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As the only journal focused specifically on social work in HIV care, Journal of .. drug use, bivariate correlates of HIV risk included: older age, female gender.
Table of contents
- You are here
- Global information and education on HIV and AIDS
- HIV / AIDS : Social and Ethical Issues
- HIV and AIDS social issues | AVERT
Young women years , and adolescent girls years in particular, account for a disproportionate number of new HIV infections. Even in regions such as Eastern Europe and Central Asia, where the population most affected by HIV is injecting drugs users, the majority of whom are men, women make up a rising proportion of people living with HIV. In Russia, for example, the number of young women living with HIV aged is double that among men of the same age. HIV disproportionately affects women and adolescent girls because of their unequal cultural, social and economic status in society.
Intimate partner violence, inequitable laws and harmful traditional practices reinforce unequal power dynamics between men and women, with young women particularly disadvantaged.
HIV is not only driven by gender inequality, but it also entrenches gender inequality, leaving women more vulnerable to its impact. In some countries, women face significant barriers to accessing healthcare services. These barriers occur at the individual, interpersonal, community and societal levels. This can lead to women choosing to have an abortion because they are misinformed about their options and how to protect their health as well as their child's. Additionally, in 29 countries women require the consent of a spouse or partner to access SRH services.
In many settings, where SRHR and HIV services exist, they are primarily for married women with children and do not meet the specific needs of unmarried young women and adolescent girls. Healthcare providers often lack the training and skills to deliver youth-friendly services and do not fully understand laws around the age of consent.
As a result, service providers were often reluctant to provide SRH services to unmarried but sexually active young people, and unmarried young people were too ashamed or afraid to ask for help. Age-restrictive laws, such as those that ban contraception under a certain age, also act as barriers to SRHR and HIV services for young women.
Adolescent girls and young women belonging to key affected populations are also negatively affected by laws that criminalise injecting drug use, sex work and homosexuality. Studies have shown that increasing educational achievement among women and girls is linked to better SRH outcomes, including delayed childbearing, safer births and safer abortions. However, many young people who are in school do not receive adequate HIV and sex education.
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The poorest women may have little choice but to adopt behaviours that put them at risk of infection, including transactional and intergenerational sex, earlier marriage, and relationships that expose them to violence and abuse. Poorer and less-educated women may be less knowledgeable about risks and therefore less able to adopt HIV risk-reducing behaviours. The risk of trafficking and sexual exploitation is also higher for young women and adolescent girls living in poverty.
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Food insecurity, often linked to poverty, acts as a barrier to treatment for women living with HIV. This increases both the risk of HIV advancing and onward transmission.
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There is evidence that shows that cash transfers to young girls can improve their SRH outcomes, empowering them and helping them to stay in school. Intimate partner violence and gender based violence prevents many women, particularly young women, from protecting themselves against HIV. Intimate partner violence has been identified as a key driver of HIV transmission in east and southern Africa. It is estimated that around half of adolescent girls aged 15—19 in Namibia will experience intimate partner violence.
Gender based violence, a physical manifestation of gender inequality, has been shown to act as an important barrier to the uptake of HIV testing and counselling, to the disclosure of HIV-positive status, and to antiretroviral treatment ART uptake and adherence, including among pregnant women who are receiving ART as part of services to prevent mother-to-child transmission PMTCT.
Age-disparate sexual relationships between young women and older men are common in many parts of the world, with particularly high levels in both East and Southern Africa and West and Central Africa. In many instances, these relationships are transactional in nature, in that they are non-commercial, non-marital sexual relationships motivated by the implicit assumption that sex will be exchanged for material support or other benefits. Transactional sex with an older man is more likely to expose young women to unsafe sexual behaviours, low condom use and an increased risk of sexually transmitted infections.
A long-term study of age-disparate sex and HIV risk for young women took place between to in South Africa.
Global information and education on HIV and AIDS
It is estimated that in South Africa a third of sexually active adolescent girls will experience a relationship with a man at least five years older than them. The study found a cycle of transmission, whereby high HIV prevalence in young women was driven by sex with older men on average 8. As of , around one in seven adolescent girls aged 15 to 19 in the world were married or in union.
Girls who marry as children are more likely to be beaten or threatened by their husbands than girls who marry later, and are more likely to describe their first sexual experience as forced. As minors, child brides are rarely able to assert their wishes, such as whether to practice safer sex. The risk of HIV acquisition during vaginal sex has been found to be higher for women than for men in most but not all biological-based studies.
This high susceptibility can be explained by a number of factors including the ability of HIV to pass through the cells of the vaginal lining, the larger surface area of the vagina. Adolescent girls are also susceptible to relatively high levels of genital inflammation which may also increase the risk of HIV acquisition. Due to the lower uptake of ART among men, in most countries it is likely that fewer men than women are virally suppressed, which means men are more likely to pass the virus on to others. A study conducted in Tanzania between and found the odds of HIV testing were higher among young women who were married than young women who were not.
It also found antenatal care to be an important determinant for HIV testing. Women who had given birth in the two years and received antenatal care had increased odds of getting tested compared to young women who had not given birth. Globally, adult women are more likely to be accessing antiretroviral treatment than men. Barriers to accessing care that disproportionately affected women included transportation, lack of gender autonomy, stigma, economic constraints, lack of knowledge, and gender roles.
HIV / AIDS : Social and Ethical Issues
The study found the most prevalent barrier to care experienced by women in the study was HIV-related stigma from within their own community. Nonetheless, AIDS-related illness are the leading cause of death among women of a reproductive age. Studies from Southern Africa have shown how loss to follow up a year after enrolling on ART is higher among young people compared to both adults and children.
Various factors can act as barriers to women adhering to ART including a lack of accurate information about the use of ARVs. Misunderstandings about treatment have been linked to poor adherence and loss to follow-up, increasing the chances of drug resistance and treatment failure. Intimate partner violence, which is fuelled by gender inequality, can also affect adherence. Reducing the number of unintended pregnancies among women living with HIV would reduce the number of children born with HIV. Pregnant women living with HIV are also at greater risk of dying from pregnancy-related complications than women who are not living with HIV.
HIV and AIDS social issues | AVERT
You are here Home. HIV disproportionately affects people belonging to certain populations, such as men who have sex with men and sex workers. HIV Stigma and Discrimination. Stigma and discrimination persist everywhere, and continue to prevent HIV services from reaching the people who need them most.
Homosexuality is illegal in 73 countries. As a result, many men who have sex with men face high levels of homophobia and can't access HIV services. Gender inequality and HIV. Human rights and HIV.
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