"You cannot eat a sweet with the wrapping," young men from South Africa told researchers as part of a recent World Bank study, explaining why they refuse to wear condoms despite a high and well-known risk of HIV. Men often don’t see condoms as manly, and women feel unable to insist.
What does this mean? A 2011 Gallup poll of 19 sub-Saharan African countries, home to more than two-thirds of the world's HIV-infected population, found most adults know how to prevent the spread of HIV. But while 72 percent agreed people should use condoms every time they have sex, only 40 percent said they ever had.
Social norms such as these help explain why AIDS disproportionately affects women in many countries. Empowering women and challenging these norms is vital to tackling the epidemic, with broader dividends in the fight to end extreme poverty and boost shared prosperity.
AIDS, like poverty, demands action and innovation on multiple fronts with women and girls in mind, from public transport to policing: During the ‘World We Want’ global conversation on post-2015 development goals, a young mother from Papua New Guinea described sometimes skipping HIV treatment because she fears being raped or attacked during her long walk to the clinic—Papua New Guinea has some of the highest rates of gender-based violence in the world.
Women often face major barriers to accessing health care because their mobility is restricted and they lack control over finances. When they become caregivers to relatives with AIDS, their opportunities at school and work are diminished.
Gender-based violence further increases HIV risk. Two recent studies in Uganda and South Africa found women who had experienced intimate partner violence were 50 percent more likely to have HIV than women who had not.
In Mali and Niger, more than 40 percent of women feel unable to refuse sex even if their husband has a sexually transmitted infection. Thirty-one percent of women in the region say refusing sex justifies wife-beating. In South Asia, 14 percent of women agree.
Huge progress has been made since AIDS emerged in 1981. Some 10 million people in developing countries are now on treatment as a result, able to live healthy lives, and new HIV infections have fallen by one-third since 2001. But major challenges remain, especially on the gender front.
Ending AIDS and tackling poverty are goals within our reach, but empowering women and girls is vital to getting there.