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Women comprise more than half of all people
living with HIV/AIDS |
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Not only are
women contracting HIV in greater numbers than
men, but increasingly African women are failing
to cope with the disproportionately heavy burden
of care placed on them by the HIV/AIDS pandemic
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Poverty and poor public services have combined
with HIV/AIDS to turn the care burden facing
women into a crisis with far-reaching social,
health and economic consequences. The term ‘care
economy’ describes the many tasks that are
carried out primarily by women and girls such as
cooking, cleaning, fetching water and caring for
the young, sick and elderly. Studies carried out
in southern Africa, where the epidemic is
hitting hardest on the continent, confirm that
it is primarily women and girls who are burdened
with the task of caring for and supporting those
who are ill with AIDS related diseases. They
also look after orphans left by relatives. The
vast majority of women and girls who shoulder
the HIV/AIDS care burden do so with very little
material or moral support. There is very little
state help, health facilities are collapsing,
and more and more patients are forced by lack of
resources to return from hospital to home-based
care. HIV/AIDS therefore intensifies the
feminisation of poverty.
The Southern Africa AIDS Training Programme (SAAT),
which supports women advocacy projects in 11
southern African countries, found that in caring
for the sick, women encounter both physical and
financial problems. "Usually they do not have
money to buy things like food, bedding and
utensils for them to adequately provide
home-based care to the patients after they are
discharged from hospitals," the SAAT's country
liaison officer for Malawi
stated. When a man falls ill, his female partner
must not only look after him but also become the
breadwinner. In rural areas, where the majority
of Africans still live, time spent on caring for
the sick leaves little time to fetch or produce
food or to earn money. In most sub-Saharan
African countries, 60-70% of food is produced by
small-scale farmers, most of them women. "The
more time women spend caring for and supporting
HIV/AIDS patients, the less time there is for
food production and this threatens family,
household and eventually national food
security," the SAAT says.
Caring for orphans is also a burden that falls
disproportionately on women. As working-age
people increasingly become sick and die of AIDS
related illness, the loss of household income
forces older women back into the workforce. At
an advanced age they often become the sole care
providers and breadwinners for HIV/AIDS affected
adult children and orphaned grandchildren. Young
girls and adolescents are forced to sacrifice
their education to home-based care, which
reduces their prospects of finding decent work
opportunities.
In countries with a high HIV prevalence rate,
girls’ enrolment in school has decreased in the
past decade. HIV/AIDS is threatening recent
positive gains in basic education and
disproportionately affecting girls' primary
school enrolments. For example, in Swaziland
school enrolment is reported to have fallen by
36% due to AIDS, with girls most affected. Girls
are also more likely than boys to fail to
complete secondary education because of early
marriage, pregnancy and care duties at home.
Surveys have shown that fewer girls than boys
aged 15-19 have basic knowledge about how to
protect themselves from HIV/AIDS, and many
misconceptions exist and remain uncorrected in
communities with limited access to accurate
information. There is growing evidence that
education is one of the key defences against the
spread of HIV and the impact of AIDS.
The high rate of infection amongst women of
childbearing age is another area of concern. A
study carried out by the Malawi National AIDS
Control Programme (NACP) established that about
500 000 women, 20% of all those between the ages
of 15 and 45 years, have contracted HIV. The
Malawi study also revealed another dimension of
the problem. Women with HIV faced a dilemma in
deciding how to raise their newborn children
since there is a high risk of virus transmission
from mother to child during breast-feeding.
Without enough money to buy milk formula women
with HIV have little choice but to risk
infecting their children through breast-feeding
the NAACP chief explained.
Women’s vulnerability to HIV/AIDS is primarily
due to inadequate knowledge, insufficient access
to HIV prevention services, inability to
negotiate safer sex, and a lack of female
controlled HIV prevention methods, such as
microbicides. Women and girls are often
powerless to abstain from sex or insist on
condom use. In addition, they are biologically
more vulnerable to infection. Once infected with
HIV women often face physical and emotional
violence. To make them less vulnerable women
need methods to protect themselves from HIV that
they can control. Microbicides are one of the
most promising prevention options on the
horizon. Formulated as a gel, film, sponge,
lubricant or time-released suppository, an
effective microbicide could provide primary
protection to women and couples who can't or
don't use condoms.
Once developed, microbicides and vaccines would
serve as complementary prevention technologies,
with microbicides putting the power of
prevention directly into the hands of women. If
only 20% of those women already in contact with
health services were to use such methods, 2.5
million new infections could be averted amongst
women, men and children in three years.
On World AIDS Day 2003, WHO and UNAIDS released
a detailed and concrete plan to provide
antiretroviral treatment to three million people
living with AIDS in developing countries by the
end of 2005. This is a vital step towards the
ultimate goal of providing universal access to
AIDS treatment to all those who require it. The
problem is urgent: 30 million people have died
of AIDS in two decades and 40 million more
people are currently infected. In poor
countries, six million people with HIV/AIDS need
antiretroviral treatment immediately. Today only
about 400 000 people receive antiretroviral
treatment, less than 8% of those in need.
Without accelerated prevention and treatment the
AIDS epidemic will continue destroying
communities, health care systems and economies,
and casting a shadow over the future of entire
countries. |
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Knowledge helps women reduce their burden Zambia/ WFP. |
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Key Indicators |
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Sub-Saharan Africa (end 2003):
58 % HIV infected women
60-70 % of food produced by small-scale farmers,
majority are women
African women:
75% of agricultural work
95% of the domestic work
Mozambique:
90% engaged in food production
Swaziland:
School enrolment fallen by 36% due to AIDS,
girls most affected
Malawi:
500,000 women, 20 % of all those between 15 - 45
have contracted HIV
Poor countries:
6 million need ARV treatment immediately
400,000 receiving ARV treatment |
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AIDS and female property
and inheritance rights |
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AIDS and girls’ education
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AIDS hits African women
hardest |
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AIDS treatment – A focus
on ‘3 by 5’ |
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Care, women and AIDS |
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HIV prevention and
protection efforts, failing women and girls |
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Violence against women and
AIDS |
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Addressing HIV-related
stigma and discrimination |
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Adolescent sexuality,
gender and the HIV epidemic |
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Confronting
marginalization in the context of HIV/AIDS
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Prevalence of behavior and
implications for negotiating safer sexual
practices |
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Famine, AIDS devastating
Malawi women |
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How AIDS affects young
women and girls |
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Most at risk: The young
women of Zimbabwe |
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Women and AIDS in southern
Africa |
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Women should be
economically empowered |
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Microbicides , women and
AIDS |
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Women hailed for leading
heroic fight against AIDS epidemic |
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The Global Coalition on
Women and AIDS |
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Special Envoy for HIV/AIDS
in Africa – 3 by 5 press briefing |
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Positive women: Voices and
choices |
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UNIFEM Gender and HIV-AIDS
Web Portal |
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