|Agenda for Action: Background Materials to the 4rth World Conference on Women (UNAIDS, 1995, 9 p.)|
Because women are sexually, economically and biologically vulnerable to HIV/AIDS, they are often stigmatized and blamed for causing HIV/AIDS and other STDs. Women are frequently identified as reservoirs of infection or as vectors for transmission to their male partners and their offspring. This inaccurate view is actually harmful in a number of ways: it fails to focus on mens equal responsibility to prevent HIV/AIDS; it prevents programmes from developing services which meet the needs of women; and it underlies some research and intervention strategies which have been designed more to protect men from women than to enable women to protect themselves.
Many people assume that if a woman has HIV infection, she has had multiple partners or engaged in prostitution and that such behaviour marks her as a bad woman. As a result of this social stigma associated with HIV infection, women known or thought to be infected have been dismissed from their jobs or not hired, evicted from their homes, abandoned by their husbands or other long-term partners, and denied the custody of their children. In addition, women perceived to be at risk of HIV infection have been denied health insurance, and health care personnel have refused to treat women they thought were or might be infected.
All the gender issues we had never tackled came up at once, says Theresa Kaijage, a founding member of the Tanzanian AIDS Service Organization called WAMATA. Initially we ignored them or thought they were irrelevant. We thought it was Eurocentric to tackle them in Africa. We thought our African culture was different and dealt with things in a different way. All the agendas that we had ignored legal, educational and health problems, inequitable gender relations suddenly we are dealing with these multiple issues, which people have not learned to analyze in a way that promotes equal sharing of both resources and power at all levels. In order to deal with AIDS, we have had to confront these.
Some countries have implemented mandatory testing schemes targeting women. Women who test positive or who are suspected of being infected suffer from increased discrimination, random and institutional violence, arrest, incarceration, and deportation. Most often such testing is without the womans informed consent, and without appropriate pretest and post-test counselling.
Perinatal transmission can occur during pregnancy, during the delivery, or as a result of breast feeding. About 30% of children born to women with HIV acquire HIV infection; consequently women infected with HIV are sometimes pressured not to become pregnant or to be sterilized, or if they are already pregnant, to terminate their pregnancies. Women infected with HIV who wish to prevent conception or terminate a pregnancy may have little access to contraceptive measures or to safe abortion, increasing the likelihood that they will either bear an unwanted child or risk their lives in unsafe, illegal abortions.
Most societies rely on women to be voluntary caregivers for their families, as well as occupational caregivers for the community. Older women may be expected to assume a major care giving responsibility at the same time that adolescent daughters may be kept out of school to care for younger children or other family members who are ill. The expectation that women will provide most of the care for people with HIV infection and AIDS results in high stress, especially if such care must be provided in addition to other work, including paid work outside of the home and family-centred work, such as subsistence farming. Such stress is compounded when the women become ill themselves, often with no one to care for them.