Contributions of Gender Perspective to HIV Infection

Abstract Since its discovery in 1981, HIV has become one of the main killers on the planet, with millions of deaths in the world. Its impact is prejudicial on individual health and well-being, families, and society, and people with HIV are discriminated against based on social stigma. In the early stages of the epidemic, HIV infection was predominantly among men in many industrialized and some developing countries. Now, however, almost 50% of all people living with HIV are women and the higher rates of new infections are produced in Africa and Asia. Indeed, there are important differences between women and men in the underlying mechanisms of HIV infection and in the personal and social consequences of it. These arise from biology, social context, and subjective experience. Some of them are sex-related differences in transmission; immunological and virological parameters; sexual behavior; socially constructed gender differences between women and men in decision-making power, roles, and gender norms; access to resources; and in the experience of living with HIV. This chapter provides a critical and exhaustive assessment of the relationship between gender, inequality, and vulnerability to HIV infection. It also presents gender-specific risks that are important to HIV prevention and useful in changing attitudes and behavior. These include: the violence perpetrated against women, their lack of rights, access and control over economic resources, and the norms related to women's sexuality and women's identity. Finally, the chapter provides a review of targeted interventions based on a gender perspective, taking into account gender barriers such as inequalities in access to and professional attention in health services, the ability to cope once infected, and social stigma.