PARIS, Nov 29 (AFP) - No-one is immune to HIV. But this is not to say the peril is equal, for some people are at greater risk of getting infected by the AIDS virus than others.
That inequality dominates World AIDS Day on Wednesday, which this year campaigns on a phenomenon that has stunned even hardened fighters in the AIDS war: the rampaging advance of AIDS and HIV among women and girls.
Of the 39.4 million people with AIDS or the human immunodeficiency virus (HIV) around the world, 47 percent are female, an increase of six percentage points since 1997, according to new UN estimates.
In sub-Saharan Africa, by far the worst-hit region, 57 percent of cases are female. In the 15-24 age group, more than three out of every four infections occur among women and girls.
Other regions are also seeing alarming increases among females, in a shift away from the male intravenous drug users or gays who previously comprised the vast majority of infections.
In Eastern Europe, Central Asia and Latin America more than a third of people with HIV/AIDS numbers are now female. In Southeast Asia, 30 percent of adults (up from 28 percent in two years) and 40 per cent of young people living with HIV/AIDS are women and girls.
One reason for this disturbing trend is that women may be physiologically more vulnerable to HIV than men.
Young teenage girls and women beyond the menopause have thinner layers of vaginal mucus than women who are in the plateau of their reproductive years, some studies suggest.
The mucus acts as a lubricant in intercourse, protecting the vagina from abrasion, and it is also a partial immune barrier. Less mucus means less of a protection against tiny cuts that help HIV to enter the bloodstream through infected semen.
Added to this is a host of social, legal and moral problems that beset women.
These can be nightmares to resolve, for they touch on sexual taboos, marital tradition, deep poverty and age-old gender roles.
Risks to women include these:
- INFECTION BY HUSBANDS: Men who get infected by prostitutes and then hand on the virus to their wives are one of the biggest transmitters in the global AIDS crisis, especially in Asia.
A Thai study shows how quickly this channel works. In 1992, 90 percent of new infections in Thailand occurred between sex workers and their clients; by 2002, 50 percent of new infections were occurring between spouses, as the current or former clients of prostitutes infected their wives.
"For most women, the major risk factor for HIV infection is being married," is the acerbic comment of AIDS specialists Elizabeth Reid and Michael Bailey, in a study published by the UN Development Programme (UNDP).
- COERCIVE SEX AND MALE VIOLENCE: In many countries, particularly in Africa, women are expected to be submissive and cannot refuse intercourse or unprotected sex with their husband. Women who are assaulted this way are likely to get little help from police or even the law.
- MALE MYTHS AND MACHISMO: The superstition prevails in Africa and also parts of Asia that having sex with a virgin will rid a man of the AIDS virus.
African men are often loath to wear a condom, saying this will spoil their pleasure, and in some cultures, men prefer unlubricated "dry sex", a practice blamed for causing vaginal abrasions that heighten the infection risk.
- POVERTY, IGNORANCE AND DISCRIMINATION: The deepest-rooted problems of all. Lack of resources, scant opportunities for work and poor self-esteem drive many young women into prostitution or a relationship with an older or wealthier man who may be infected.
Ignorance about sexual health is another potential killer. In many poor countries where males are favoured, women suffer unequal access to education and medical care, which thus places them at risk.
"Women are suffering multiple vulnerabilities," says Thoraya Ahmed Obaid, executive director of the UN Population Fund (UNFPA).
"The social and economic empowerment of women is key. The epidemic won't be reversed unless governments provide the resources needed to ensure women's rights to sexual and reproductive health."
041129
AF0411C6
©AFP 2004.. All Rights Reserved. AFP articles contained on the AEGiS web site may not be reproduced, distributed, transmitted, displayed, published or broadcast without AFP's prior written permission. You may make one copy of each article for your personal, non-commercial use only; more copies would require AFP's prior written permission. http://www.afp.com/
AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted grants from Boehringer Ingelheim, Elton John AIDS Foundation, the National Library of Medicine, Bridgestone Firestone Trust Fund, and donations from users like you. Always watch for outdated information. This article first appeared in 2004. This material is designed to support, not replace, the relationship that exists between you and your doctor.
©1990, 2004 - AEGiS. AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.
