In this "Development Outreach" article published by the World Bank, A. Waafas Ofosu-Amaah asserts that gender differences affect risk and vulnerability factors for HIV/AIDS in complex ways because gender norms influence people's attitudes, and therefore men's and women's relative ability to protect themselves.

According to UNAIDS (2002), women constitute 50 percent of infected people in the Caribbean, 55 percent in Middle East and North Africa region, and 58 percent in Sub-Saharan Africa. In Africa, 68 percent of all young persons infected are female. Research conducted by the World Bank shows that the more unequal gender relationships are in a country, the higher is its HIV prevalence rate (World Bank, 2001).

Often reinforced under the law, the subordinate roles of females in many segments of society, such as in the household or in family relations, places them at a disadvantage as far as HIV/AIDS is concerned. Some of the legal and regulatory systems affecting women include:

• "Property rights: because laws generally deny women the right of inheritance or succession.
• Employment: laws often do not provide benefits for HIV/AIDS victims and their families.
• Reproductive rights: some laws do not grant women, especially young women, the right to control their fertility.
• Rape, sexual harassment and coerced sex: narrow definitions for these offenses in some legal systems, coupled with the associated stigma, transform a rape victim into a suspect, deny rights if the victim is married to the offender, or decriminalizes many kinds of unwanted sexual advances.
• Marriage: some laws do not recognize co-ownership of family property, equal division of property upon the termination of marriage, or marital rape."

Based on this information, the author suggests some "entry points" for solutions - they include:

• "Safe and secure environments for young girls and good quality, youth-friendly information and sexual health services.
• Privacy and confidentiality in voluntary-counseling and testing services, including separate counseling for males and females.
• Legal literacy and legal aid services to promote and enforce women's rights under customary and statutory law.
• Sensitization of law enforcement officials, police, legal profession and judiciary about the gender and legal dimensions of HIV/AIDS. This is important, given the relatively new nature of the epidemic.
• Strategic litigation, through filing of test cases on legislation that violates the Constitution, that would force legislatures to act quickly on law reform.
• Anti-stigma and anti-discrimination laws, policies, strategies, practices and educational programs targeting the sexual and economic exploitation of females.
• Criminalization of willful transmission, including marital rape and spousal forced sex.
• Reproductive law and policy to enable women to make decisions free of coercion, violence and discrimination and to promote access to safe services and information."

In conclusion, A. Waafas Ofosu-Amaah advocates for a multisectoral response to addressing women’s and men’s different vulnerability to HIV/AIDS. "This approach should target both women’s economic empowerment and women’s rights, especially their rights to: safe sex; freedom from coercion; access to resources (i.e., property rights in marriage, divorce and upon death of a spouse); privacy (voluntary counseling and testing being a good entry point); services (health, counseling, legal aid); workplace protections; and protection from stigma and victimization."

A. Waafas Ofosu-Amaah. Senior Gender Specialist, Gender and Development, Poverty Reduction and Economic Management, The World Bank.

"Development Outreach" is a magazine in the field of global knowledge for development which reflects the learning programmes of the World Bank and aim to present a range of viewpoints by renowned authors and specialists worldwide. It is published three times a year and is designed to occupy a middle ground between the scholarly journal and the general interest magazine.

This publication no longer appears to be online. Our apologies.

Press Release from the World Bank to The Communication Initiative on July 7 2004; Development Outreach, Vol. 6, No. 2, July 2004: Special Report: Access for All Fighting HIV/AIDS.