Gender and HIV/AIDS

Young girls and women often confront a number of gender-based obstacles when trying to protect themselves from HIV infection.

The nature of a woman's body makes them at least 2 to 4 times more susceptible than men in contracting the disease. The threat is compounded by social, cultural, economic and legal forms of discrimination.

Poverty, low status, and unequal economic rights and educational opportunities can place women and girls at greater risk of sexual exploitation, trafficking and abuse.

Gender power relations that limit their ability to negotiate safe sex or refuse unwanted sex, are a real problem as is gender-based violence.

Gender-based violence and sexual exploitation are a reality in zones of civil wars.

Females are also threatened by certain gender norms - such as those that encourage men and boys to engage in risky, early or aggressive sexual behaviour.

Other problems include cultural practices that deprive women of a means of protecting themselves from HIV infection, including early and forced marriages.

We believe teaching healthy behaviour, tolerance, respect for the opposite sex and equality must be instilled at a young age.

Attitudinal and behavioural changes are essential to defeating the HIV/AIDS pandemic.

How impoverished mothers spread HIV to their children

For many women in the developing world, breastfeeding is the only way to feed their newborn babies. They do not have the option of using supplements. For an HIV-positive woman, breastfeeding could mean passing on a life-threatening virus to her baby.

Each year HIV infects 640,000 children worldwide. Most infections come as the result of mother-to-child transmission (MTCT) with breastfeeding accounting for 33 per cent of these transmission infections.

The World Health Organization (WHO) recommends that HIV-positive mothers avoid all breastfeeding if replacement feeding is "affordable, feasible, acceptable, sustainable, and safe." This is rarely the case. Alternative methods of feeding are often neither safe nor accessible for HIV-infected mothers. Some mothers get wet nurses to feed their infants, but these nurses may also be infected with the HIV virus. For those living in poverty, using milk formula is too expensive and unsanitary storage and water conditions expose infants to other serious health threats.

Cultural barriers

Some of the greatest challenges facing HIV-positive women come from their own communities.

Cultural norms and misconceptions make it difficult for women to stop breastfeeding. Also, people with HIV are highly stigmatized. Women are forced to choose between the rejection and criticism of their community or the lives of their children. In fact, many HIV-positive women will choose to breastfeed, not out of sole necessity, but so others will not suspect them of having the disease. When a woman does not choose to breastfeed she may lie to family, friends and neighbours about her reasons for not breastfeeding.

A mother who tests positive for HIV prior to her husband's positive results, worries that she may be accused of bringing HIV into the home, and fears persecution. According to the Journal of Nutrition, communities may believe that a woman who does not breastfeed is "a witch, stole the child, has a bad omen or spirit, has been promiscuous (the child is not her husband's), or that she is HIV-positive."

In the face of numerous medical and social challenges, CCFC is educating the developing world about how HIV is transmitted and how transmission can be prevented through innovative programs. Mothers are taught ways to decrease the rate of MTCT. One way is to breastfeed exclusively for the first six months and then switch to replacement feeding.

CCFC's monitoring in the field has shown that mothers who receive anti-retroviral therapy (ART) as part of a CCFC program, are less likely to pass HIV to their children.

To decrease the number of children infected through breastfeeding, CCFC is pursuing a two-pronged approach: empowering mothers to make well-informed decisions for their children, and breaking through the discrimination that discourages them from doing so.