 |
|
|
The Other Face of AIDS |
|
By Noeleen Heyzer *
In many countries, women are powerless to reject unwanted sexual relations. The AIDS epidemic is profoundly linked to gender differences, says the executive director of UNIFEM.
NEW YORK - There is a growing awareness worldwide that the HIV/AIDS epidemic is less about infection and more about social factors. While the disease is a health issue, the epidemic is a gender issue.
While the disease itself is a health matter, the epidemic is an issue related to the social differences between women and men.
In Africa, for instance, the epidemic is not a gender issue simply because 55 percent of those affected are women, or because in many parts of sub-Saharan Africa teenage girls are infected at a rate of 5 or 6 times higher than their male counterparts.
Nor is it a gender issue because the percentage of people worldwide living with HIV/AIDS that are women jumped from 41 percent in 1997 to 47 percent in 2000.
The epidemic is a gender issue because in many countries it is unacceptable for women to say ''No'' to unwanted and unprotected sex. Cultural beliefs, practices, and values run so deep that women are silenced from making this simple life-saving demand.
Of the strategies being promoted to reverse the epidemic, the use of condoms is critically important. However, millions of women around the world - regardless of geography, education or class - are unable to negotiate safe sex without fearing reprisals, which can vary from anger and accusations, to violent abuse and rape. Both men and women are socialized to believe that men have a right to have sex with their wives, regardless of their desires.
In the June 2000 UNAIDS global report, a study in Zambia confirmed how much subservience in marriage, often reinforced by violence, can compromise women's ability to protect themselves.
Fewer than 25 percent of the women in the study believed that a married woman could refuse to have sex with her husband even if he had been demonstrably unfaithful and was infected. And only 11 percent of the women thought that a woman could even ask her husband to use a condom in these circumstances, let alone insist on its use.
Promoting condom use will accomplish little unless women are able to say ''No!'' and be both heard and respected.
Women's knowledge of their own reproductive system is often scanty. The belief that women should be virgins at marriage is widespread, and with it comes the view that knowledge of sex and reproduction means that women must have been sexually active.
Moreover, treatment for all those infected with the virus must be designed with a gender perspective in mind. Access to treatment is a privilege that men enjoy far more than women. Stories abound in Africa in which families deplete their resources in order to buy drugs for the male head of household, only to be left in abject poverty after his death.
It is also important to take gender into account when devising ways of distributing drugs. For instance, in one country that UNIFEM studied, in principle AZT was provided to everyone, but it was distributed through the formal labor sector. As most of the women work in the informal sector, they were unable to get the drugs.
Other strategies for responding to the epidemic involve community support, which could more aptly be described as ''support from women''. It is the women, because of their culturally prescribed roles and responsibilities in the household, who are the primary caretakers for their sick husbands, their children and increasingly their orphaned grandchildren.
Their unpaid labor subsidizes the social welfare and health sectors in their countries. At home, many women who care for their HIV positive relatives do so without wearing gloves and with limited knowledge of how the virus is transmitted or how they could best protect themselves.
Finally, while stigmatization and discrimination are a daily reality for people living with HIV/AIDS, the communities themselves are likely to tolerate an infected man. Many women are physically and emotionally abused when their positive status is revealed.
Unless gender inequality, which derives from power relations, is specifically addressed in every strategy, policy, and program - from the global and governmental level to the community and family level - efforts to reverse the epidemic will be stalled. It is not simply a matter of justice or fairness: gender inequality is fatal.
* Noeleen Heyzer, Executive Director of the United Nations Development Fund for Women (UNIFEM).
|
