Addressing gender inequalities to improve the sexual and reproductive health and wellbeing of women living with HIV

Abstract

IntroductionGlobally, women constitute 50% of all persons living with HIV. Gender inequalities are a key driver of women's vulnerabilities to HIV. This paper looks at how these structural factors shape specific behaviours and outcomes related to the sexual and reproductive health of women living with HIV.DiscussionThere are several pathways by which gender inequalities shape the sexual and reproductive health and wellbeing of women living with HIV. First, gender norms that privilege men's control over women and violence against women inhibit women's ability to practice safer sex, make reproductive decisions based on their own fertility preferences and disclose their HIV status. Second, women's lack of property and inheritance rights and limited access to formal employment makes them disproportionately vulnerable to food insecurity and its consequences. This includes compromising their adherence to antiretroviral therapy and increasing their vulnerability to transactional sex. Third, with respect to stigma and discrimination, women are more likely to be blamed for bringing HIV into the family, as they are often tested before men. In several settings, healthcare providers violate the reproductive rights of women living with HIV in relation to family planning and in denying them care. Lastly, a number of countries have laws that criminalize HIV transmission, which specifically impact women living with HIV who may be reluctant to disclose because of fears of violence and other negative consequences.ConclusionsAddressing gender inequalities is central to improving the sexual and reproductive health outcomes and more broadly the wellbeing of women living with HIV. Programmes that go beyond a narrow biomedical/clinical approach and address the social and structural context of women's lives can also maximize the benefits of HIV prevention, treatment, care and support.

The Effect of Stress Management Training on Stigma and Social Phobia in HIV‐positive women

“…The participants in this study were 55 HIV-positive women referring to the Shohada Comprehensive Health Center in Hamadan. The high mean of the stigma (119.98) before the intervention indicates that stigma is one of the most important health problems in HIV-positive women.Our findings are consistent with previous studies[ Amin et al (2015) asserted that stigma, discrimination, poor social support, violence, and mental health problems (e.g., depression and neurological disorders) are big challenges for people with HIV, especially for women[ 28] Baugher et al (2017). reported that nearly 8 out of every 10 people with HIV experienced stigma.…”

How Are Gender Equality and Human Rights Interventions Included in Sexual and Reproductive Health Programmes and Policies: A Systematic Review of Existing Research Foci and Gaps

“…This context includes gender inequality as a determinant on its own and in combination with other social and economic inequalities including: unequal power dynamics in interpersonal relationships, harmful gender and other socio-cultural norms and practices, limited economic circumstances, lack of access to education, limited employment opportunities, poor living conditions, disability, ethnicity, as well as the challenging political and legal environments where they live[1]. Studies have shown that harmful gender norms that promote male dominance over women prevent women from practicing safer sex, limit their use of contraceptives, and increase their risk of STIs, including HIV[2]. Similarly, research has also shown a relationship between violation and neglect of human rights and negative health outcomes and emphasizes the need to better integrate human rights approaches into interventions, particularly with attention to provider training, service delivery, raising awareness and capacity building[3, 4].…”

"Demand what you prefer": the role of sexual assertiveness among HIV-infected women

“…These women are more prone to engage in unwanted sexual activities, and they also have little likelihood of experiencing safe sex. In addition, the stigma associated with HIV and consequent employment issues cause financial insecurity and related consequences (Amin, 2015;Robinson et al, 2017). In our setting, we found significant differences between assertive and non-assertive groups in terms of pregnancy experience, having live children, and number of children.…”