Women and HIV

“HIV and AIDS is not a democratic disease. It infects selectively. It discriminates easily. It victimises readily. It shows this in the people it infects and the communities it affects in Zambia and several of the countries of sub-Saharan Africa. Most of all, it shows its discriminatory character in its preferential option for women and girls.”

Michael J Kelly 6:2010 TIWHH

In the initial reports of the spread of HIV, men appeared to be more infected. More recently though, it is women who have become more vulnerable to the virus, especially in countries where the primary mode of transmission is through heterosexual intercourse. It is undeniable that now, more than ever, HIV and AIDS is a ferocious attack on women, most notably on women in sub-Saharan Africa where, according to UNAIDS, HIV rates are higher among women than men. Of the 22.5 million adults currently living with HIV in sub-Saharan Africa, 57% are women. In this region, women aged between 15 and 24 years are three times more likely to become infected than men of a similar age. This increase in the number of women and girls becoming infected at ever younger ages is now referred to as the ‘feminisation of HIV and AIDS’. This reality is not simply devastating for the women affected and infected; it impacts all at a variety of fundamental levels on society in general, with consequences for the future development and well-being of individuals, families, communities and countries.

The negative impact of the virus on the lives of women is more severe than that of men principally due to their subordinate status in society – for example, how the majority of women do not have any power in terms of making household decisions, including during sex. In many sub-Saharan African countries the sustainability of women’s unequal status leaves them vulnerable to poverty discrimination and violence and, ultimately, to HIV infection.

Women’s subordinate position in society is not only an obstacle for their empowerment, but this position also compounds their vulnerability to HIV and AIDS. There are a number of vulnerabilities for women to the disease – biological, economic, educational, legal and sociocultural. There appears to be an intrinsic link between these vulnerabilities and fundamental gender inequalities as one perpetuates the other, and therefore leads to women’s disempowerment overall which we will now discuss in the following section.

Vulnerabilities affecting women:

  • Bio-medical
  • Economic
  • Educational
  • Social and Cultural
  • Legal

Bio-medical Vulnerabilities

During sexual intercourse, women are physically more vulnerable to infection than men. This is due to the fact that women’s genitalia consist of fragile tissues which, during sexual intercourse, are exposed to large volumes of high-risk bodily fluids. The mucous membranes on the cervix of the uterus are especially vulnerable to sexually transmitted infections such as HIV. Teenage girls are particularly more vulnerable due to the susceptibility of their immature cervix and genital tract to tearing, lacerations and subsequent infection during intercourse – with this risk doubling during and just after pregnancy. Male to female HIV transmission is 7 times more likely than female to male transmission, a fact that is referred to by some as ‘biological sexism’. It is also more difficult for women to tell if they have a sexually transmitted infection than a man. This can bring a ten-fold increase in the risk of HIV infection during sexual intercourse.


As a result of many traditional practices; of women’s generally subordinate position in society; of the fact that they are physically more vulnerable to infection; of poor ‘capacity building’ life skills (such as reading and writing); of little effective legal knowledge or protection, women become heavily dependent on men. This reality disempowers women and makes them more vulnerable to HIV infection. It becomes more difficult for women to negotiate safe sex for the fear that economic support will be removed or will disappear, or they will be violently abused – this is especially true for married women in sub-Saharan Africa and thus married women as a group are more vulnerable to HIV and AIDS. Violence against women is of particular concern in countries with high prevalence rates, such as Zambia, as studies have suggested that the rate of transmission is much higher for women in abusive relationships. Women’s lack of access to a basic education generally deepens gender inequalities leaving many women uneducated or ill-informed as regards issues such as the transmission of HIV and protecting themselves.