By James Welsh | March 26, 2013

While the impact of HIV/AIDS is highly publicized, what often receives less attention is the unequal effect this disease has on women. In 2011, the World Health Organization (WHO) estimated that 30.7 million adults were living with HIV globally. Of those, approximately half were women. Yet that percentage remains far higher in certain regions.

In sub-Saharan Africa, for instance, women make up 60 percent of infected adults. In the Middle East and North Africa, women account for 54 percent. These two regions are the only regions where infected women outnumber infected men—a major regional disparity that casts the gender divide in a new light, considering the fact that women constitute 37 percent or less of HIV-infected people across seven of the 10 regions worldwide. Therefore, the majority of people infected with HIV, which includes an overwhelming majority of women, live in Africa and the Middle East.

Inequality is a function of this uneven distribution, because access to medical care and treatment in these two regions tends to be poor. In addition, cultural biases often keep women from reporting their disease or seeking treatment. Women who report their disease are at times labeled as promiscuous and immoral, or as sex workers when this is often not the case. This can lead to a loss of social standing and ostracism.

Power imbalances between men and women in these patriarchal societies usually translate into limitations in access to services and resources. In these regions, barriers restrict women’s access to education; both material and immaterial preventive measures, such as condoms and knowledge about the benefits of abstinence; and treatment services, such as antiretroviral treatment. Typically, these women have fewer resources than men to seek prevention and treatment, and those who do may face stigmas.

Profound Gender Bias

Property rights laws in many areas of the world leave women with little if their husbands die. When HIV/AIDS is added to the inherent sexism of this picture, another major hurdle for women with the disease becomes evident. If a husband dies from AIDS, there is a chance his wife is also infected. Already possessing fewer personal resources even with a living husband, the newly widowed wife now has no resources available to find treatment.

Women also face high instances of rape and arranged marriages. Having sexual partners forced upon them leaves women—frequently young women—without the ability to choose their sexual partners. Few men have an HIV-infected partner forced upon them, but for women, this is an all too common occurrence.

Social norms about femininity in these regions prevent young women from seeking knowledge about HIV. “Only about…20 percent of young women in developing countries have comprehensive and correct knowledge about HIV,” said Bertil Lindblad, director of the UNAIDS New York Office, in a statement last year to the Commission on the Status of Women.

Norms about masculinity often drive men of all ages to find as many sexual partners as they can, usually among young women. This is why HIV rates among young adults are higher for young women than for young men.

“Women and girls continue to suffer from gender inequality and violence that put them at risk of HIV. For women living with HIV, this includes denial of their sexual and reproductive rights, including forced sterilization,” said Michel Sidibé, UNAIDS executive director, in a statement to a UN panel on HIV. “This is all the more tragic in a world where we can, and must, achieve the elimination of mother-to-child transmission in the developing world, as we have in high income countries. In many places, young people continue to have the highest infection rates and are denied the information, education and services they need to avoid HIV.”

According to UNAIDS estimates, women between ages 15-24 account for 26 percent of all new HIV cases worldwide, and more strikingly, this group accounts for 64 percent of young people globally. Worse, these numbers are higher in parts of Africa and the Middle East. An unfortunate result of the inequality regarding treatment, resources, social norms and stigmatization is the fact that HIV/AIDS is the number one killer of women of reproductive age.

Ending Inequality, Ending the Disease

Because HIV disproportionally affects women, its prevention and treatment have become salient women’s rights issues. UNAIDS (the Joint United Nations Programme on HIV/AIDS) works to reverse the spread of HIV by coordinating a global response. An umbrella organization heavily involved with efforts and organizations combating this epidemic, UNAIDS represents perhaps the best chance to defeat HIV/AIDS; it brings a global focus and coordination to the fight, while helping specific local programs make a difference on the ground with support, general care and treatment for those infected.

UNAIDS also advocates for proper HIV prevention and treatment and supports research to help ameliorate the epidemic. An outcome of UNAIDS’ efforts has been an estimated 20 percent decline in new HIV infections in the last decade.

The UNAIDS strategy for 2011 to 2015 is called “Getting to Zero.” This strategy seeks to achieve universal access to HIV prevention, treatment, care and support, and to halt and reverse the spread of HIV worldwide. The future vision of the strategy is to reach zero new infections, zero AIDS-related deaths and zero discrimination.

To end discrimination, the goal is to see that HIV-specific needs of women and girls are addressed in at least half of all national HIV responses by 2015. An additional objective is to reduce by half the countries that maintain punitive laws and practices around HIV transmission that impede effective responses.

On the Local Level

As a means of empowering women infected with HIV, UN Women supports local community-based organizations that provide a network of supportive friends and fellow women hurt by the disease. Such organizations fight to provide these marginalized women with renewed and strengthened voices, both for themselves and for HIV-positive individuals as a whole. These groups work to dispel myths about HIV/AIDS and stereotypes that demean women with HIV. They also highlight the positive contributions that those affected by the disease can make to their communities.

UNICEF, in its goal to protect children, highlights another important issue pertaining to women and HIV. Prevention of Mother To Child Transmission, or PMTCT, is an integral objective in achieving its mission. According to UNICEF, in 2009, an estimated 1,000 babies were infected with HIV every day by their mothers during pregnancy, birth or breastfeeding. Furthermore, an estimated 1.4 million pregnant women were living with HIV/AIDS in low- and middle-income countries. Of these women, only 26 percent received tests for HIV.

These chilling numbers are why, in conjunction with UNAIDS, UNICEF launched the Countdown to Zero campaign in 2011. This campaign strives both to eliminate new HIV infections among children and to keep the mothers of those children alive. Furthermore, the campaign is trying to ensure that all women, but especially pregnant women, have access to quality life-saving HIV prevention and treatment services.

Along with increasing respect for the rights of infected women and empowering them within their communities to seek HIV prevention and treatment, Countdown to Zero helps ensure that adequate resources are available to women with families affected by HIV/AIDS.

This campaign works with national and global leaders to achieve its goals and has built itself upon successful past programs. These programs from 2000 to 2010 reduced the number of newly infected infants per year by over 100,000. While there are still many hurdles, with international support, women can gain greater respect and be empowered to defend their children and families from the depredations of this terrible disease.

WHO’s Role and Treatment 2.0

A champion of the fight against HIV/AIDS, the WHO is a cosponsor of UNAIDS and has led the global health sector’s response. WHO’s Department of HIV/AIDS provides support to UN member states attempting to improve treatment, prevention and care services to their citizens. WHO also helps supply HIV commodities to countries dealing with the epidemic.

In their quest to assist, organize and enhance states’ responses, WHO and UNAIDS have launched Treatment 2.0. This initiative attempts to quicken the next phase of HIV treatment by promoting techniques that improve innovation and efficiency. The initiative focuses work in five areas: optimization of drug regimens, provision of point-of-care diagnoses, cost reduction, adaption of delivery services and mobilization of communities.

Such efforts are enabling people around the world to access better, cheaper care. In particular, cheaper care helps women in lower-income countries who are often poorer and cannot afford care at its current price. These programs help remove social pressure and stigmas that denigrate and marginalize women infected with the disease. These organizations advocate for laws that respect the rights of HIV-infected individuals, especially women in middle- and lower-income countries.

The impact of HIV/AIDS on women is disproportionately harsh due to inequalities of care, but with the help of these organizations, women can empower themselves to defeat such inequalities. In the process, women can help defeat a terrible disease and correct the state of global human rights.