisted in identifying unhelpful norms and sharing personal prevention strategies. Affordable female condoms and the development of microbicides can reduce women’s vulnerability. Health care for sexually transmitted diseases (STDs), which magnify HIV transmission if untreated, should be geared to the specific needs of young and adult men and women. The reproductive rights of women with HIV should be protected, and men encouraged to care for those with AIDS.

· To reduce vulnerability through social transformation, partnerships should be created with those working outside the AIDS field to raise women’s status, reduce coercive or violent sex, and support family integrity among migrants and mobile workers.