The effect of women's property rights on HIV: a search for quantitative evidence

Abstract

In recent years efforts to reduce HIV transmission have begun to incorporate a structural interventions approach, whereby the social, political, and economic environment in which people live is considered an important determinant of individual behaviors. This approach to HIV prevention is reflected in the growing number of programs designed to address insecure or nonexistent property rights for women living in developing countries. Qualitative and anecdotal evidence suggests that property ownership may allow women to mitigate social, economic, and biological effects of HIV for themselves and others through increased food security and income generation. Even so, the relationship between women's property and inheritance rights (WPIR) and HIV transmission behaviors is not well understood. We explored sources of data that could be used to establish quantitative links between WPIR and HIV. Our search for quantitative evidence included (1) a review of peer-reviewed and "grey" literature reporting on quantitative associations between WPIR and HIV, (2) identification and assessment of existing data sets for their utility in exploring this relationship, and (3) interviews with organizations addressing women's property rights in Kenya and Uganda about the data they collect. We found no quantitative studies linking insecure WPIR to HIV transmission behaviors. Data sets with relevant variables were scarce, and those with both WPIR and HIV variables could only provide superficial evidence of associations. Organizations addressing WPIR in Kenya and Uganda did not collect data that could shed light on the connection between WPIR and HIV, but two had data and community networks that could provide a good foundation for a future study that would include the collection of additional information. Collaboration between groups addressing WPIR and HIV transmission could provide the quantitative evidence needed to determine whether and how a WPIR structural intervention could decrease HIV transmission. Keywordsownership; socioeconomic factors; sexism; HIV infections/prevention and control; intervention studies; transmission; widowhood; condoms/utilization; wills; prostitution; food supply; income * Corresponding author: ktumlin@email.unc.edu. NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptMany HIV prevention efforts are focused on biomedical technologies and the promotion of individual behavior change. However, a large and growing literature suggests that contextual factors such as the social, political, and economic environments in which people live, also play an important role in HIV transmission (Amon & Kasambala, 2009;J. Auerbach, 2009;Blankenship, Friedman, Dworkin, & Mantell, 2006;Cohen, Scribner, & Farley, 2000;Gupta, Parkhurst, Ogden, Aggleton, & Mahal, 2008;Kippax, 2008;Whelan, 1998). Structural interventions address circumstances beyond an individual's control, with the goal of transforming the living conditions that shape risks, opportunities, and choices (Cohen et al., ...