Factors Affecting Women's Risk of HIV
High rates of intergenerational sex are likely to contribute to many new infections among young women, in part because high rates of infection among older men make them particularly risky partners. Gender inequalities and high rates of coercive sex may also contribute to many new infections among both younger and older women. Closer inspection reveals that a complex array of factors, including personal beliefs, social norms, and economic and environmental demands, can all conspire to sustain and support conditions that elevate women’s risk of HIV. Breaking apparent cycle of transmission HIV from older men to younger women and combating underlying circumstances that can fuel sexual risk coercion will require implementation a variety initiatives are positioned reach both women.
Young women stand to benefit from programs that encourage delay of sexual debut and increase their awareness of the risks associated with sexual activity, particularly with older male partners. However, for these programs to be successful,they need to be buttressed by broader efforts to change risky male sexual norms – particularly those that foster multiple partnerships and the selection of younger partners.
USAID's HIV Prevention Programs
In an effort to transform this recognition into practice, the U.S. Agency for International Development (USAID) strives to support HIV prevention programs and initiatives around the world that seek to work with women, men, and entire communities to combat the HIV infection risks faced by women.
As a partner in the President’s Emergency Plan for AIDS Relief, USAID manages the implementation of more than 14international programs designed to promote abstinence or the delay of sexual initiation among youth. Each of these programs places a strong emphasis on empowering young women to adopt safer behaviors, ensuring their ability to do so, and combating stigma and gender inequalities that may contribute to new infections.
In Mozambique, for example, USAID supports the grassroots work of more than 2,600 volunteer peer educators through an abstinence and behavior change for youth program. Many of the volunteers are young married couples, who serve both as role models and mentors for others in their communities about the central role that fidelity can play in HIV prevention and the importance of gender equity and male support for services like HIV counseling and testing .Volunteers are mobilized through faith-based networks and now work in more than 200 schools and more than 600churches in southern and central Mozambique.
To better address the kinds of male norms and behaviors that can introduce girls and women to HIV risk, USAID has also helped launch activities like Program H, an initiative designed to promote more gender-equitable attitudes among young men ages 15 to 24 in Brazil. The program, run by a local nongovernmental organization called Institutor Promundo, encourages young men to enter into relationships with women based on equality and respect rather than sexual conquest; to be involved fathers; to take responsibility for reproductive health and prevention of HIV and other sexually transmitted infections (STIs), including discussion of reproductive health concerns; and to oppose violence against women. A preliminary assessment of Program H found that the initiative was successful in promoting gender-equitable norms and improvements in HIV/STI risk outcomes. Based on this initial success, the program is currently being adapted and replicated in other parts of Brazil and in Central and South America, Asia, and Africa.
The Men as Partners (MAP) program also encourages men to become actively involved in HIV/AIDS prevention and the prevention of gender-based violence. The program operates in a number of countries and is particularly active in South Africa, where it helps strengthen the provision of, and demand for, HIV/AIDS-related services such as voluntary counseling and testing, antiretroviral treatment, and the treatment of STIs among men. Building similar linkages across prevention, care, and treatment initiatives can help to strengthen and reinforce efforts in each of these areas.
Finally, in all of its efforts to curtail the sexual transmission of HIV, USAID seeks to work with communities to support a balanced and evidence-based “ABC” – Abstinence, Be faithful, and correct and consistent Condom use – approach to prevention. This involves the culturally and age-appropriate promotion of each of these elements in a manner that will prevent the most new HIV infections in a given setting and that will fundamentally ensure and protect the ability of girls and women to adopt such HIV prevention behaviors.
April 2005
Download a Printer-Friendly Version of this Issue Brief [PDF, 404KB]
|
