Looking at complicating non-biological issues in women with HIV

Abstract

Introduction:The increasing number of women acquiring Human Immunodeficiency Virus (HIV) has resulted in a ‘feminization’ of the epidemic. In this article we are reviewing whether females are disadvantaged in the epidemic, due to factors independent of the biological differences in sexes.Materials and Methods:We searched MEDLINE and EMBASE for articles with key words ‘Women’, ‘Gender,’ and ‘HIV’ in any field. The search was restricted to articles published in English within the last 10 years (1999-2009). Data were coded independently by two reviewers from 94 selected sources. The coded data were categorized under five commonly encountered concepts; violence, poverty, gender norms, prevention-/treatment-related issues, and Highly Active Anti-Retroviral Treatment (HAART).Results:The link between inter-partner violence (IPV) and HIV risk for women is observed by many authors. In assessing the link between poverty and HIV, indicators such as food insufficiency and income inequality may be better indicators compared to wealth itself. Although women are disadvantaged with male-dominated gender norms, evidence suggests that the traditional norms are changing in many societies. A positive association between living in urban communities, education, and better HIV knowledge has been observed in females, although it is not always synonymous with reduced risk behavior.Conclusions:Women are still disadvantaged in many HIV-related issues such as poverty, violence, and gender norms. At least in Africa, there is evidence of a positive change in spheres of education and gender norms. However, the situation in Asia is largely unexplored.

HIV-Testing Rates and Testing Locations Among Women Who Have Experienced Intimate Partner Violence

“…Also congruent with earlier studies (Belle, 1990;Goodman, Smyth, Borges, & Singer, 2009;Sorenson et al, 1996), our findings showed that a lower socioeconomic status was associated with women's risk of experiencing IPV. Potential explanations for this pattern include psychosocial stressors such as poverty, social isolation, homelessness, and unemployment, which have been found to be associated with HIV risk and IPV (Rodrigo & Rajapakse, 2010;Zierler et al, 2000). Additional efforts must be made to reach this population because the problems associated with poverty might limit access to quality health care, HIV testing, and HIV-prevention education (CDC, 2006).…”

Understanding intra-vaginal and labia minora elongation practices among women heads-of-households in Zambézia Province, Mozambique

“…The magnitude of risk for HIV and STI acquisition among women in sub-Saharan Africa (SSA) is unparalleled (World Health Organization 2011, Magadi 2013). In some parts of SSA, young women have an HIV prevalence eight times higher than men, and the gap in infection prevalence continues to widen (Rodrigo and Rajapakse 2010, Rodrigo and Rajapakse 2010, Stöckl, Kalra et al 2013). Researchers postulate several hypotheses for this gender discrepancy including: early sexual debut among girls (Pettifor, Measham et al 2004, Hallett, Lewis et al 2007), genital inflammation due to untreated STIs (Freeman, Weiss et al 2006, Boily, Baggaley et al 2009, Masson, Passmore et al 2015), bacterial vaginosis (BV) (Myer, Kuhn et al 2005, Chersich and Rees 2008, Hilber, Francis et al 2010, Low, Chersich et al 2011, Cohen, Lingappa et al 2012), intra-vaginal cleaning and tightening practices (Myer, Kuhn et al 2005, Bagnol and Mariano 2008, Hilber, Francis et al 2010, Turner, Morrison et al 2010); and/or high incidence of sexual assault (Abrahams and Jewkes 2010).…”