Women are in nature more vulnerable than men to HIV infection. "Rainbow Nari O Shishu Kallyan Foundation" has found that male to female transmission appears to be 2 to 4 times more efficient than female to male transmission, in part because semen contains a far higher concentration of HIV than vaginal fluid. Adolescent girls are predominantly vulnerable.
Their immature cervixes and low vaginal mucus production presents less of a barrier to HIV infection. The developing world is now bearing the full brunt of the human immunodeficiency virus (HIV) epidemic. More than 90 per cent of new infections are in the developing countries and the virus has spread to most areas. In many areas of sub-Saharan Africa, where infection has been prevalent for a decade or more, HIV has already become the leading cause of adult illness and death. Similarly profound changes in the patterns of the disease and death are likely in those regions of Asia and Latin America where the virus has more recently become epidemic.
Most parts of the world have reported cases of HIV infection and AIDS. Although Sub Saharan Africa is the worst affected region, containing perhaps three-quarters of all cases, the virus is now spreading most rapidly in India and South-East Asia. Heterosexual and vertical transmission of the virus has resulted in its wide distribution in the general population, in sexually active adults and adolescent.
The economic disparity, gender discrimination, social and physical right imbalance between men and women contribute to the lack of safety in sexual relationships and the difficulty for many women in negotiating safer sex.
To do so may have serious repercussions, ranging from stigma to fear of violence or desertion. The right differential between men and women is compounded by age differences. Women naturally marry or have sex with older men, who have been sexually dynamic longer and are more possible to have become infected.
Men are also beginning to seek younger sexual partners believing that these girls are less likely to be infected with HIV. The majority infections take place in infants or young children, adolescent and sexually active adults. Women tend to become infected on average 5 to 10 years earlier than men. Women also have a higher risk of acquiring infection which may, in East Africa, be from 1.2 to 1.5 times greater in females than males. Most adults who die are economically active and have many dependants. Major social and economic problems are emerging: orphans, changes in the dependency ratio, loss of skilled and unskilled labour.
Women are vulnerable to coerced sex, including rape and other sexual abuse -- within and outside the family -- and forced sex work. Any non-consensual or coerced penetrative sex can carry an increased risk of HIV transmission, particularly as men are not likely to use condoms in these situations.
Subordination in education, employment, social and legal status makes women more vulnerable to HIV/AIDS. Women who have limited access to financial resources are more likely to become economically dependent on men, relegated to the subsistence sector or forced into commercial sex work.
The writer is Senior Section Officer, Institute of Social welfare and Research, Dhaka University