Report: Discrimination against women in southern Africa fuels HIV/AIDS

A landmark study released on May 25 by the US-based Physicians for Human Rights (PHR) connects widespread discriminatory views against women in Botswana and Swaziland to sexual risk-taking and, in turn, to extremely high HIV prevalence. The report, entitled 'Epidemic of Inequality: Women's Rights and HIV/AIDS in Botswana and Swaziland,' found that "deeply entrenched gender inequalities perpetuate the HIV/AIDS pandemic." According to the report, improving women's rights could boost the battle against AIDS in these and other southern African countries, where women are often forced into risky sex by male partners or economic desperation. Almost 25 million Africans are infected with the HIV virus, giving the continent the worst AIDS burden in the world. Women make up 75 percent of HIV-positive Africans aged between 15-25. The PHR study concentrated on the two African countries with the highest HIV prevalence rates -- Swaziland, where an estimated 33 percent of adults are infected, and Botswana, where about 24 percent carry the virus. Researchers conducted random surveys on gender attitudes and sexual behavior and concluded that greater social and economic inequality between the sexes directly correlated to the HIV risk faced by African women. The study, based on over 2,000 respondents in Botswana and Swaziland, found that four key factors contributed to women's vulnerability to HIV/AIDS: their lack of control over sexual decision-making, including the decision to use a condom; the prevalence of HIV-related stigma and discrimination; gender-discriminatory beliefs (associated with sexual risk-taking) and a failure of traditional and government leadership to promote the equality, autonomy and economic independence of women. "Women bear a disproportionate burden of the AIDS epidemic, particularly here [Southern Africa] -- their legal status, lack of social power, certain cultural or socially constructed practices, lack of access to resources and lack of income all are factors in women's daily lives that translate into elevated vulnerability and sexual risk taking," said PHR's Senior Research Associate Karen Leiter, lead investigator of the study. "If we are to reduce the continuing, extraordinary HIV prevalence in Botswana and Swaziland, particularly among women, the countries' leaders need to enforce women's legal rights, and offer them sufficient food and economic opportunities to gain agency in their own lives. Men and women must be educated and supported to acknowledge women's equal status with men and abandon these prejudices and risky sexual practices. The impact of women's lack of power cannot be underestimated," said Leiter. "Food insufficiency is one of the highlights from the survey that should be explored further. Food insecurity is known as a consequence of the HIV/AIDS epidemic but is also becoming more understood as a driver, particularly for women," Leiter sad. The report said that many HIV-positive women were forced to engage in risky sex with men in exchange for food for themselves and their children. "Women are having sex because they are hungry. If you give them food, they would not need to have sex to eat," one interviewee quoted in the report said. Leiter said that in both countries there was a sense of a lack of leadership "at all levels" -- from government officials to traditional leaders -- in protecting and empowering women. The report suggests that women's rights must be made the top priority by the countries' leaders if HIV prevalence is to be reduced. In particular, both Botswana and Swaziland need to work to end discrimination against women in marriage, inheritance, property and employment rights and boost efforts to end domestic and sexual violence against women. Leiter said that despite their very distinct demographic and policy profiles, the key issues that characterized the epidemic in Botswana and Swaziland -- women's disempowerment, lack of human rights, poverty and food insufficiency–were typical in most southern African countries. "The findings are relevant throughout the region," she added.