WUNRN
Young, Poor & Female in Latin America and the Caribbean
Wealth
Disparities Feminize Poverty and HIV/AIDS
Laura is a 16-year-old girl from a middle class family in Santiago del estero,
Argentina. The economic crisis of 2002 forced her to drop out of primary school
in her last year to care for five younger siblings; her mother worked all day
outside of the house to feed the family. Laura's father and two siblings left
home a few years ago and have not been heard from. Last year, at 15, she got
pregnant by her 28-year-old boyfriend, emilio, and now has a son, Rodrigo. She
knows that there are ways of avoiding pregnancy, but at the health-care center
they told her they could not give her contraceptives because she was under age.
When she got pregnant, they gave her an HIV test and that is when she found out
she was positive. It had never even occurred to her she would be infected.
Laura is typical of an adolescent girl in Latin America and the Caribbean
(LAC), who is sexually initiated by a boyfriend 10 or more years her senior,
and never imagines that she could be infected by having sex with a man she is
hoping to marry. If we were to ask her now what she fears most, without a doubt
she would say getting pregnant again, not because she is living with HIV, but
because she and emilio have no way of caring for another child. This is the
reality of many adolescent and young poor people in Argentina and other
countries in Latin America and the Caribbean.
Although countries with the most highly affected regions such as those in
sub-Saharan Africa have experienced the highest numbers of girls and women,
aged 15-24, infected by HIV, the rates of infection in this population have
already begun to climb in countries of LAC with far lower overall prevalence
rates. It is alarming that in four of Haiti's most populated counties, a
country with one of the world's largest AIDS epidemics, 4.2 percent of women,
aged 15-24, are infected with HIV, whereas males are only 2 percent. In
Honduras in 2002, the prevalence in young people was 1.5 percent in women and
1.18 percent in men; and in Guatemala, it was almost equal. In 2001, in
Trinidad and Tobago, according to the PanAmerican Health organization (PAHo),
the rate of HIV in adolescent girls and young women, aged 15-19, was five times
greater than that for boys. In Argentina since 2004, new infections in the
15-24 age group arose predominantly in women, a figure that increases when
considering the even higher rate of increase in the 13-19-year-old female
population.
Wealth Disparities Feminize Poverty and HIV/AIDS
Latin America and the Caribbean is a region with enormous wealth disparities.
even in countries with strong economic growth, the main characteristic is a
concentration of wealth among small groups and the remaining distribution among
a large number of increasingly impoverished people. In the last few decades,
the increase in poverty has mainly affected women and girls and this
feminization of poverty has translated into the feminization of HIV/AIDS. Women
who are young and poor are increasingly the face of HIV/AIDS in LAC (as well as
Africa and Asia), according to the report of the Dialogue, "Strategies for
the South: Building Synergies in HIV/AIDS and Sexual and Reproductive Health
Rights," a conference that took place in Buenos Aires, Argentina, this
May. The 2006 UNAIDS report said that 40 percent of the 3.8 million new
infections among people aged 15 and up, are between 15 and 24 years old.
Poverty is a key factor in the increase of girls' vulnerability to HIV/AIDS. A
2002-2003 study on socio-cultural factors and HIV/AIDS in Argentina developed
by FeIM within the framework of a larger multi-country study by uNeSCo and
uNAIDS, says that Argentina is a good example of the relationship between an
increase in poverty and in HIV/AIDS, as the economic crisis at the end of 2001
and early 2002 resulted in 50 percent of the population falling to a level of
poverty, and 50 percent of those to extreme poverty. The damage experienced by
poor and newly-poor families forces them to seek additional means of income
through contributions by all members of the family. often this means that
girls, and less often boys, exchange sexual favors to obtain money or goods.
Failure of Sexual and Reproductive Health Education and Services
An increase of poverty together with the promotion of consumerism among
adolescents of both sexes and the lack of access to sexual education, family
planning services, and condoms created an explosive combination that
facilitated an increase in pregnancies and HIV infection of young girls.
Adolescent pregnancy in Argentina increased specifically among the 10-14 age
group. If we consider ages 13-19, this predominance of female infection in the
15-24 age group is even higher. Also, among AIDS cases we observed the lowest
ratio (2.3:1) between men and women in the 15-24 age group, compared to the
general population (3:1).
At the end of 2002, a new sexual and reproductive health law was passed in
Argentina, creating the National Sexual and Reproductive Health Program.
Although this program theoretically provides services to adolescents of both
sexes, actual access is still scarce due to the resistance of health-care
professionals and the religious and conservative opposition to provide
contraceptive methods to adolescents without the permission of an adult. The
resistance of health-care personnel is greater in poorer provinces that are
usually characterized by a more conservative and religious opposition. The myth
that providing contraceptive methods to adolescents will promote their sexual
activity and promiscuity persists.
In Argentina, due to the sudden increase in poverty at the end of 2001,
transactional and intergenerational sex and the rising rate of rape and sexual
abuse among girls increased, making them more vulnerable to HIV. In Argentina,
60 percent of sexual abuses in 2002 occurred in girls and adolescents, most of
them in the home and perpetrated by a relative or acquaintance. So we must
recognize that the home nowadays is no longer a safe place for girls. Like
Laura, thousands of adolescent girls in Argentina and other LAC countries
became HIV infected by their unique partner. They are unable to protect
themselves because they ignored the risks and couldn't ask to use condoms.
It is urgent that governments adopt policies and interventions to develop sexuality
education for young people in the schools and in non-formal programs that reach
those who do not attend, overcoming the resistance by religious and
conservative groups.
Only in october 2006, after many attempts, a national law was finally passed in
Argentina that established sexual education at all levels without permission of
students' parents. educating girls about sexuality and safe sex are crucial
ways of decreasing the rate of infection. In the words of one Argentine AIDS
activists, without this knowledge, "we are sending them into battle
without arms."
Also, young people must be reached by campaigns and messages in the mass media
as well as face-to-face training to achieve a better rate of condom use, which
is currently low and non-existent in stable relationships. It is necessary to
continue strengthening interventions to promote the use of condoms among young
people, particularly women, including free distribution. The bottom line is
that young women must perceive their vulnerability to HIV/AIDS and they must
have access to prevention methods, to confidential/ voluntary testing and
counseling, and access to "friendly" health-care services, including
HIV/AIDS care and treatment provision.
There must also be cultural change to eliminate sexual inequality. Abstinence
only and fidelity programs are not effective for girls and women in the LAC
context of poverty and gender imbalance. Also, girls and women need to increase
the generation of income to be economically independent, an important factor in
controlling the epidemic.
Finally, policies to decrease poverty to improve the economic income of girls
and women and access to education are the best ways to slow the spread of HIV.
Religious and conservative opposition as well as economic constraints must be
defeated by governments in LAC to succeed in the fight against HIV/AIDS and to
avoid the suffering of girls and adolescents.