Approximately 36.7 million people are living with HIV worldwide. Great progress has been made over the last 15 years to increase the availability and acceptability of HIV services, expand access to life-saving treatment and develop new prevention technologies. Yet achieving the global goal of ending the AIDS epidemic by 2030 will require an accelerated approach. Women, girls and key populations most at risk of HIV are at the heart of this approach.
Gender plays an important role in the HIV epidemic. Around the world, women are disproportionately affected by HIV. Because of their biological makeup, women and girls are more susceptible than men to sexually transmitted infections, including HIV. In many countries, expectations about women’s roles – in relationships or at home – limit their ability to control their sexual lives and protect themselves from harm. Violence against women and girls also makes them more vulnerable to HIV. If women fear being abused by their partners, they’re less likely to get tested for the virus. That fear can also hinder women who are HIV-positive from seeking counseling or disclosing to their partners that they are infected. Meanwhile, women’s low status in some countries hampers them from earning an education, leading a business or owning property – opportunities that can give women more of a voice in their relationships, at home and in their communities. With such power, studies show they are less likely to become infected with HIV.
Men and boys face unique risks, too, primarily because some feel pressured to have multiple sexual partners, which increases their vulnerability to infections. Still, the continued spread of HIV remains largely driven by inequalities between women and the men in their lives. The gender imbalance is particularly apparent in sub-Saharan Africa, where HIV prevalence is highest. Among reproductive aged adults in 2015, 25 percent of all new infections occurred among adolescent girls and young women aged 15-24 and 56 percent among women 25 and older. While HIV and AIDS remain the leading cause of death among women ages 15 to 44 in 2016, according to the World Health Organization, greater declines in AIDS-related deaths have occurred among women than men over the last few years.
In other parts of the world, social inequality and discrimination put key populations — such as men who have sex with men, sex workers, transgender people and people who inject drugs—at a greater risk for HIV. In these contexts, repressive legal environments and other human rights violations make it difficult to access and engage key populations in HIV services.
While women, girls and key populations in developing countries may be among those most vulnerable to HIV, they are also the key to an effective response. The last three decades has demonstrated the effectiveness of empowered communities claiming their rights to treatment access, appropriate prevention technologies and policies that protect those most vulnerable from HIV.
Jennifer Abrahamson writes about Joyce, an 18 year-old girl
ICRW was among the first organizations in the early 1990s to call attention to how gender inequality fueled the transmission of HIV and AIDS among women. ICRW also played a critical role in understanding how stigma and discrimination has fueled the epidemic around the world.
Today, ICRW continues to push the HIV agenda forward, contributing evidence to remove human rights barriers to prevention, care and treatment services. and improve access, acceptability and quality of services. As the global response moves from a focus on crisis management into a sustained, long-term strategy to end AIDS within a generation, ICRW provides evidence-based solutions to better serve the needs of women, girls and key populations most at risk for HIV.
We work with partners to design, monitor and evaluate the effectiveness of programs to shift harmful gender norms, integrate services like HIV testing and gender-based violence screening, and ensure that women are able to access and use biomedical prevention options that work for them. Ultimately, we strive to influence national policies by guiding governments and others on how to address harmful gender norms, gender inequality, stigma, discrimination and other human rights violations that impede access to and engagement in HIV prevention, care and treatment services.